Efficacy of platelet-rich plasma injections for treating Achilles tendonitis : Systematic review of high-quality randomized controlled trials

Orthopade. 2019 Sep;48(9):784-791. doi: 10.1007/s00132-019-03711-y.

Abstract

Background: The Achilles tendon is the coarsest tendon in the body. Achilles tendonitis is relatively common and its incidence is increasing.

Purpose: To evaluate the efficacy of platelet-rich plasma (PRP) injections for treating Achilles tendonitis.

Methods: A literature search was carried out in the Cochrane Library Central Register of Controlled Trials (2017), PubMed (January 1976-March 2017) and EMBASE (January 1976-March 2017) databases to retrieve the available clinical evidence for PRP in the treatment of Achilles tendon lesions for a systematic review. The inclusion criteria were (1) conservative PRP treatment of Achilles tendon inflammation in a randomized controlled trial (RCT), (2) level I clinical research evidence and (3) published in English. The exclusion criteria were (1) unclear experimental methods and data and (2) PRP treatment of other diseases.

Results: A total of 4 articles involving 152 cases were included in the analysis. The mean age of subjects was 49 years. Data on the Victorian Institute of Sport Assessment-Achilles (VISA-A) score, color Doppler ultrasound index and recovery time to normal exercise were extracted. There were no significant differences between the treatment groups and control groups following the PRP injections.

Conclusion: The lack of differences between data from the control group and the patient groups included in the studies may be related to the difficulty of performing a randomized controlled trial (RCT). A strong basis for using PRP to treat Achilles tendonitis was not found, although PRP has important clinical significance for treating Achilles tendonitis.

Keywords: Color Doppler ultrasonography; Fibroblasts; Meta-analysis; Regeneration; Vascular endothelial growth factor.

Publication types

  • Systematic Review

MeSH terms

  • Achilles Tendon*
  • Humans
  • Injections
  • Middle Aged
  • Platelet-Rich Plasma*
  • Randomized Controlled Trials as Topic
  • Tendinopathy / therapy*