Skip to main content
SpringerLink
Log in

Platelet-rich plasma in tendon-related disorders: results and indications

  • Sports Medicine
  • Published:
Knee Surgery, Sports Traumatology, Arthroscopy Aims and scope

Abstract

Purpose

Platelet-rich plasma (PRP) is currently the most exploited strategy in the clinical practice to provide a regenerative stimulus for tendon healing. The aim of the present study was to systematically review the available evidence on the treatment of the main tendon disorders where PRP is currently applied.

Methods

A systematic review of the literature was performed on the use of PRP as a treatment for tendinopathies focusing on the following sites: Achilles tendon, patellar tendon, rotator cuff tendons, and lateral elbow tendons. The following inclusion criteria for relevant articles were used: clinical trials written in English language up to 21 June 2016 on the use of PRP in the conservative or surgical treatment of the aforementioned tendinopathies.

Results

The research identified the following clinical trials dealing with the application of PRP in the selected tendons: 19 papers on patellar tendon (6 being RCTs: 4 dealing with PRP conservative application and 2 surgical), 24 papers on Achilles tendon (4 RCTs: 3 conservative and 1 surgical), 29 on lateral elbow tendons (17 RCTs, all conservative), and 32 on rotator cuff (22 RCTs: 18 surgical and 3 conservative).

Conclusion

Patellar tendons seem to benefit from PRP injections, whereas in the Achilles tendon, PRP application is not indicated neither as a conservative approach nor as a surgical augmentation. Lateral elbow tendinopathy showed an improvement in most of the high-level studies, but the lack of proven superiority with respect to the more simple whole-blood injections still questions its use in the clinical practice. With regard to rotator cuff pathology, the vast majority of surgical RCTs documented a lack of beneficial effects, whereas there is still inconclusive evidence concerning its conservative application in rotator cuff disorders.

Level of evidence

Systematic review of level I–IV trials, Level IV.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

  1. Andia I, Latorre PM, Gomez MC et al (2014) Platelet-rich plasma in the conservative treatment of painful tendinopathy: a systematic review and meta-analysis of controlled studies. Br Med Bull 110(1):99–115

    Article  PubMed  CAS  Google Scholar 

  2. Andriolo L, Di Matteo B, Kon E et al (2015) PRP augmentation for ACL reconstruction. Biomed Res Int. 2015:371746

    Article  PubMed  PubMed Central  Google Scholar 

  3. Antuña S, Barco R, Martínez Diez JM et al (2013) Platelet-rich fibrin in arthroscopic repair of massive rotator cuff tears: a prospective randomized pilot clinical trial. Acta Orthop Belg 79(1):25–30

    PubMed  Google Scholar 

  4. Barber FA, Hrnack SA, Snyder SJ et al (2011) Rotator cuff repair healing influenced by platelet-rich plasma construct augmentation. Arthroscopy 27(8):1029–1035

    Article  PubMed  Google Scholar 

  5. Behera P, Dhillon M, Aggarwal S et al (2015) Leukocyte-poor platelet-rich plasma versus bupivacaine for recalcitrant lateral epicondylar tendinopathy. J Orthop Surg (Hong Kong). 23(1):6–10

    Article  Google Scholar 

  6. Bergeson AG, Tashjian RZ, Greis PE et al (2012) Effects of platelet-rich fibrin matrix on repair integrity of at-risk rotator cuff tears. Am J Sports Med 40(2):286–293

    Article  PubMed  Google Scholar 

  7. Boswell SG, Cole BJ, Sundman EA et al (2012) Platelet-rich plasma: a milieu of bioactive factors. Arthroscopy 28(3):429–439

    Article  PubMed  Google Scholar 

  8. Brkljac M, Kumar S, Kalloo D et al (2015) The effect of platelet-rich plasma injection on lateral epicondylitis following failed conservative management. J Orthop 12(Suppl 2):S166–S170

    Article  PubMed  PubMed Central  Google Scholar 

  9. Carr AJ, Murphy R, Dakin SG et al (2015) Platelet-rich plasma injection with arthroscopic acromioplasty for chronic rotator cuff tendinopathy: a randomized controlled trial. Am J Sports Med 43(12):2891–2897

    Article  PubMed  Google Scholar 

  10. Castricini R, Longo UG, De Benedetto M et al (2011) Platelet-rich plasma augmentation for arthroscopic rotator cuff repair: a randomized controlled trial. Am J Sports Med 39(2):258–265

