A Single Platelet-Rich Plasma Injection for Chronic Midsubstance Achilles Tendinopathy

Smyth, Niall A.; Newman, Hunter; Kennedy, John G.

doi:10.1177/1938640014532129

Cited by 42 publications

(28 citation statements)

References 25 publications

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“…The follow-up in those studies lasted 24 weeks and 28 months respectively. As for Achilles tendinopathy, several other studies also demonstrated a decrease in pain following a PRP injection [15][16][17]. To the authors' opinion, the lack of significant results in the tendon-specific part of the present study is therefore due to the small number of patients recruited.…”

Section: Are There Biologic Factors Of Good Prognosis After a Platelecontrasting

confidence: 52%

Are There Biologic Factors of Good Prognosis after a Platelet Rich Plasma (PRP) Injection for Tendinopathies ?

Libertiaux

Sancerne²,

Goff

et al. 2016

JESO

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Open Access Short communicationof extrinsinc factors include unadapted material, bad training planification, or usage of some drugs (quinolones, corticoids,…) [4]. Some patients are refractory to the traditional treatments (including physiotherapy, shockwaves, deep transverse massage, etc.) and thus need another option. Less invasive than surgery, Platelet-Rich Plasma (PRP) injection has become more and more popular over the last decades, particularly in sports medicine [5][6][7]. In this paper, in addition of presenting the data asserting the effectiveness of injections of reproducible PRP collected from an apheresis machine on different tendinopathies, we introduce another original contribution : the investigation of the possible correlation between several biomarkers and healing evolution to determine the factors of good prognosis, if any. Material and MethodsForty-eight patients (mean age = 49 y.o +/-10 y.o, min = 26 y.o, max = 77 y.o. ; 15 women and 33 men) afflicted with different pathologies participated in this study after they gave their informed consent (lateral epicondylitis (n=20), medial epicondylitis (n=3), tendinopathy of the gluteus medius (n=1), patellar tendinopathy (n=6), calcaneal tendinopathy (n=14), and plantar fasciitis (n=4)). To be recruited, the patients have had to suffer from a chronic tendinopathy for more than 3 months and be refractory to the following classical treatments : non steroidal anti inflammatory drugs, electrotherapy, deep transverse massage, eccentric revalidation and shockwaves therapy. A clinical examination was carried out to confirm the diagnosis and to exclude any other pathology, including metabolic disease. After this first step, a blood sample was drawn and analyzed to quantify the presence of various metabolic biomarkers (glycemia, thyroid hormons, cholesterolemia, uricemia) which are considered to be risk factors of tendinopathies. The initial pain assessment was made using a Visual Analogic Scale (VAS) of pain and a pressure algometer (Commander Algometer, Tech Medical) prior to the PRP collection. The PRP collection and injection protocol used has already been described in previous AbstractBackground : The aims of this study were to evaluate the effect of a single PRP injection followed by a standardized reeducation protocol among patients suffering from different tendinopathies, but otherwise healthy, and to determine the biomarkers that constitute good prognosis factors, if any.

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Section: Are There Biologic Factors Of Good Prognosis After a Platelecontrasting

confidence: 52%

Are There Biologic Factors of Good Prognosis after a Platelet Rich Plasma (PRP) Injection for Tendinopathies ?

Libertiaux

Sancerne²,

Goff

et al. 2016

JESO

View full text Add to dashboard Cite

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“…However, the evidence for use in human chronic Achilles tendinopathy remains insufficient [60,50,74,56]. In humans, the use of PRP for Achilles tendinopathy is no more beneficial than the use of placebo treatment or control [67,16,62] Several studies suggesting an improvement of clinical symptoms provide weak evidence with a lack of control groups [20,23,49,51].…”

