title: A retrospective comparative study with historical control to determine the effectiveness of platelet-rich plasma as part of nonoperative treatment of acute achilles tendon rupture.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effectiveness of platelet-rich plasma (PRP) in the nonoperative treatment of acute Achilles tendon rupture.
  
  
  METHODS
  This was a comparative study that included a prospective cohort and a historical control group. The control group was formed from a randomized trial in which one arm of the trial underwent nonoperative treatment, including accelerated functional rehabilitation after acute Achilles tendon rupture identical to that performed in the prospective treatment group. Patients in the prospective group were recruited consecutively and were administered 2 injections of PRP during the first 2 weeks after the injury. The primary outcome was isokinetic plantar flexion strength at 1 and 2 years after injury. Secondary outcomes included range of motion (ROM), calf circumference, and Leppilahti score. The ankle-hindfoot scale (American Orthopedic Functional Ankle Scale [AOFAS]) was administered to patients who received the PRP injection in the prospective group but was not measured for the historical group.
  
  
  RESULTS
  A total of 73 patients participated in the prospective PRP study group and were compared with a retrospective control group of 72 patients from a previous randomized controlled trial (RCT). The mean difference between groups in isokinetic plantar flexion strength (injured/uninjured) at 1 year after injury was -4.3% (95% confidence interval [CI], -15.9 to 7.3; P = .5) and 2.4% (95% CI, -8.6 to 13.5; P = .7) at 30°/s and 60°/s, respectively. Results at 2 years after injury were -3.1% (95% CI, -13.5 to 7.2; P = .6) and 4.8% (95% CI, -3.5 to 13.1; P = .3) at 30°/s and 60°/s, respectively. All secondary outcomes were also not statistically different.
  
  
  CONCLUSIONS
  The results of this study suggest that there is no measurable clinical benefit to the addition of PRP to the treatment regimen for nonoperatively treated acute Achilles tendon rupture.
  
  
  METHODS
  Level III, retrospective comparative study.
authors.affiliation: Faculty of Health Sciences, Health and Rehabilitation Sciences, Western University, London, Ontario, Canada.
authors.forename: Nicole
authors.initials: N
authors.lastname: Kaniki
authors.affiliation: Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Faculty of Health Sciences, School of Kinesiology, Western University, London, Ontario, Canada; Fowler Kennedy Sports Medicine Clinic, London, Ontario, Canada. Electronic address: kwillits2001@yahoo.com.
authors.forename: Kevin
authors.initials: K
authors.lastname: Willits
authors.affiliation: University of Calgary Sport Medicine Centre, Calgary, Alberta, Canada.
authors.forename: Nicholas G H
authors.initials: NG
authors.lastname: Mohtadi
authors.affiliation: Fowler Kennedy Sports Medicine Clinic, London, Ontario, Canada.
authors.forename: Vincent
authors.initials: V
authors.lastname: Fung
authors.affiliation: Faculty of Health Sciences, Health and Rehabilitation Sciences, Western University, London, Ontario, Canada; Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada; Faculty of Health Sciences, School of Kinesiology, Western University, London, Ontario, Canada; Faculty of Health Sciences, School of Physical Therapy, Western University, London, Ontario, Canada; Department of Epidemiology and Biostatistics, Faculty of Medicine, McMaster University, Hamilton, Ontario, Canada.
authors.forename: Dianne
authors.initials: D
authors.lastname: Bryant
mesh_terms: D000125:Achilles Tendon / Q000293:injuries*; D000328:Adult; D000368:Aged; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D026741:Physical Therapy Modalities; D053657:Platelet-Rich Plasma; D011446:Prospective Studies; D016059:Range of Motion, Articular; D012189:Retrospective Studies; D012421:Rupture / Q000534:rehabilitation / Q000628:therapy; D016896:Treatment Outcome