PRP injection did not reduce Achilles tendon dysfunction at 6 months
A single injection of intratendinous platelet-rich plasma did not reduce Achilles tendon dysfunction at 6 months compared with sham injection, according to published results.
Rebecca S. Kearney, PhD, and colleagues randomly assigned 240 patients who had midportion Achilles tendon pain for more than 3 months with tendinopathy confirmed by ultrasound, MRI or both to receive either a PRP injection (n=121) or a sham injection (n=119) between April 2016 and February 2020. Researchers measured the Victorian Institute of Sport Assessment-Achilles (VISA-A) score 6 months after treatment as the primary outcome, with primary analysis adjusted for laterality, age, sex and baseline VISA-A score. Secondary outcomes included the VISA-A score at 3-month follow-up, health-related quality of life assessed by the EuroQol-5D questionnaire at 3-month and 6-month follow-up and pain assessed with the VAS at 2-week, 3-month and 6-month follow-up.
Among 92% of patients who completed the trial, results showed patients in the PRP group had a mean VISA-A score of 54.4 vs. 53.4 in the sham injection group at 6-month follow-up. Researchers found no significant differences between the two groups in regard to VISA-A score, quality of life or pain. Among adverse events, 82% of patients in the PRP group had mild discomfort at the injection site at 2 weeks after the injection vs. 61% in the sham group, according to results. Researchers noted 47% and 40% of patients in the PRP group reported swelling and bruising, respectively, compared with 44% and 41% of patients in the sham group.
“The recommendation from this trial is that PRP should not be used to treat Achilles tendinopathy. It is not effective, it costs money, and we found some evidence that it can cause harm in the short term,” Kearney told Healio Orthopedics. “Alternative treatments should be considered for the management of Achilles tendinopathy.”