Thermann, H, Fischer, R, Gougoulias, N, Cipollaro, L and Maffulli, N ORCID: https://orcid.org/0000-0002-5327-3702 (2020) Endoscopic debridement for non-insertional Achilles tendinopathy with and without platelet-rich plasma. Journal of Sport and Health Science.

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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.

Item Type: Article
Additional Information: The final version of this article can be found online with all relevant information, including copyrights, at; https://www.sciencedirect.com/science/article/pii/S2095254620300788?via%3Dihub
Subjects: R Medicine > R Medicine (General)
R Medicine > R Medicine (General) > R735 Medical education. Medical schools. Research
R Medicine > RM Therapeutics. Pharmacology > Physical medicine. Physical therapy. Including massage, exercise, occupational therapy, hydrotherapy, phototherapy, radiotherapy, thermotherapy, electrotherapy
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Depositing User: Symplectic
Date Deposited: 04 Jun 2021 14:51
Last Modified: 04 Jun 2021 14:51
URI: https://eprints.keele.ac.uk/id/eprint/9669

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