Section: Platelet-rich Plasmamentioning

confidence: 99%

Biologics in Achilles tendon healing and repair: a review

Shapiro

Grande

Drakos

2015

Curr Rev Musculoskelet Med

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Injuries of the Achilles tendon are relatively common with potentially devastating outcomes. Healing Achilles tendons form a fibrovascular scar resulting in a tendon which may be mechanically weaker than the native tendon. The resulting strength deficit causes a high risk for reinjury and other complications. Treatments using biologics aim to restore the normal properties of the native tendon and reduce the risk of rerupture and maximize tendon function. The purpose of this review was to summarize the current findings of various therapies using biologics in an attempt to improve the prognosis of Achilles tendon ruptures and tendinopathies. A

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“…Over eight clinical human trials, the vast majority of patients suffering from chronic, recalcitrant tendinosis saw significant and substantial reductions in pain [88][89][90][91][92][93][94][95] and increases in joint function [72,88,90,[92][93][94][95] when treated with PRP without supplemental procedures. These patients had experienced symptoms of tendonosis for at least 3 months and had not responded to nonsurgical interventions [88][89][90][92][93][94][95].…”

Section: Prp For Chronic Tendinopathiesmentioning

confidence: 99%

“…Nine of ten patients who had been forced to leave their jobs due to their injuries were able to return to work, and 18 of 22 treated athletes were able to resume playing their sports. In a similar study, 32 patients suffering from midsubstance Achilles tendinosis were treated with a single PRP injection [91]. Within 6 months, 25 patients were asymptomatic.…”

Section: Prp For Chronic Tendinopathiesmentioning

confidence: 99%

Biologic and Tissue Engineering Strategies for Tendon Repair

Sigal

Grande

Dines

et al. 2016

Regen. Eng. Transl. Med.

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This review summarizes recent developments in biologic treatments-including growth factors, platelet-rich plasma (PRP), stem cells, and cell-seeded scaffolds-for tendon repair. Growth and differentiation faction-5 (GDF-5), insulin-related growth factor-1 (IGF-1), and basic fibroblast growth factor (bFGF) all improved extracellular matrix (ECM) production and tensile strength of treated tendons; however, no clinical trials were done on GDF-5. Platelet-derived growth factor-BB (PDGF-BB) improved proliferation and ECM production, but did not consistently improve mechanical properties. The literature was mixed on the efficacy of PRP for the treatment of chronic and acute tendinopathies. However, PRP did cause any complications, and its benefits may be enhanced once an ideal, standardized composition is developed. Therefore, PRP may be a valid treatment, especially once nonsurgical management options have failed. Mesenchymal stem cells (MSCs) significantly and substantially improved the quality of tendon repairs and demonstrated the ability to regenerate an enthesis. Adipose-derived stem cells (ADSCs) have similar effects and are easier to harvest. The periosteum may also regenerate the tendon-bone attachment. Tenocytes, meanwhile, may be ideal for midsubstance tendon repairs. Cell-seeded scaffolds-especially ECMderived scaffolds-were demonstrated to improve ECM production, enhancing the healing abilities of tenocytes or stem cells while providing early mechanical support to healing tendons.Each of these treatments demonstrated enhanced healing compared to common surgical techniques; moreover, patient outcomes may be enhanced by combining these treatments. Lay SummaryTendon injuries are very prevalent and can be debilitating. Tendon heals poorly, and the scar tissue that forms is weak and susceptible to reinjury. A major focus of orthopedic research is regenerative medicine, encouraging the formation of healthy tendon rather than mechanically inferior scar tissue. This review summarizes the recent scientific literature on biologic treatments for tendon repair, such as growth factors, platelet-rich plasma, and stem cells. The purpose of which is to show which treatments are promising candidates for clinical use and research, helping to guide physicians and to lay out a path for future research.

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A Single Platelet-Rich Plasma Injection for Chronic Midsubstance Achilles Tendinopathy

Abstract: Therapeutic, Level IV: Retrospective case series.

Cited by 42 publications

References 25 publications

Are There Biologic Factors of Good Prognosis after a Platelet Rich Plasma (PRP) Injection for Tendinopathies ?

Are There Biologic Factors of Good Prognosis after a Platelet Rich Plasma (PRP) Injection for Tendinopathies ?

Biologics in Achilles tendon healing and repair: a review

Biologic and Tissue Engineering Strategies for Tendon Repair

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