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Can platelet-rich plasma have a role in Achilles tendon surgical repair?

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Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Our hypothesis was that the Achilles tendon healing process after surgical treatment would be promoted by PRP with a faster return to sports activities.

Methods

Thirty patients with Achilles tendon rupture and surgically treated with a combined mini-open and percutaneous technique were prospectively enroled in the study. Patients were alternately case-by-case assigned to Group A (control group; 15 patients) or Group B (study group; 15 patients). In Group B, PRP was locally infiltrated both during surgery and 14 days after surgery. Patients in both groups were followed up at 1, 3, 6 and 24 months post-operatively via physical examination, VAS, FAOS and VISA-A scales; ultrasonography (US) and MRI were also conducted at one and 6 months; at the 6-month follow-up, isokinetic and jumping capacity tests were also performed.

Results

The VAS, FAOS and VISA-A scale showed no difference between the two groups at 1, 3, 6 and 24 months post-operatively. Isokinetic evaluation showed no differences at both angular speeds. Jumping evaluation showed no difference at 6 months. Also US evaluation showed no differences. MRI data analysis before administration of gadolinium did not reveal significant differences between the two groups. Moreover, after intravenous injection of gadolinium, patients in Group B showed signal enhancement in 30 % of patients compared to 80 % in Group A at 6 months, as indirect evidence of better tendon remodelling (P < 0.05).

Conclusions

A substantial equivalence in structural and functional results in Achilles tendon ruptures surgically treated with and without addition of PRP is shown by present study. Clinical results, morphological features and jumping capability were similar in both groups. The addition of PRP to the surgical treatment of Achilles tendon rupture does not appear to offer superior clinical and functional results.

Level of evidence

IV.

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Conflict of interest

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Orthopaedic Unit, “Kirk Kilgour” Sports Injury Center, S. Andrea Hospital, University of Rome “La Sapienza”, Via di Grottarossa 1035, 00189, Rome, Italy

    Angelo De Carli, Riccardo Maria Lanzetti, Alessandro Ciompi, Domenico Lupariello, Antonio Vadalà & Andrea Ferretti

  2. Diagnostic Imaging Unit, S. Andrea Hospital, University of Rome “La Sapienza”, Via di Grottarossa 1035, 00189, Rome, Italy

    Giuseppe Argento

  3. Physical Medicine and Rehabilitation Unit, S. Andrea Hospital, University of Rome “La Sapienza”, Rome, Italy

    M. C. Vulpiani & M. Vetrano

Authors
  1. Angelo De Carli
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  2. Riccardo Maria Lanzetti
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  3. Alessandro Ciompi
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  4. Domenico Lupariello
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  5. Antonio Vadalà
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  6. Giuseppe Argento
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  7. Andrea Ferretti
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  8. M. C. Vulpiani
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  9. M. Vetrano
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Correspondence to Alessandro Ciompi.

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De Carli, A., Lanzetti, R.M., Ciompi, A. et al. Can platelet-rich plasma have a role in Achilles tendon surgical repair?. Knee Surg Sports Traumatol Arthrosc 24, 2231–2237 (2016). https://doi.org/10.1007/s00167-015-3580-1

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  • DOI: https://doi.org/10.1007/s00167-015-3580-1

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