Platelet-rich plasma and acute Achilles tendon rupture

Abstract

Objective To study the clinical efficacy of platelet-rich plasma (PRP) in the treatment of acute Achilles tendon rupture. Methods A retrospective study was performed of the 21 patients who had been treated for acute Achilles tendon rupture at Department of Orthopaedics, The First Affiliated Hospital to Soochow University from January 2018 to January 2019. Of them, 15 were treated by modified Kessler suture combined with PRP injection (PRP group) and 6 by simple modified Kessler suture (control group). The 2 groups were compared in terms of plantar flexion, dorsal expansion, visual analogue scale (VAS), Victorian Institute of Sport Assessment (VISA), and ankle-hindfoot score of American Orthopaedic Foot and Ankle Society (AOFAS) at 3, 6, and 9 months postoperation. Results The 2 groups were comparable due to insignificant differences between them in the preoperative general data (P>0.05). All patients were followed up for 9 to 12 months (mean, 11.3 months). At 3, 6, and 9 months postoperation, the degrees of plantar flexion (33.5°±1.8°, 38.1°±1.2° and 41.6°±1.6°) and dorsal expansion (10.3°, 16.5° and 21.5°) in the PRP group were all significantly larger than those in the control group (26.9°±2.0°, 31.5°±1.6° and 35.6°±1.4°; 5.3°, 12.7°±0.6° and 18.2°), and the VISA scores (41.2±6.5, 78.7±10.4 and 91.0±4.1) and the AOFAS scores (75.5±5.4, 88.6±5.2 and 95.2±3.5) in the PRP group were all significantly higher than those in the control group (29.8±2.5, 68.0±3.5 and 84.5±2.1; 66.8±4.8, 82.8±3.6 and 90.7±1.1) (all P<0.05). At 3 and 6 months postoperation, the VAS scores in the PRP group (1.7±0.9 and 1.3±0.4) were significantly lower than those in the control group (3.0±0.8 and 2.2±0.7) (all P<0.05). Conclusion As PRP can release a high concentration of growth factors to promote recovery of Achilles tendon rupture and accelerate recovery of foot and ankle function, it can be considered a safe, practical and reliable treatment to use modified Kessler suture plus PRP injection. Key words: Achilles tendon; Platelet-rich plasma; Wounds and injuries; Function recovery