title: Long-term beneficial effects of platelet-rich plasma for non-insertional Achilles tendinopathy.
abstract: BACKGROUND
  The aim of this retrospective study is evaluating the long-term clinical outcome in patients affected by mid-portion Chronic Recalcitrant Achilles Tendinopathies (CRAT) treated with administration of single platelet-rich plasma (PRP).
  
  
  METHODS
  A total of 83 tendons (73 patients, 59 males and 14 females; age 43±17.5 years) affected by non-insertional CRAT were treated with single PRP injection. These were evaluated with the Victorian Institute of Sport Assessment - Achilles (VISA-A) questionnaire, Blazina score and satisfaction index at baseline at intervals of 3 weeks, 3 months, 6 months. Final follow-up was carried out at a mean of 50.1 months (range, 24-96).
  
  
  RESULTS
  Baseline VISA-A was 45±15. Results relative to the final follow-up improved significantly to a mean of 88±8 (p<00.1). Blazina was used for patients practicing sports (54 tendons out of 46 different patients): 37 tendons were grade IIIa, 11 II, and 6 IIIbis. Final follow-up Blazina scores improved for 45 grade 0, 5 I, 4 II (p<00.5). Seventy-six tendons (91.6%) were rated as satisfactory and patients would repeat the treatment. Seven tendons (8.4%) were classified as unsatisfactory at the 6 months follow-up and underwent a second PRP injection. In addition to this, patients reported no Achilles tendon rupture.
  
  
  CONCLUSIONS
  The study shows beneficial effects and low complication rate following of single PRP injections on a large cohort of patients with mid-long-term follow-up. No cases reported Achilles tendon rupture, in contrast to literature, which described CRAT as one of the most common risk factors. The use of a single PRP injection can therefore be a safe and attractive alternative in the treatment of non-insertional CRATs.
authors.affiliation: Orthopaedic and Traumatology Division, "G. d'Annunzio" University, Via dei Vestini 35, 66013 Chieti, Italy. Electronic address: matteogue@hotmail.com.
authors.forename: Matteo
authors.initials: M
authors.lastname: Guelfi
authors.affiliation: Orthopaedic and Traumatology Division, "G. d'Annunzio" University, Via dei Vestini 35, 66013 Chieti, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pantalone
authors.affiliation: Orthopaedic and Traumatology Division, "G. d'Annunzio" University, Via dei Vestini 35, 66013 Chieti, Italy.
authors.forename: Daniele
authors.initials: D
authors.lastname: Vanni
authors.affiliation: Orthopaedic and Traumatology Division, "G. d'Annunzio" University, Via dei Vestini 35, 66013 Chieti, Italy.
authors.forename: Michele
authors.initials: M
authors.lastname: Abate
authors.affiliation: Orthopaedic Division, Clinica Montallegro, Via M. Te Zovetto 27, 16145 Genoa, Italy.
authors.forename: Marco G B
authors.initials: MG
authors.lastname: Guelfi
authors.affiliation: Orthopaedic and Traumatology Division, "G. d'Annunzio" University, Via dei Vestini 35, 66013 Chieti, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Salini
mesh_terms: D000125:Achilles Tendon; D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015552:Injections, Intralesional; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D053657:Platelet-Rich Plasma; D012189:Retrospective Studies; D052256:Tendinopathy / Q000175:diagnosis / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
keywords: Achilles tendinopathy; Blazina score; Clinical outcome; Follow-up; L-PRP; Leukocyte-rich; Long term; Non-insertional; PRP; Platelet-rich plasma