Is Platelet-rich Plasma Injection Effective for Chronic Achilles Tendinopathy? A Meta-analysis

Abstract

Level I, therapeutic study.

Clinical management of tendinopathy: A systematic review of systematic reviews evaluating the effectiveness of tendinopathy treatments

“…Krey et al demonstrated tendon needling alone produced reductions in pain and improvements in function for Achilles, lateral elbow, and rotator cuff tendinopathy 43 . PRP provided the most conflicting evidence with some systematic reviews showing benefits while others showed no effect on tendinopathy patients 29,35,36,38,47,50,51,53 . For chronic lateral epicondyle tendinopathy, de Vos et al one study supporting PRP use, but the evidence for its effectiveness was poor in patients with lateral elbow tendinopathy, 38 whereas Miller et al found that PRP decreased pain in patients with symptomatic lateral elbow tendinopathy and that it may be more effective in women 47 .…”

Injection Techniques for Common Chronic Pain Conditions of the Foot: A Comprehensive Review

“…One form of treatment currently being researched is platelet-rich plasma (PRP) injections, which is thought to reduce chronic pain in patients with AT [24]. PRP treatment involves injection of a solution of increased platelet count compared to baseline of the body to promote platelet-derived growth factor levels (TGF-beta) to increase and promote healing [25]. In 2017, Chen et al looked at PRP treatment in various tendon and ligament injuries and found that there was a significant decrease in short-term pain in PRP injection groups compared to control groups [26].…”

“…They saw an overall mean decrease in pain for rotator cuff injuries, anterior cruciate ligament (ACL) injuries, and lateral epicondylitis injuries between the experimental and control groups (MD = -0.72, 95% CI -1.10 to -0.34; P \ 0.01) [26]. However, in 2018 a study conducted by Zhang et al looked at PRP injection benefits in AT treatment and they saw that there was no difference in mean improvements of Victorian Institute of Sport Assessment-Achilles scores (VISA-A) between the PRP and saline control groups (MD: 5.3, 95% CI [-0.7 to 11.3] P = 0.085) [25]. Overall, both research groups state that there needs to be more research done on PRP therapy before it is recommended for treatment purposes [25,26].…”

Platelet Concentrates in Musculoskeletal Medicine

“…Other studies did not show a superiority of PRP injection over saline solution [206,207,213] and no differences between patients treated with leukocyte-rich or -poor PRP [208] Evidence for the efficacy of PRP in Achilles tendinopathy is not in agreement, and despite the important clinical significance, a strong basis for the use of PRP for Achilles tendinopathy was not demonstrated by meta-analyses and a systematic review [216][217][218][219].…”