    Article  PubMed  Google Scholar 

  11. Charousset C, Zaoui A, Bellaiche L et al (2014) Are multiple platelet-rich plasma injections useful for treatment of chronic patellar tendinopathy in athletes? A prospective study. Am J Sports Med 42(4):906–911

    Article  PubMed  Google Scholar 

  12. Charousset C, Zaoui A, Bellaïche L et al (2014) Does autologous leukocyte-platelet-rich plasma improve tendon healing in arthroscopic repair of large or massive rotator cuff tears? Arthroscopy 30(4):428–435

    Article  PubMed  Google Scholar 

  13. Chaudhury S, de La Lama M, Adler RS et al (2013) Platelet-rich plasma for the treatment of lateral epicondylitis: sonographic assessment of tendon morphology and vascularity (pilot study). Skeletal Radiol 42(1):91–97

    Article  PubMed  Google Scholar 

  14. Creaney L, Wallace A, Curtis M et al (2011) Growth factor-based therapies provide additional benefit beyond physical therapy in resistant elbow tendinopathy: a prospective, single-blind, randomised trial of autologous blood injections versus platelet-rich plasma injections. Br J Sports Med 45(12):966–971

    Article  PubMed  Google Scholar 

  15. Crescibene A, Napolitano M, Sbano R et al (2015) Infiltration of autologous growth factors in chronic tendinopathies. J Blood Transfus. 2015:924380

    PubMed  PubMed Central  Google Scholar 

  16. Dallaudière B, Pesquer L, Meyer P et al (2014) Intratendinous injection of platelet-rich plasma under US guidance to treat tendinopathy: a long-term pilot study. J Vasc Interv Radiol 25(5):717–723

    Article  PubMed  Google Scholar 

  17. de Almeida AM, Demange MK, Sobrado MF et al (2012) Patellar tendon healing with platelet-rich plasma: a prospective randomized controlled trial. Am J Sports Med 40(6):1282–1288

    Article  PubMed  Google Scholar 

  18. De Carli A, Lanzetti RM, Ciompi A et al (2016) Can platelet-rich plasma have a role in Achilles tendon surgical repair? Knee Surg Sports Traumatol Arthrosc 24(7):2231–2237

    Article  PubMed  Google Scholar 

  19. de Jonge S, de Vos RJ, Weir A et al (2011) One-year follow-up of platelet-rich plasma treatment in chronic Achilles tendinopathy: a double-blind randomized placebo-controlled trial. Am J Sports Med 39(8):1623–1629

    Article  PubMed  Google Scholar 

  20. de Vos RJ, Weir A, van Schie HT et al (2010) Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial. JAMA 303(2):144–149

    Article  PubMed  Google Scholar 

  21. Deans VM, Miller A, Ramos J (2012) A prospective series of patients with chronic Achilles tendinopathy treated with autologous-conditioned plasma injections combined with exercise and therapeutic ultrasonography. J Foot Ankle Surg 51(6):706–710

    Article  PubMed  Google Scholar 

  22. Del Buono A, Oliva F, Osti L et al (2013) Metalloproteases and tendinopathy. Muscles Ligaments Tendons J 3(1):51–57

    PubMed  PubMed Central  Google Scholar 

  23. DeLong JM, Russell RP, Mazzocca AD (2012) Platelet-rich plasma: the PAW classification system. Arthroscopy 28(7):998–1009

    Article  PubMed  Google Scholar 

  24. Di Benedetto P, Di Benedetto ED, Beltrame A et al (2016) Arthroscopic rotator cuff repair with or without PrP: our experience. Acta Biomed 87(Suppl 1):75–83

    PubMed  Google Scholar 

  25. Di Matteo B, Filardo G, Kon E et al (2015) Platelet-rich plasma: evidence for the treatment of patellar and Achilles tendinopathy-a systematic review. Musculoskelet Surg. 99(1):1–9

    Article  PubMed  Google Scholar 

  26. Dohan Ehrenfest DM, Bielecki T, Jimbo R et al (2012) Do the fibrin architecture and leukocyte content influence the growth factor release of platelet concentrates? An evidence-based answer comparing a pure platelet-rich plasma (P-PRP) gel and a leukocyte- and platelet-rich fibrin (L-PRF). Curr Pharm Biotechnol 13(7):1145–1152

