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Treating Achilles tendinopathy

Issue 35 Synovium (Spring 2012)

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Three years ago we reported a randomised controlled trial that cast doubt on the value of platelet-rich plasma (PRP) for the treatment of Achilles tendinopathy.

A recent meta-analysis of trials of PRP in bone and soft tissue disorders1 increases this doubt, finding no significant benefit of the treatment in 6 randomised controlled trials and 3 prospective cohort studies. However as one novel treatment appears to be hitting the buffers another emerges into the research spotlight.

In a randomised controlled trial2 40 Achilles tendons in 32 patients with a diagnosis of Achilles tendinosis (tendinopathy) were injected with skin-derived fibroblasts suspended in autologous plasma or with local anaesthetic. Significant improvement in pain scores was seen in the patients with unilateral tendinopathy injected with fibroblasts – but intriguingly not in the 8 patients with bilateral pathology.

No significant adverse effects were observed, and the authors propose that this new treatment should be subject to large-scale trials.

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