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

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


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.

Acceptance Date Jun 8, 2020
Publication Date Jun 30, 2020
Publicly Available Date Mar 29, 2024
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

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