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Der Orthopäde

, Volume 48, Issue 9, pp 784–791 | Cite as

Efficacy of platelet-rich plasma injections for treating Achilles tendonitis

Systematic review of high-quality randomized controlled trials
  • Yuzhong Wang
  • Changxu Han
  • Jianghui Hao
  • Yizhong RenEmail author
  • Jihong WangEmail author
Originalien

Abstract

Background

The Achilles tendon is the coarsest tendon in the body. Achilles tendonitis is relatively common and its incidence is increasing.

Purpose

To evaluate the efficacy of platelet-rich plasma (PRP) injections for treating Achilles tendonitis.

Methods

A literature search was carried out in the Cochrane Library Central Register of Controlled Trials (2017), PubMed (January 1976–March 2017) and EMBASE (January 1976–March 2017) databases to retrieve the available clinical evidence for PRP in the treatment of Achilles tendon lesions for a systematic review. The inclusion criteria were (1) conservative PRP treatment of Achilles tendon inflammation in a randomized controlled trial (RCT), (2) level I clinical research evidence and (3) published in English. The exclusion criteria were (1) unclear experimental methods and data and (2) PRP treatment of other diseases.

Results

A total of 4 articles involving 152 cases were included in the analysis. The mean age of subjects was 49 years. Data on the Victorian Institute of Sport Assessment-Achilles (VISA-A) score, color Doppler ultrasound index and recovery time to normal exercise were extracted. There were no significant differences between the treatment groups and control groups following the PRP injections.

Conclusion

The lack of differences between data from the control group and the patient groups included in the studies may be related to the difficulty of performing a randomized controlled trial (RCT). A strong basis for using PRP to treat Achilles tendonitis was not found, although PRP has important clinical significance for treating Achilles tendonitis.

Keywords

Meta-analysis Vascular endothelial growth factor Regeneration Color Doppler ultrasonography Fibroblasts 

Abbreviations

BMI

Body mass index

EQ-5D

5-Dimension questionnaire

IGF

Insulin-like growth factor

PDGF

Platelet-derived growth factor

PRP

Platelet-rich plasma

RCT

Randomized controlled trial

TGF-β

Transforming growth factor beta

VEGF

Vascular endothelial growth factor

VISA-A

Victorian Institute of Sport Assessment-Achilles score

Wirksamkeit von Injektionen mit „platelet-rich plasma“ zur Behandlung einer Achillessehnenentzündung

Systematischer Review von qualitativ hochwertigen randomisierten kontrollierten Studien

Zusammenfassung

Hintergrund

Die Achillessehne ist die stärkste Sehne des Körpers. Eine Achillessehnenentzündung ist relativ häufig, mit steigender Inzidenz.

Zweck

Die Wirksamkeit von Injektionen mit „platelet-rich plasma“ zur Behandlung einer Achillessehnenentzündung wird evaluiert.

Methoden

Eine Literaturrecherche wurde in den Datenbanken Cochrane Library Central Register of Controlled Trials (2017), PubMed (Januar 1976 bis März 2017) und EMBASE (Januar 1976 bis März 2017) durchgeführt, um die verfügbare klinische Evidenz für PRP zur Behandlung von Achillessehnenläsionen für einen systematischen Review zu erhalten. Die Einschlusskriterien waren (1) konservative PRP-Behandlung einer Achillessehnenentzündung in einer randomisierten kontrollierten Studie (RCT), (2) Level-I-Evidenz der klinischen Studie und (3) Publikation in englischer Sprache. Die Ausschlusskriterien waren (1) unklare experimentelle Methoden und Daten sowie (2) PRP-Behandlung anderer Erkrankungen.

Ergebnisse

Es wurden 4 Artikel mit insgesamt 152 Fällen in die Analyse eingeschlossen. Das mittlere Patientenalter lag bei 49 Jahren. Daten zum Score des Victorian Institute of Sport Assessment-Achilles (VISA-A), Farbdoppler-Sonographie-Index und zur Heilungsdauer bis zur Ausführung normaler Bewegungen wurden extrahiert. Es gab keine signifikanten Unterschiede zwischen den Behandlungsgruppen und den Kontrollgruppen nach PRP-Injektionen.

Schlussfolgerung

Der Mangel an Unterschieden zwischen den Daten der Kontroll- und Patientengruppen, die in die Studien eingeschlossen wurden, kann mit der schwierigen Durchführung einer randomisierten kontrollierten Studie (RCT) zusammenhängen. Eine haltbare Grundlage für die Verwendung von PRP zur Behandlung einer Achillessehnenentzündung wurde nicht gefunden, obwohl PRP einen signifikanten klinischen Vorteil bei der Therapie einer Achillessehnenentzündung zeigt.

Schlüsselwörter

Metaanalyse Vaskulärer endothelialer Wachstumsfaktor Regeneration Farbdoppler-Sonographie Fibroblasten 

Notes

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

Compliance with ethical guidelines

Conflict of interest

Y. Wang, C. Han, J. Hao, Y. Ren and J. Wang declare that they have no competing interests.

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer Medizin Verlag GmbH, ein Teil von Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Hand-foot and Microsurgery 2, The 2nd affiliated HospitalInner Mongolia Medical UniversityHyumin District, HohhotChina
  2. 2.Department of Arthroscopy and Sports Medicine, The 2nd affiliated HospitalInner Mongolia Medical UniversityHyumin District, HohhotChina
  3. 3.Department of Neurology, The Second HospitalHebei Medical UniversityXinhua District, ShijiazhuangChina
  4. 4.Department of OrthopedicsHebei Chest HospitalShijiazhuangChina

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