PRP (Platelet Rich Plasma) For Chronic Achilles Tendinitis
PRP For Achilles Tendon Injury
Previous and Recent studies have shown that PRP treatment can positively affect gene expression within tendon cells. Tendon injury can lead to a cascade of degenerative changes that eventually may increase rupture risk. This can include - reduced blood flow and repetitive micro-trauma which can then lead to tissue degeneration and weakness of the tendon. Platelet rich plasma (PRP) has the potential to reverse the effects of tendon degenerative changes by stimulating increased blood flow and improving healing at a cellular level.
Initially inflammation and adhesions can form within the tendon and then the tendon can undergo degenerative changes. It has been shown that the introduction of PRP into the problematic tendon can aid in the repair and remodelling of the tendon.
One study used PRP on the Achilles tendon found a significant increase in regeneration in a PRP group in comparison to a control group, and this during the first two weeks of the healing process. This study also noted a number of newly formed blood vessels in the PRP group, identifying that PRP can increase blood supply. It was also observed that the orientation of collagen fibres in the PRP group was better organised. Another study performed on 15 patients with Achilles tendinitis found that long term there had been significant improvements in reduced pain, concluding that PRP is a viable treatment alternative for Achilles tendinitis.
A recent double-blind, randomised study by de Vos looked at PRP injection in patients with chronic Achilles tendinopathy involving 54 patients evenly divided into the PRP group and control group. PRP was injected into five sites along the injured tendon. Patients were only allowed to walk short distances indoors in the first 48 hours. In days 3-7 days, patients were allowed walks up to 30 minutes. After 1 week, patients started an exercise routine with 1 week of stretching and a 12-week daily functional exercise program eccentric loading. No weight-bearing sports activities for 4 weeks followed by a gradual return to activities. The results showed an improvement long term in the PRP group.
In one study, surgically transected tendons treated with PRP showed a 42 percent increase in their force to failure, a 61 percent increase in ultimate stress and a 90 percent increase in energy after two weeks in comparison to the control. In another study, those tendons treated with PRP had a 30 percent increase in strength and stiffness after one week.
PRP has been used for the treatment of chronic Achilles issues and rupture repair in many cases. The treatment protocol is very similar to that of plantar fasciitis, with patients who have failed with conservative treatments after 3 months being good candidates.
In clinical practice we have seen a significant reduction in pain, a decrease in the size of fibrous nodules within the tendon, and an earlier return to regular and sporting activity after using PRP. Most patients have been able to return to increased exercise and activity within two months of the injection. Again, some patients have benefited from a second injection about six weeks after the first.
Regenerative medicine has been increasingly studied in the field of tendon injury, with PRP treatment becoming a popular application to stimulate the release of growth factors to stimulate healing and repair. In our experience, PRP has offered promising results in the treatment of many tendon injuries including Achilles tendinitis. This for decreased pain, faster recovery and reduced fibrous nodules within the tendon. We know and appraise that PRP is reactively new in the field of injury treatment, and for this reason it takes time for research to develop, but more well designed prospective and retrospective studies exploring PRP wider a field is underway.
Here at Dynamic Regenerative Medicine in Solihull and Birmingham we believe in the beneficial effects of PRP treatment and offer this treatment for a wide range of conditions whether it be related to sports injury of general occupation.
For further information or to schedule a FREE consultation please contact us firstname.lastname@example.org or 01564 330773.