    Article  PubMed  Google Scholar 

  27. Dohan Ehrenfest DM, Rasmusson L, Albrektsson T (2009) Classification of platelet concentrates: from pure platelet-rich plasma (P-PRP) to leucocyte- and platelet-rich fibrin (L-PRF). Trends Biotechnol 27(3):158–167

    Article  PubMed  CAS  Google Scholar 

  28. Dragoo JL, Wasterlain AS, Braun HJ et al (2014) Platelet-rich plasma as a treatment for patellar tendinopathy: a double-blind, randomized controlled trial. Am J Sports Med 42(3):610–618

    Article  PubMed  Google Scholar 

  29. Ferrero G, Fabbro E, Orlandi D et al (2012) Ultrasound-guided injection of platelet-rich plasma in chronic Achilles and patellar tendinopathy. J Ultrasound 15(4):260–266

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  30. Filardo G, Kon E, Della Villa S et al (2010) Use of platelet-rich plasma for the treatment of refractory jumper’s knee. Int Orthop 34(6):909–915

    Article  PubMed  Google Scholar 

  31. Filardo G, Kon E, Di Matteo B et al (2014) Platelet-rich plasma injections for the treatment of refractory Achilles tendinopathy: results at 4 years. Blood Transfus. 12(4):533–540

    PubMed  PubMed Central  Google Scholar 

  32. Filardo G, Kon E, Di Matteo B et al (2013) Platelet-rich plasma for the treatment of patellar tendinopathy: clinical and imaging findings at medium-term follow-up. Int Orthop 37(8):1583–1589

    Article  PubMed  PubMed Central  Google Scholar 

  33. Filardo G, Kon E, Roffi A et al (2015) Platelet-rich plasma: why intra-articular? A systematic review of preclinical studies and clinical evidence on PRP for joint degeneration. Knee Surg Sports Traumatol Arthrosc 23(9):2459–2474

    Article  PubMed  CAS  Google Scholar 

  34. Filardo G, Presti ML, Kon E et al (2010) Nonoperative biological treatment approach for partial Achilles tendon lesion. Orthopedics. 33(2):120–123

    Article  PubMed  Google Scholar 

  35. Finnoff JT, Fowler SP, Lai JK et al (2011) Treatment of chronic tendinopathy with ultrasound-guided needle tenotomy and platelet-rich plasma injection. PM R. 3(10):900–911

    Article  PubMed  Google Scholar 

  36. Flury M, Rickenbacher D, Schwyzer HK et al (2016) Does pure platelet-rich plasma affect postoperative clinical outcomes after arthroscopic rotator cuff repair? A randomized controlled trial. Am J Sports Med. doi:10.1177/0363546516645518

    Article  PubMed  Google Scholar 

  37. Ford RD, Schmitt WP, Lineberry K et al (2015) A retrospective comparison of the management of recalcitrant lateral elbow tendinosis: platelet-rich plasma injections versus surgery. Hand (NY) 10(2):285–291

    Article  Google Scholar 

  38. Gautam VK, Verma S, Batra S et al (2015) Platelet-rich plasma versus corticosteroid injection for recalcitrant lateral epicondylitis: clinical and ultrasonographic evaluation. J Orthop Surg (Hong Kong). 23(1):1–5

    Article  CAS  Google Scholar 

  39. Gaweda K, Tarczynska M, Krzyzanowski W (2010) Treatment of Achilles tendinopathy with platelet-rich plasma. Int J Sports Med 31(8):577–583

    Article  PubMed  CAS  Google Scholar 

  40. Glanzmann MC, Audigé L (2015) Platelet-rich plasma for chronic lateral epicondylitis: Is one injection sufficient? Arch Orthop Trauma Surg 135(12):1637–1645

    Article  PubMed  Google Scholar 

  41. Gosens T, Den Oudsten BL, Fievez E et al (2012) Pain and activity levels before and after platelet-rich plasma injection treatment of patellar tendinopathy: a prospective cohort study and the influence of previous treatments. Int Orthop 36(9):1941–1946

    Article  PubMed  PubMed Central  Google Scholar 

  42. Gosens T, Peerbooms JC, van Laar W et al (2011) Ongoing positive effect of platelet-rich plasma versus corticosteroid injection in lateral epicondylitis: a double-blind randomized controlled trial with 2-year follow-up. Am J Sports Med 39(6):1200–1208

