Non-insertional Achilles tendinopathy commonly impedes the functioning of active persons. Treatment methods vary, as do their results. The aim of the study was to evaluate the effectiveness of non-insertional Achilles tendinopathy treatment with autologous platelet-rich plasma (PRP). Autologous PRP was injected into the affected Achilles tendon of 14 prospectively selected patients (15 Achilles tendons). Before PRP administration, all patients were evaluated using the American Orthopedic Foot and Ankle Society (AOFAS) scale for the hind foot, and the Victorian Institute of Sport Assessment – Achilles (VISA-A) scale. Ultrasonography (US) and Power-Doppler ultrasonography (PDUS) of the area was also performed. Identical physical and imaging evaluations were performed at 6 weeks, and at 3, 6, and 18 months after injection. During follow up, a significant improvement was observed in the clinical and imaging results. The AOFAS scale improved from a baseline median of 55 points to 96 points at 18 months (p=0.000655), while the VISA-A scale improved from a baseline of 24 to 96 (p=0.000655) in the final evaluations. During the final evaluation, one subject experienced minor pain following prolonged daily activity, while another subject complained of pain following overloading activity. Local, accurate PRP administration improved symptoms of non-insertional Achilles tendinopathy.
1
Anitua E, Sanchez M, Zalduendo M, de la Fuente M, Orive G, Azofra J, Andia I.
Autologous fibrin matrices: a potential source of biological mediators that modulate tendon cell activities.
J Biomed Mater Res A.
2006;
77
285-293
2
Åstrom M, Gentz CF, Nillson P, Rausing A, Sjoberg S, Westlin N.
Imaging in chronic Achilles tendinopathy: a comparison of ultrasonography, magnetic resonance imaging and surgical findings in 27 histologically verified cases.
Skeletal Radiol.
1996;
25
615-620
6
Fox JM, Blazina ME, Jobe FW, Kerlan RK, Carter VS, Shields Jr CL, Carlson GJ.
Degeneration and rupture of the Achilles tendon.
Clin Orthop.
1975;
107
221-224
7
Harriss DJ, Atkinson G.
International Journal of Sports Medicine – Ethical Standards in Sport and Exercise Science Research.
Int J Sports Med.
2009;
30
701-702
9
Kitaoka HB, Alexander JJ, Adelaar RS, Nunley JA, Mark S, Myerson MS, Sanders M.
Clinical rating system for the ankle-hindfoot, midfoot, hallux and lesser toes.
Foot and Ankle International.
1994;
15
349-353
10
Knobloch K, Kraemer R, Lichtenberg A, Jagodzinski M, Gossling T, Richter M, Zeichen J, Hufner T, Krettek C.
Achilles tendon and paratendon microcirculation in midportion and insertional tendinopathy in athletes.
Am J Sports Med.
2006;
34
92-97
11
Kurtz CA, Loebig TG, Anderson DD, DeMeo PJ, Campbell PG.
Insulin-like growth factor 1 accelerates functional recovery from Achilles tendon injury in a rat model.
Am J Sports Med.
1999;
27
363-369
15
Mahieu NN, Witvrouw E, Stevens V, Van Tiggelen D, Roget P.
Intrinsic risk factors for the development of Achilles tendon overuse injury: A prospective study.
Am J Sports Med.
2006;
34
226-235
17
Ohberg L, Lorentzon R, Alfredson H.
Neovascularisation in Achilles tendons with painful tendinosis but not in normal tendons: an ultrasonographic investigation.
Knee Surg Sports Traumatol Arthrosc.
2001;
9
233-238
18
Paavola M, Paakkala T, Kannus P, Jarvinen M.
Ultrasonography in the differential diagnosis of Achilles tendon injuries and related disorders.
Acta Radiol.
1998;
39
612-619
20
Robinson JM, Cook JL, Purdam C, Visentini PJ, Ross J, Maffulli N, Taunton JE, Khan KM.
The VISA – A Questionnaire: A valid and reliable index of the clinical severity of Achilles tendinopathy.
Br J Sports Med.
2001;
35
335-341
21
Rompe JD, Nafe B, Furia JP, Maffulli N.
Eccentric loading, shock-wave treatment or a wait-and-see policy for tendinopathy of the main body of tendon Achilles: A randomized controlled trial.
Am J Sports Med.
2007;
35
374-383
22
Sanchez M, Anitua E, Azofra J, Andia I, Padilla S, Mujika I.
Comparison of surgically repaired Achilles tendon tears using platelet-rich fibrin matrices.
Am J Sports Med.
2007;
35
245-251
27
Weibrich G, Kleis WK, Hafner G, Hitzler WE, Wagner W.
Comparison of platelet, leukocyte, and growth factor levels in point-of-care platelet-enriched plasma, prepared using a modified Curasan kit, with preparations received from a local blood bank.
Clin Oral Implants Res.
2003;
14
357-362
30
Zanetti M, Metzdorf M, Kundert HP, Zollinger H, Vienne P, Seifert B, Hodler J.
Achilles tendons: Clinical relevance of neovascularisation diagnosed with Power Doppler US.
Radiology.
2003;
227
556-560