One-Year Follow-up of Platelet-Rich Plasma Treatment in Chronic Achilles Tendinopathy

A Double-Blind Randomized Placebo-Controlled Trial

1. Suzan de Jonge, MD*†‡,
2. Robert J. de Vos, MD, PhD‡,
3. Adam Weir, MD‡,
4. Hans T. M. van Schie, DVM, PhD†§,
5. Sita M. A. Bierma-Zeinstra, PhD†‖,
6. Jan A. N. Verhaar, MD, PhD†,
7. Harrie Weinans, PhD†¶ and
8. Johannes L. Tol, MD, PhD‡

+Author Affiliations

1. ^†Department of Orthopaedics, Erasmus University Medical Center, Rotterdam, the Netherlands
2. ^‡Department of Sports Medicine, The Hague Medical Center Antoniushove, Leidschendam, the Netherlands
3. ^§Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Utrecht, the Netherlands
4. ^‖Department of General Practice, Erasmus University Medical Center, Rotterdam, the Netherlands
5. ^¶Department of Biomechanical Engineering, Delft University of Technology, Delft, the Netherlands
6. Investigation performed at the Department of Sports Medicine, The Hague Medical Center Antoniushove, Leidschendam, the Netherlands

1. ↵* Suzan de Jonge, MD, Departments of Orthopaedics, Erasmus University Medical Center, PO Box 2040, 3000 CA Rotterdam, the Netherlands (e-mail:s.dejonge@erasmusmc.nl).

Abstract

Background: Achilles tendinopathy is a common disease among both athletes and in the general population in which the use of platelet-rich plasma has recently been increasing. Good evidence for the use of this autologous product in tendinopathy is limited, and data on longer-term results are lacking.

Purpose: To study the effects of a platelet-rich plasma injection in patients with chronic midportion Achilles tendinopathy at 1-year follow-up.

Study Design: Randomized controlled trial; Level of evidence, 1.

Methods: Fifty-four patients, aged 18 to 70 years, with chronic tendinopathy 2 to 7 cm proximal to the Achilles tendon insertion were randomized to receive either a blinded injection containing platelet-rich plasma or saline (placebo group) in addition to an eccentric training program. The main outcome was the validated Victorian Institute of Sports Assessment–Achilles score. Patient satisfaction was recorded and ultrasound examination performed at baseline and follow-up.

Results: The mean Victorian Institute of Sports Assessment–Achilles score improved in both the platelet-rich plasma group and the placebo group after 1 year. There was no significant difference in increase between both groups (adjusted between-group difference, 5.5; 95% confidence interval, −4.9 to 15.8, P= .292). In both groups, 59% of the patients were satisfied with the received treatment. Ultrasonographic tendon structure improved significantly in both groups but was not significantly different between groups (adjusted between-group difference, 1.2%; 95% confidence interval, −4.1 to 6.6, P = .647).

Conclusion: This randomized controlled trial showed no clinical and ultrasonographic superiority of platelet-rich plasma injection over a placebo injection in chronic Achilles tendinopathy at 1 year combined with an eccentric training program.

For further information: http://ajs.sagepub.com/content/39/8/1623.abstract