    Article  PubMed  Google Scholar 

  43. Guelfi M, Pantalone A, Vanni D et al (2015) Long-term beneficial effects of platelet-rich plasma for non-insertional Achilles tendinopathy. Foot Ankle Surg. 21(3):178–181

    Article  PubMed  Google Scholar 

  44. Gumina S, Campagna V, Ferrazza G et al (2012) Use of platelet-leukocyte membrane in arthroscopic repair of large rotator cuff tears: a prospective randomized study. J Bone Joint Surg Am 94(15):1345–1352

    Article  PubMed  Google Scholar 

  45. Hak A, Rajaratnam K, Ayeni OR et al (2015) A double-blinded placebo randomized controlled trial evaluating short-term efficacy of platelet-rich plasma in reducing postoperative pain after arthroscopic rotator cuff repair: a pilot study. Sports Health. 7(1):58–66

    Article  PubMed  PubMed Central  Google Scholar 

  46. Hechtman KS, Uribe JW, Botto-vanDemden A et al (2011) Platelet-rich plasma injection reduces pain in patients with recalcitrant epicondylitis. Orthopedics. 34(2):92

    PubMed  Google Scholar 

  47. Ilhanli I, Guder N, Gul M (2015) Platelet-rich plasma treatment with physical therapy in chronic partial supraspinatus tears. Iran Red Crescent Med J 17(9):e23732

    Article  PubMed  PubMed Central  Google Scholar 

  48. Jo CH, Kim JE, Yoon KS et al (2011) Does platelet-rich plasma accelerate recovery after rotator cuff repair? A prospective cohort study. Am J Sports Med 39(10):2082–2090

    Article  PubMed  Google Scholar 

  49. Jo CH, Shin JS, Lee YG et al (2013) Platelet-rich plasma for arthroscopic repair of large to massive rotator cuff tears: a randomized, single-blind, parallel-group trial. Am J Sports Med 41(10):2240–2248

    Article  PubMed  Google Scholar 

  50. Kaniki N, Willits K, Mohtadi NG et al (2014) A retrospective comparative study with historical control to determine the effectiveness of platelet-rich plasma as part of nonoperative treatment of acute Achilles tendon rupture. Arthroscopy 30(9):1139–1145

    Article  PubMed  Google Scholar 

  51. Karaduman M, Okkaoglu MC, Sesen H et al (2016) Platelet-rich plasma versus open surgical release in chronic tennis elbow: A retrospective comparative study. J Orthop 13(1):10–14

    Article  PubMed  PubMed Central  Google Scholar 

  52. Kaux JF, Bruyere O, Croisier JL et al (2015) One-year follow-up of platelet-rich plasma infiltration to treat chronic proximal patellar tendinopathies. Acta Orthop Belg 81(2):251–256

    PubMed  Google Scholar 

  53. Kaux JF, Croisier JL, Bruyere O et al (2015) One injection of platelet-rich plasma associated to a submaximal eccentric protocol to treat chronic jumper’s knee. J Sports Med Phys Fitness 55(9):953–961

    PubMed  CAS  Google Scholar 

  54. Kaux JF, Croisier JL, Forthomme B et al (2016) Using platelet-rich plasma to treat jumper’s knees: exploring the effect of a second closely-timed infiltration. J Sci Med Sport. 19(3):200–204

    Article  PubMed  CAS  Google Scholar 

  55. Kaux JF, Croisier JL, Léonard P et al (2014) Exuberant inflammatory reaction as a side effect of platelet-rich plasma injection in treating one case of tendinopathy. Clin J Sport Med 24(2):150–152

    Article  PubMed  Google Scholar 

  56. Kearney RS, Parsons N, Costa ML (2013) Achilles tendinopathy management: a pilot randomised controlled trial comparing platelet-rich plasma injection with an eccentric loading programme. Bone Joint Res 2(10):227–232

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  57. Kesikburun S, Tan AK, Yilmaz B et al (2013) Platelet-rich plasma injections in the treatment of chronic rotator cuff tendinopathy: a randomized controlled trial with 1-year follow-up. Am J Sports Med 41(11):2609–2616

    Article  PubMed  Google Scholar 

  58. Khaliq A, Khan I, Inam M et al (2015) Effectiveness of platelets rich plasma versus corticosteroids in lateral epicondylitis. J Pak Med Assoc 65(11 Suppl 3):S100–S104

    PubMed  Google Scholar 

  59. Kon E, Filardo G, Delcogliano M et al (2009) Platelet-rich plasma: new clinical application: a pilot study for treatment of jumper’s knee. Injury. 40(6):598–603

