One-Year Follow-up of Platelet-Rich Plasma Treatment in Chronic Achilles Tendinopathy: A Double-Blind Randomized Placebo-Controlled Trial

• Published in: The American journal of sports medicine 2011-08, Vol.39 (8), p.1623-1630
• Main Authors: de Jonge, Suzan, de Vos, Robert J., Weir, Adam, van Schie, Hans T. M., Bierma-Zeinstra, Sita M. A., Verhaar, Jan A. N., Weinans, Harrie, Tol, Johannes L.
• Format: Article
• Language: English
• Subjects: Achilles Tendon - diagnostic imaging; Adult; Aged; Biological and medical sciences; Clinical trials; Confidence intervals; Diseases of the osteoarticular system; Double-Blind Method; Follow-Up Studies; Humans; Juxtaarticular diseases. Extraarticular rhumatism; Medical sciences; Middle Aged; Miscellaneous. Osteoarticular involvement in other diseases; Patient satisfaction; Placebo effect; Plasma; Platelet-Rich Plasma; Sports injuries; Sports medicine; Studies; Tendinopathy - diagnostic imaging; Tendinopathy - therapy; Tendons; Treatment Outcome; Ultrasonic imaging; Ultrasonography
• ISSN: 0363-5465; 1552-3365
• DOI: 10.1177/0363546511404877

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.