PRP enhances healing after Achilles Tendon Rupture

PRP being added to an Achilles Tendon Repair

If you rupture your Achilles tendon, new data suggests platelet rich plasma can enhance the healing.  In an abstract published by the journal Lancet, researchers from England discussed how they treated patients who had ruptured their Achilles with either PRP or a placebo.  Six weeks later, they biopsied the healing tendons under ultrasonic guidance.  In the study, they found improved cell content, better tendon fiber structure and more normal collagen (type 1) in the tendons treated with PRP.  The study included 20 patients (10 PRP, 10 Control) and is the first investigation in humans showing the significant value of using PRP to help treat Achilles tendon ruptures.  Of course, more data will be needed to confirm these important findings.  For years, I have been adding PRP to my achilles tendon repairs and if I ever rupture my own, I will certainly request that PRP is included in the treatment protocol.

AM 

Total Tendon

NFL grants $100,000 to study PRP and Stem Cells for Tendon Disorders

The National Football League recently granted $100,000 to the Hospital for Special Surgery to study the effects of platelet rich plasma and stem cells on tendons.  The research will be conducted by Dr. Scott Rodeo, associate team physician for the New York Giants.  The focus will be to better understand the effects of different formulations of PRP in a preclinical model.  Specific evaluations of how PRP influences the tendon structure will be done.

This is important research that should help answer multiple questions.  Clinical studies to date have been variable in their outcomes.  The best available data today supports the use of PRP with white blood cells injected in an unactivated form for chronic tennis elbow.  We need to better understand the mechanisms underlying various forms of PRP in order to best apply it clinically.

We will all be most interested in following the results of their investigations.

See full article about research grant. 

Allan Mishra
TotalTendon
@BloodCure

Platelet Rich Plasma effective in treating Chronic Achilles Tendonitis

In the study outlined below, patients with chronic achilles tendinosis (also known as achilles tendonitis) severe enough to consider surgery were treated with platelet rich plasma.  Clinical success was found in 93% of patients treated with PRP (28/30).  This is an uncontrolled study but did show efficacy in a very difficult group of patients.  

Allan Mishra (@bloodcure)

TotalTendon

Foot Ankle Int. 2012 May;33(5):379-85.

Platelet rich plasma treatment for chronic achilles tendinosis.

Monto RR.

Source

Abstract

BACKGROUND:

Chronic Achilles tendinosis is a relatively common but difficult orthopedic condition to treat. In this study, autologous platelet rich plasma (PRP), a concentrated bioactive blood component rich in cytokines and growth factors, was evaluated to determine its potential long-term efficacy in treating chronic cases of Achilles tendinosis resistant to traditional nonoperative management.

METHODS:

Thirty patients with chronic Achilles tendinosis who did not respond to a minimum of 6 months of traditional nonoperative treatment modalities were treated with a single ultrasound guided injection of PRP. AOFAS scoring was completed for all patients pretreatment and at 0, 1, 2, 3, 6, 12, and 24 months post-treatment. MRI and/or ultrasound studies were completed for all patients pre-treatment and at 6 months post-treatment. Prior to the PRP treatment all of the patients in this study were considering surgical Achilles repair for their severe symptoms.

RESULTS:

The average AOFAS score increased from 34 (range, 20 to 60) to 92 (range, 87 to 100) by 3 months after PRP treatment and remained elevated at 88 (range, 76 to 100) at 24 months post-treatment. Pretreatment imaging abnormalities present in the Achilles tendon on MRI and ultrasound studies resolved in 27 of 29 patients at 6 months post-treatment. Clinical success was achieved in 28 of 30 patients.

CONCLUSION:

Platelet-rich plasma was used effectively to treat chronic recalcitrant cases of Achilles tendinosis.