    Article  PubMed  Google Scholar 

  60. Kon E, Filardo G, Di Matteo B et al (2013) PRP for the treatment of cartilage pathology. Open Orthop J. 3(7):120–128

    Article  Google Scholar 

  61. Krogh TP, Ellingsen T, Christensen R et al (2016) Ultrasound-guided injection therapy of Achilles tendinopathy with platelet-rich plasma or saline: a randomized, blinded, placebo-controlled trial. Am J Sports Med. doi:10.1177/0363546516647958

    Article  PubMed  Google Scholar 

  62. Krogh TP, Fredberg U, Stengaard-Pedersen K et al (2013) Treatment of lateral epicondylitis with platelet-rich plasma, glucocorticoid, or saline: a randomized, double-blind, placebo-controlled trial. Am J Sports Med 41(3):625–635

    Article  PubMed  Google Scholar 

  63. Kujala UM, Sarna S, Kaprio J (2015) Cumulative incidence of Achilles tendon rupture and tendinopathy in male former elite athletes. Clin J Sport Med 15(3):133–135

    Article  Google Scholar 

  64. Lebiedziński R, Synder M, Buchcic P et al (2015) A randomized study of autologous conditioned plasma and steroid injections in the treatment of lateral epicondylitis. Int Orthop 39(11):2199–2203

    Article  PubMed  Google Scholar 

  65. Lian OB, Engebretsen L, Bahr R (2005) Prevalence of jumper’s knee among elite athletes from different sports: a cross-sectional study. Am J Sports Med 33(4):561–567

    Article  PubMed  Google Scholar 

  66. Malavolta EA, Gracitelli ME, Ferreira Neto AA et al (2014) Platelet-rich plasma in rotator cuff repair: a prospective randomized study. Am J Sports Med 42(10):2446–2454

    Article  PubMed  Google Scholar 

  67. Mautner K, Colberg RE, Malanga G et al (2013) Outcomes after ultrasound-guided platelet-rich plasma injections for chronic tendinopathy: a multicenter, retrospective review. PM R. 5(3):169–175

    Article  PubMed  Google Scholar 

  68. Mautner K, Malanga GA, Smith J et al (2015) A call for a standard classification system for future biologic research: the rationale for new PRP nomenclature. PM R. 7(4 Suppl):S53–S59

    Article  PubMed  Google Scholar 

  69. McCarrel TM, Minas T, Fortier LA (2012) Optimization of leukocyte concentration in platelet-rich plasma for the treatment of tendinopathy. J Bone Joint Surg Am 94(19):e143(1–8)

    Article  Google Scholar 

  70. Mishra A, Pavelko T (2006) Treatment of chronic elbow tendinosis with buffered platelet-rich plasma. Am J Sports Med 34(11):1774–1778

    Article  PubMed  Google Scholar 

  71. Mishra AK, Skrepnik NV, Edwards SG et al (2014) Efficacy of platelet-rich plasma for chronic tennis elbow: a double-blind, prospective, multicenter, randomized controlled trial of 230 patients. Am J Sports Med 42(2):463–471

    Article  PubMed  Google Scholar 

  72. Montalvan B, Le Goux P, Klouche S et al (2016) Inefficacy of ultrasound-guided local injections of autologous conditioned plasma for recent epicondylitis: results of a double-blind placebo-controlled randomized clinical trial with one-year follow-up. Rheumatology (Oxford) 55(2):279–285

    Article  Google Scholar 

  73. Monto RR (2014) Platelet-rich plasma efficacy versus corticosteroid injection treatment for chronic severe plantar fasciitis. Foot Ankle Int 35(4):313–318

    Article  PubMed  Google Scholar 

  74. Murawski CD, Smyth NA, Newman H et al (2014) A single platelet-rich plasma injection for chronic midsubstance Achilles tendinopathy: a retrospective preliminary analysis. Foot Ankle Spec. 7(5):372–376

    Article  PubMed  Google Scholar 

  75. Oloff L, Elmi E, Nelson J, Crain J (2015) Retrospective analysis of the effectiveness of platelet-rich plasma in the treatment of Achilles tendinopathy: pretreatment and posttreatment correlation of magnetic resonance imaging and clinical assessment. Foot Ankle Spec. 8(6):490–497

