No effects of PRP on ultrasonographic tendon structure and neovascularisation in chronic midportion Achilles tendinopathy.

Abstract:

OBJECTIVE:To assess whether a platelet-rich plasma (PRP) injection leads to an enhanced tendon structure and neovascularisation, measured with ultrasonographic techniques, in chronic midportion Achilles tendinopathy. DESIGN:Double-blind, randomised, placebo-controlled clinical trial. SETTING:Sports medical department of The Hague medical centre. PATIENTS:54 patients with chronic midportion Achilles tendinopathy were included. INTERVENTIONS:Patients were randomised to eccentric exercise therapy with either a PRP injection (PRP group) or a saline injection (placebo group). MAIN OUTCOME MEASUREMENTS:Tendon structure was evaluated by ultrasonographic tissue characterisation, a novel technique which quantifies tendon structure into four echo-types: echo-types I+II represent organised tendon bundles, whereas echo-types III+IV represent a disorganised tendon structure. Colour Doppler ultrasonography was used to measure the degree of neovascularisation. Follow-up was at 6, 12 and 24 weeks. RESULTS:A significant improvement in echo-types I+II was found after 24 weeks within both the PRP group (n=27) and the placebo group (n=27), but there was no significant between-group difference (95% CI -1.6 to 7.8, p=0.169). After 6 weeks, the neovascularisation score increased within the PRP group (p=0.001) and the placebo group (p=0.002), but there was no significant between-group difference in change in neovascularisation score at any point in time. CONCLUSION:Injecting PRP for the treatment of chronic midportion Achilles tendinopathy does not contribute to an increased tendon structure or alter the degree of neovascularisation, compared with placebo. FUNDING:Biomet Biologics LLC, Warsaw, Indiana.

journal_name

Br J Sports Med

authors

de Vos RJ,Weir A,Tol JL,Verhaar JA,Weinans H,van Schie HT

doi

10.1136/bjsm.2010.076398

subject

Has Abstract

pub_date

2011-04-01 00:00:00

pages

387-92

issue

5

eissn

0306-3674

issn

1473-0480

pii

bjsm.2010.076398

journal_volume

45

pub_type

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