Purpose
The tendinosis and other degenerative disease of the tendons,
are today treated with drugs and physiotherapies to reduce the pain (sometimes there can be also an improvement of function).
The injection of platelet-rich plasma (PRP) is introduced as a therapy to reduce the pain on the basis of the anti-inflammatory effect,
but also,
through the action of tissue regeneration to recover the functionality.
Methods and Materials
For the study were recruited 57 patients with lesions of the patellar and Achilles tendon.
We have infiltrated the tendons,
under ultrasound guide,
for three times,
at the distance of 21 days from each other.
We adopted the VAS scale for the evaluation of the pain,
and the VISA-A and VISA-P scales for the evaluation of recovery of the function of the Achilles and the patellar tendon respectively.We asked each patient to complet the test before any infiltration and 30 days from the last infiltration....
Results
For the Achilles tendons,
at the end of treatment,
we have recorded an improvement of the mean values about the VAS and VISA-A scale of 76% and 109% respectively.
For the patellar tendons the improvements were of 71% (VAS) and 91% (VISA-P).
We have also obtained a reduction of sectional area of the Achilles tendons of 17.5% at the medium third and of 18.1% at the insertional level in patients with less of 30 years old.
In the older patients,
the results are less satisfactory...
Conclusion
This study shosw as the PRP gives very satisfactory results in terms of pain and function recovery in patients with tendinosis of Achilles and patellar tendons.
The instrumental tests confirm that the PRP promotes the tissue regeneration,
in fact we have obtained a morphological recovery in a significant percentage of treated patients.
We need further studies with wider number of cases to confirm these good results.
References
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Puskas BL,
Mandelbaum BR,
Gerhardt MB,
Rodeo SA.
Platelet-rich plasma: from basic science to clinical applications.
Am J Sports Med.
2009 Nov;37(11):2259-72.
[2] Molloy T.
,
Wang Y.
and Murrell G.
A.C.
The role of growth factors in tendon and ligament healing.
Sports Med 2003; 33 (5) 381-394.
[3] Wang H.
and Avila G.
Platelet rich plasma: Myth or Reality? 2007 European Journal of Dentistry.
[4] Giusti I,
Rughetti A,
D’Ascenzo S.
et al.
Identification of an optimal concentration of platelet gel...