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Study: PRP accelerates Achilles tendon healing, functional recovery

Issue: Issue 5 2012

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MANCHESTER — Results of a small, randomized controlled pilot study that involved mechanobiologic and clinical assessments showed that platelet-rich plasma improved healing in acute Achilles tendon tears that were either percutaneously sutured or nonoperatively treated.

Joseph Alsousou, LMSSA Lon, MD , MRCS Ed, of Nuffield Department of Orthopaedic Rheumatology and Musculoskeletal Sciences  at the University of Oxford, United Kingdom, presented the findings of the PATH study — platelet-rich plasma (PRP) in accelerated Achilles tendon healing — at the British Orthopaedic Association Congress, here. He received the Young Investigator Award sponsored by Arthritis Research United Kingdom and was awarded a grant to attend the American Academy of Orthopaedic Surgeons Annual Meeting next year.

 

Joseph Alsousou

“Our findings showed that platelet-rich plasma had the potential to accelerate regeneration of the Achilles tendon in acute tears and really helped the return to function,” Alsousou said.

Prior to treatment, investigators collected 55 mL whole blood from patients for processing into PRP. Patients were blinded as to whether or not they received PRP.

Ten patients with an Achilles tendon gap smaller than 5 mm formed the nonoperative group: five patients received a PRP injection and five control patients had a pseudo injection to the skin. Ten patients with a tendon gap greater than 5 mm formed the operative group: five patients had their tendon tears percutaneously sutured and received a concomitant PRP injection and five control patients underwent suture repair alone.

All patients were casted in a standard manner following treatment, Alsousou said.

Investigators used a Magellan automated platelet separator system (Arteriocyte Medical System; Hopkinton, Mass., USA) for PRP preparation. They followed up all patients at 1, 3, 6, 12, and 24 weeks with the Achilles Tendon Rupture Score, the Victoria Institute of Sport Activity-Achilles score, and the Foot and Ankle Outcome Score, and they also performed a foot ultrasound elasticity scan for all patients.

The scans showed larger and thicker tendons in both PRP-treated groups, according to the study abstract.

Among the study limitations were the small number of patients included, Alsousou said. There is more work to do in this area, he said, and “to achieve statistically significant power in this study we need 360 patients, so we recommend continuing study to achieve this.”

Reference:

Alsousou J, Handley R, Thompson M, et al. Platelet-rich plasma in accelerated Achilles tendon healing (PATHT): A randomized controlled trial –  pilot phase. Presented at the British Orthopaedic Association Congress 2012. Sept. 11-14. Manchester.

Disclosure: Alsousou’s research was funded by the BOA Joint Action program, NIHR and the Oxford University BRC.