Platelet rich plasma treatment for chronic Achilles tendinosis.
BACKGROUND
Chronic Achilles tendinosis is a relatively common but difficult orthopedic condition to treat. In this study, autologous platelet rich plasma (PRP), a concentrated bioactive blood component rich in cytokines and growth factors, was evaluated to determine its potential long-term efficacy in treating chronic cases of Achilles tendinosis resistant to traditional nonoperative management.


METHODS
Thirty patients with chronic Achilles tendinosis who did not respond to a minimum of 6 months of traditional nonoperative treatment modalities were treated with a single ultrasound guided injection of PRP. AOFAS scoring was completed for all patients pretreatment and at 0, 1, 2, 3, 6, 12, and 24 months post-treatment. MRI and/or ultrasound studies were completed for all patients pre-treatment and at 6 months post-treatment. Prior to the PRP treatment all of the patients in this study were considering surgical Achilles repair for their severe symptoms.


RESULTS
The average AOFAS score increased from 34 (range, 20 to 60) to 92 (range, 87 to 100) by 3 months after PRP treatment and remained elevated at 88 (range, 76 to 100) at 24 months post-treatment. Pretreatment imaging abnormalities present in the Achilles tendon on MRI and ultrasound studies resolved in 27 of 29 patients at 6 months post-treatment. Clinical success was achieved in 28 of 30 patients.


CONCLUSIONS
Platelet-rich plasma was used effectively to treat chronic recalcitrant cases of Achilles tendinosis.
Nantucket Cottage Hospital, Orthopedic Surgery, Nantucket, MA 02554, USA. drmonto@hotmail.com
Raymond Rocco
RR
Monto
D000125:Achilles Tendon / Q000000981:diagnostic imaging / Q000473:pathology / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D053657:Platelet-Rich Plasma; D052256:Tendinopathy / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome; D014463:Ultrasonography