    Article  PubMed  Google Scholar 

  76. Owens RF Jr, Ginnetti J, Conti SF et al (2011) Clinical and magnetic resonance imaging outcomes following platelet rich plasma injection for chronic midsubstance Achilles tendinopathy. Foot Ankle Int 32(11):1032–1039

    Article  PubMed  Google Scholar 

  77. Palacio EP, Schiavetti RR, Kanematsu M et al (2016) Effects of platelet-rich plasma on lateral epicondylitis of the elbow: prospective randomized controlled trial. Rev Bras Ortop. 51(1):90–95

    Article  PubMed  PubMed Central  Google Scholar 

  78. Pandey V, Bandi A, Madi S et al (2016) Does application of moderately concentrated platelet-rich plasma improve clinical and structural outcome after arthroscopic repair of medium-sized to large rotator cuff tear? A randomized controlled trial. J Shoulder Elbow Surg. doi:10.1016/j.jse.2016.01.036

    Article  PubMed  Google Scholar 

  79. Peerbooms JC, Sluimer J, Bruijn DJ et al (2010) Positive effect of an autologous platelet concentrate in lateral epicondylitis in a double-blind randomized controlled trial: platelet-rich plasma versus corticosteroid injection with a 1-year follow-up. Am J Sports Med 38(2):255–262

    Article  PubMed  Google Scholar 

  80. Perdisa F, Filardo G, Di Matteo B et al (2014) Platelet rich plasma: a valid augmentation for cartilage scaffolds? A systematic review. Histol Histopathol 29(7):805–814

    PubMed  CAS  Google Scholar 

  81. Perut F, Filardo G, Mariani E et al (2013) Preparation method and growth factor content of platelet concentrate influence the osteogenic differentiation of bone marrow stromal cells. Cytotherapy. 15(7):830–839

    Article  PubMed  CAS  Google Scholar 

  82. Peters JA, Zwerver J, Diercks RL et al (2016) Preventive interventions for tendinopathy: a systematic review. J Sci Med Sport. 19(3):205–211

    Article  PubMed  Google Scholar 

  83. Raeissadat SA, Rayegani SM, Hassanabadi H et al (2014) Is Platelet-rich plasma superior to whole blood in the management of chronic tennis elbow: one year randomized clinical trial. BMC Sports Sci Med Rehabil. 18(6):12

    Article  Google Scholar 

  84. Raeissadat SA, Sedighipour L, Rayegani SM et al (2014) Effect of platelet-rich plasma (PRP) versus autologous whole blood on pain and function improvement in tennis elbow: a randomized clinical trial. Pain Res Treat. 2014:191525

    PubMed  PubMed Central  Google Scholar 

  85. Randelli P, Arrigoni P, Ragone V et al (2011) Platelet rich plasma in arthroscopic rotator cuff repair: a prospective RCT study, 2-year follow-up. J Shoulder Elbow Surg 20(4):518–528

    Article  PubMed  Google Scholar 

  86. Randelli PS, Arrigoni P, Cabitza P et al (2008) Autologous platelet rich plasma for arthroscopic rotator cuff repair. A pilot study. Disabil Rehabil 30(20–22):1584–1589

    Article  PubMed  Google Scholar 

  87. Rha DW, Park GY, Kim YK et al (2013) Comparison of the therapeutic effects of ultrasound-guided platelet-rich plasma injection and dry needling in rotator cuff disease: a randomized controlled trial. Clin Rehabil. 27(2):113–122

    Article  PubMed  Google Scholar 

  88. Riley G (2004) The pathogenesis of tendinopathy. A molecular perspective. Rheumatology (Oxford) 43(2):131–142

    Article  CAS  Google Scholar 

  89. Rodeo SA, Delos D, Williams RJ et al (2012) The effect of platelet-rich fibrin matrix on rotator cuff tendon healing: a prospective, randomized clinical study. Am J Sports Med 40(6):1234–1241

    Article  PubMed  Google Scholar 

  90. Ruiz-Moneo P, Molano-Muñoz J, Prieto E et al (2013) Plasma rich in growth factors in arthroscopic rotator cuff repair: a randomized, double-blind, controlled clinical trial. Arthroscopy 29(1):2–9

    Article  PubMed  Google Scholar 

  91. Salini V, Vanni D, Pantalone A et al (2015) Platelet Rich Plasma therapy in non-insertional Achilles tendinopathy: the efficacy is reduced in 60-years old people compared to young and middle-age individuals. Front Aging Neurosci. 10(7):228

