Purpose
The aim of this study was to evaluate the effectiveness of platelet-rich plasma (PRP)
in the nonoperative treatment of acute Achilles tendon rupture.
Methods
This was a comparative study that included a prospective cohort and a historical control
group. The control group was formed from a randomized trial in which one arm of the
trial underwent nonoperative treatment, including accelerated functional rehabilitation
after acute Achilles tendon rupture identical to that performed in the prospective
treatment group. Patients in the prospective group were recruited consecutively and
were administered 2 injections of PRP during the first 2 weeks after the injury. The
primary outcome was isokinetic plantar flexion strength at 1 and 2 years after injury.
Secondary outcomes included range of motion (ROM), calf circumference, and Leppilahti
score. The ankle-hindfoot scale (American Orthopedic Functional Ankle Scale [AOFAS])
was administered to patients who received the PRP injection in the prospective group
but was not measured for the historical group.
Results
A total of 73 patients participated in the prospective PRP study group and were compared
with a retrospective control group of 72 patients from a previous randomized controlled
trial (RCT). The mean difference between groups in isokinetic plantar flexion strength
(injured/uninjured) at 1 year after injury was −4.3% (95% confidence interval [CI], −15.9
to 7.3; P = .5) and 2.4% (95% CI, −8.6 to 13.5; P = .7) at 30°/s and 60°/s, respectively. Results at 2 years after injury were −3.1%
(95% CI, −13.5 to 7.2; P = .6) and 4.8% (95% CI, −3.5 to 13.1; P = .3) at 30°/s and 60°/s, respectively. All secondary outcomes were also not statistically
different.
Conclusions
The results of this study suggest that there is no measurable clinical benefit to
the addition of PRP to the treatment regimen for nonoperatively treated acute Achilles
tendon rupture.
Level of Evidence
Level III, retrospective comparative study.
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Article info
Publication history
Published online: July 03, 2014
Accepted:
April 10,
2014
Received:
June 4,
2013
Footnotes
The authors report that they have no conflicts of interest in the authorship and publication of this article.
Identification
Copyright
© 2014 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.
