Treatment of Achilles Tendinopathy with Platelet-Rich Plasma

Abstract

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.