    Google Scholar 

  92. Sánchez M, Anitua E, Azofra J et al (2007) Comparison of surgically repaired Achilles tendon tears using platelet-rich fibrin matrices. Am J Sports Med 35(2):245–251

    Article  PubMed  Google Scholar 

  93. Scarpone M, Rabago D, Snell E et al (2013) Effectiveness of platelet-rich plasma injection for rotator cuff tendinoplasty: a prospective open-label study. Glob Adv Health Med. 2(2):26–31

    Article  PubMed  PubMed Central  Google Scholar 

  94. Schepull T, Kvist J, Norrman H et al (2011) Autologous platelets have no effect on the healing of human Achilles tendon ruptures: a randomized single-blind study. Am J Sports Med 39(1):38–47

    Article  PubMed  Google Scholar 

  95. Seijas R, Cuscó X, Sallent A et al (2016) Pain in donor site after BTB-ACL reconstruction with PRGF: a randomized trial. Arch Orthop Trauma Surg 136(6):829–835

    Article  PubMed  Google Scholar 

  96. Tan XX, Ju HY, Yan W et al (2016) Autologous platelet lysate local injections for the treatment of refractory lateral epicondylitis. J Orthop Surg Res. 11:17

    Article  PubMed  PubMed Central  Google Scholar 

  97. Tetschke E, Rudolf M, Lohmann CH et al (2015) Autologous proliferative therapies in recalcitrant lateral epicondylitis. Am J Phys Med Rehabil 94(9):696–706

    Article  PubMed  Google Scholar 

  98. Thanasas C, Papadimitriou G, Charalambidis C et al (2011) Platelet-rich plasma versus autologous whole blood for the treatment of chronic lateral elbow epicondylitis: a randomized controlled clinical trial. Am J Sports Med 39(10):2130–2134

    Article  PubMed  Google Scholar 

  99. Tol JL, Spiezia F, Maffulli N (2012) Neovascularization in Achilles tendinopathy: have we been chasing a red herring? Knee Surg Sports Traumatol Arthrosc 20(10):1891–1894

    Article  PubMed  Google Scholar 

  100. Tonk G, Kumar A, Gupta A (2014) Platelet rich plasma versus laser therapy in lateral epicondylitis of elbow. Indian J Orthop. 48(4):390–393

    Article  PubMed  PubMed Central  Google Scholar 

  101. Torricelli P, Fini M, Filardo G et al (2011) Regenerative medicine for the treatment of musculoskeletal overuse injuries in competition horses. Int Orthop 35(10):1569–1576

    Article  PubMed  PubMed Central  Google Scholar 

  102. Tschon M, Fini M, Giardino R et al (2011) Lights and shadows concerning platelet products for musculoskeletal regeneration. Front Biosci (Elite Ed). 1(3):96–107

    Google Scholar 

  103. Vannini F, Di Matteo B, Filardo G et al (2014) Platelet-rich plasma for foot and ankle pathologies: a systematic review. Foot Ankle Surg. 20(1):2–9

    Article  PubMed  CAS  Google Scholar 

  104. Verhaegen F, Brys P, Debeer P (2016) Rotator cuff healing after needling of a calcific deposit using platelet-rich plasma augmentation: a randomized, prospective clinical trial. J Shoulder Elbow Surg 25(2):169–173

    Article  PubMed  Google Scholar 

  105. Vetrano M, Castorina A, Vulpiani MC et al (2013) Platelet-rich plasma versus focused shock waves in the treatment of jumper’s knee in athletes. Am J Sports Med 41(4):795–803

    Article  PubMed  Google Scholar 

  106. Virchenko O, Aspenberg P (2006) How can one platelet injection after tendon injury lead to a stronger tendon after 4 weeks? Interplay between early regeneration and mechanical stimulation. Acta Orthop 77(5):806–812

    Article  PubMed  Google Scholar 

  107. Volpi P, Quaglia A, Schoenhuber H et al (2010) Growth factors in the management of sport-induced tendinopathies: results after 24 months from treatment. A pilot study. J Sports Med Phys Fitness 50(4):494–500

    PubMed  CAS  Google Scholar 

  108. von Wehren L, Blanke F, Todorov A et al (2015) The effect of subacromial injections of autologous conditioned plasma versus cortisone for the treatment of symptomatic partial rotator cuff tears. Knee Surg Sports Traumatol Arthrosc. doi:10.1007/s00167-015-3651-3

