Does a Ruptured Achilles Tendon Respond to Platelet-Rich Plasma?
The Achilles tendon is a thick fibrous cord at the back of our ankles. This strong tendon connects the calf muscles to the heel bone. Overstretching the Achilles tendon can lead to partial or complete rupture. This type of injury is frequently sports related, but stepping into a hole and falling can also lead to rupture of the Achilles tendon. The tendon is repaired surgically or managed nonoperatively. Now, scientists have examined the efficacy of platelet-rich plasma in treating a ruptured Achilles tendon.
Background
Platelet-rich plasma (PRP), as the name suggests, is supra-concentrated plasma. This autologous derivative of whole blood is prepared in a centrifuge in the laboratory. The supra-physiological concentration of platelets has been shown to improve tissue healing in bone, tendon, cartilage, and muscle. Researchers investigated the response of ruptured Achilles tendons to PRP treatment.
Method
Twenty patients with ruptured Achilles tendons were recruited into the study. Ten patients received PRP treatment and the other ten received a placebo. Six weeks following the injection, tissue samples were obtained from the injured area by way of ultrasound-guided needle biopsies.
Biopsy samples were examined under the microscope in the laboratory with special stains and immunohistochemistry markers to identify lymphocyte proliferation and collagen and blood vessel formation.
Findings
The tendons of the patients who had received PRP were significantly more cellular, contained more glycosaminoglycans, and had a stronger fiber structure. In addition, collagen type I content was higher in the PRP-treated tendons. However, the PRP-treated tendons had the same amount of collagen III and fewer blood vessels than the control group. Patients who received the PRP treatment had a significantly lower Bonar score (a measure of tendon degeneration), indicating improved healing in the ruptured Achilles tendon.
Conclusion
The findings of the study indicate that ruptured Achilles tendons respond well to platelet-rich plasma treatment. This treatment enhances the healing of the injured tissues by promoting deposition of collagen I and glycosaminoglycan, increasing cellularity, and decreasing vascularity. Larger studies are needed to determine the efficacy, safety, and long-term effects of PRP in Achilles tendon ruptures and other musculoskeletal injuries.
References:
- http://www.mayoclinic.org/diseases-conditions/achilles-tendon-rupture/basics/definition/con-20020370
- http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(15)60334-8/fulltext
