Endoscopic debridement for non-insertional Achilles tendinopathy with and without platelet-rich plasma.

Abstract

BACKGROUND: When non-operative management fails to improve symptoms in patients with non-insertional Achilles tendinopathy, surgery may be required. Various open and endoscopic techniques have been proposed, and platelet-rich plasma (PRP) injections have been proposed as an adjunct to aid tendon healing.

METHODS: Thirty-six patients with mid-portion Achilles tendinopathy were randomized to undergo endoscopic debridement alone (n?=?19) or in combination with intraoperative PRP application (n?=?17). Clinical outcome measures included the Visual Analogue Scale for pain, function, and satisfaction and the Victorian Institute of Sports Assessment - Achilles (VISA-A) questionnaire. Patients were followed-up at 6 weeks, 3 months, 6 months, and 12 months after surgery. An MRI examination at 3 and 12 months was used to assess signal alterations within the tendon.

RESULTS: Both groups showed significant clinical improvement (p < 0.05) after surgery, with no difference between the 2 groups. Tendon diameter increased at 3 months and decreased at 12 months. The tendinopathy area increased at 3 months and decreased at 12 months below baseline level in both groups. There was no significant difference between the groups regarding the MRI parameters. Nodular thickening and MRI-detected signal alteration persisted after surgery, with no association between imaging and clinical outcome. Five minor complications were reported: 2 in the PRP group and 3 in the control group.

CONCLUSION: Endoscopic debridement of the Achilles tendon improved clinical outcomes in patients with mid-portion tendinopathy. The addition of PRP did not improve outcomes compared to debridement alone. MRI parameters showed no association with clinical outcomes.

Citation

(2020). Endoscopic debridement for non-insertional Achilles tendinopathy with and without platelet-rich plasma. Journal of Sport and Health Science, 12(2), 275-280. https://doi.org/10.1016/j.jshs.2020.06.012

• Acceptance Date: Jun 8, 2020
• Publication Date: Jun 30, 2020
• Journal: Journal of Sport and Health Science
• Print ISSN: 2095-2546
• Electronic ISSN: 2213-2961
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 12
• Issue: 2
• Pages: 275-280
• DOI: https://doi.org/10.1016/j.jshs.2020.06.012
• Keywords: Achilles tendon; Endoscopic; Non-insertional; PRP; Tendinopathy
• Publisher URL: https://www.sciencedirect.com/science/article/pii/S2095254620300788?via%3Dihub