Autologous Platelets Have No Effect on the Healing of Human Achilles Tendon Ruptures

Schepull, Thorsten; Kvist, Joanna; Norrman, Hanna; Trinks, Marie; Berlin, Gösta; Aspenberg, Per

doi:10.1177/0363546510383515

Cited by 247 publications

(221 citation statements)

References 27 publications

(47 reference statements)

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“…Pilot studies, for example, have demonstrated safety of either PRP alone or in conjunction with other therapies including surgical suturing techniques and physiotherapy [191][192][193][194]. On the other hand, the use of PRP injections is opposed based on data demonstrating no added value in patients received anterior cruciate ligament (ACL) allograft replacement and PRP injections [195] and on data revealing tendon thickening, pain and reduction in mechanical properties, following PRP injections [196][197][198]. Primary limitations of this approach include the lack of standardisation for PRP potency, preparation and dosing.…”

Section: Delivery Of Biological Molecules -Growth Factorsmentioning

confidence: 99%

The past, present and future in scaffold-based tendon treatments

Lomas

Ryan

Sorushanova

et al. 2015

Advanced Drug Delivery Reviews

171

185

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Section: Delivery Of Biological Molecules -Growth Factorsmentioning

confidence: 99%

The past, present and future in scaffold-based tendon treatments

Lomas

Ryan

Sorushanova

et al. 2015

Advanced Drug Delivery Reviews

171

185

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“…We have shown that the use of ultrasound for guided injections definitely helps in giving the injection at the right site, and this has also been advised by other authors. 13,29 However, the role of PRP in other tendinopathies like Achilles tendinopathy has not been encouraging, 30,31 despite successful usage of PRP in patellar tendinopathies. 32,33 Plantar fasciitis is also another commonly encountered problem which at times can be frustrating to both the patient and the treating doctor.…”

Section: Discussionmentioning

confidence: 99%

Platelet-rich Plasma in Orthopedics: Efficacy, Evidence, and Evolution of Our Understanding over 10 Years

2018

Journal of Postgraduate Medicine, Education and Research

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Introduction: Platelet-rich plasma (PRP) is fast emerging as a minimally invasive treatment option in a wide variety of orthopedic conditions. We were the forerunners in India in its use in osteoarthritis (OA), lateral epicondylitis, plantar fasciitis, and sports injuries. We present our experience with prospective clinical studies and multiple research projects, and have shown some aspects to be reproducible and evidence-based, whereas some areas of application seem to demand more evidence prior to routine recommendation for use.

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“…In a human clinical study, PRP augmentation of Achilles rupture repair did not improve modulus or tendon function (as measured using a heel-raise index) after 1 year [87]. This may suggest that PRP is less effective at healing more severe injuries.…”

Section: Prp For Acute Tendinopathiesmentioning

confidence: 95%

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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Autologous Platelets Have No Effect on the Healing of Human Achilles Tendon Ruptures

Abstract: Background

Cited by 247 publications

References 27 publications

The past, present and future in scaffold-based tendon treatments

The past, present and future in scaffold-based tendon treatments

Platelet-rich Plasma in Orthopedics: Efficacy, Evidence, and Evolution of Our Understanding over 10 Years

Biologic and Tissue Engineering Strategies for Tendon Repair

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