    Article  Google Scholar 

  109. Wang A, McCann P, Colliver J et al (2015) Do postoperative platelet-rich plasma injections accelerate early tendon healing and functional recovery after arthroscopic supraspinatus repair? A randomized controlled trial. Am J Sports Med 43(6):1430–1437

    Article  PubMed  Google Scholar 

  110. Weber SC, Kauffman JI, Parise C et al (2013) Platelet-rich fibrin matrix in the management of arthroscopic repair of the rotator cuff: a prospective, randomized, double-blinded study. Am J Sports Med 41(2):263–270

    Article  PubMed  Google Scholar 

  111. Weibrich G, Hansen T, Kleis W et al (2004) Effect of platelet concentration in platelet-rich plasma on peri-implant bone regeneration. Bone 34(4):665–671

    Article  PubMed  CAS  Google Scholar 

  112. Werthel JD, Pelissier A, Massin P et al (2014) Arthroscopic double row cuff repair with suture-bridging and autologous conditioned plasma injection: functional and structural results. Int J Shoulder Surg. 8(4):101–106

    Article  PubMed  PubMed Central  Google Scholar 

  113. Wesner M, Defreitas T, Bredy H et al (2016) A pilot study evaluating the effectiveness of platelet-rich plasma therapy for treating degenerative tendinopathies: a randomized control trial with synchronous observational cohort. PLoS ONE 11(2):e0147842

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  114. Yadav R, Kothari SY, Borah D (2015) Comparison of local injection of platelet rich plasma and corticosteroids in the treatment of lateral epicondylitis of humerus. J Clin Diagn Res 9(7):RC05-7

    PubMed  Google Scholar 

  115. Zayni R, Thaunat M, Fayard JM et al (2015) Platelet-rich plasma as a treatment for chronic patellar tendinopathy: comparison of a single versus two consecutive injections. Muscles Ligaments Tendons J 5(2):92–98

    PubMed  PubMed Central  Google Scholar 

  116. Zhang Z, Wang Y, Sun J (2016) The effect of platelet-rich plasma on arthroscopic double-row rotator cuff repair: a clinical study with 12-month follow-up. Acta Orthop Traumatol Turc. 50(2):191–197

    PubMed  Google Scholar 

  117. Zumstein MA, Rumian A, Lesbats V et al (2014) Increased vascularization during early healing after biologic augmentation in repair of chronic rotator cuff tears using autologous leukocyte- and platelet-rich fibrin (L-PRF): a prospective randomized controlled pilot trial. J Shoulder Elbow Surg 23(1):3–12

    Article  PubMed  Google Scholar 

  118. Zumstein MA, Rumian A, Thélu CÉ et al (2016) SECEC Research Grant 2008 II: use of platelet- and leucocyte-rich fibrin (L-PRF) does not affect late rotator cuff tendon healing: a prospective randomized controlled study. J Shoulder Elbow Surg 25(1):2–11

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

The present study was partially supported by PRRU (Emilia-Romagna Region/University of Bologna Project) 2010–2012.

Author information

Authors and Affiliations

  1. Nano-Biotechnology Laboratory, Rizzoli Orthopaedic Institute, Bologna, Italy

    Giuseppe Filardo, Elizaveta Kon & Giulia Merli

  2. I Orthopaedic and Traumatologic Clinic, Rizzoli Orthopaedic Institute, Via Di Barbiano, 1/10, 40136, Bologna, Italy

    Berardo Di Matteo

  3. Biomechanics and Technology Innovation Laboratory, Rizzoli Orthopaedic Institute, Via Di Barbiano, 1/10, 40136, Bologna, Italy

    Maurilio Marcacci

Authors
  1. Giuseppe Filardo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Berardo Di Matteo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Elizaveta Kon
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Giulia Merli
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Maurilio Marcacci
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Berardo Di Matteo.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Funding

There is no funding source.

Ethical approval

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

Informed consent

For this kind of study (systematic review of literature) formal consent is not required.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (PDF 57 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Filardo, G., Di Matteo, B., Kon, E. et al. Platelet-rich plasma in tendon-related disorders: results and indications. Knee Surg Sports Traumatol Arthrosc 26, 1984–1999 (2018). https://doi.org/10.1007/s00167-016-4261-4

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00167-016-4261-4

Keywords

Search

Navigation