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Factors associated with positive outcomes of platelet-rich plasma therapy in Achilles tendinopathy

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European Journal of Orthopaedic Surgery & Traumatology Aims and scope Submit manuscript

Abstract

Background

The efficacy of platelet-rich plasma in the treatment for Achilles tendinopathy is debated. Therefore, it is important to know which factors, related to the subjects and/or the disease, are associated with positive or negative outcomes. Aim of this study was to evaluate in a large cohort of patients with Achilles mid-portion tendinopathy which variables were independently associated with a positive outcome after platelet-rich plasma treatment.

Material and methods

Eighty-four subjects with Achilles tendinopathy were evaluated by means of VISA-A score and ultrasound and treated with a single platelet-rich plasma injection once a week for 3 weeks. Afterward, a rehabilitation program, based on eccentric training, was implemented. At 3 and 6 months, the relationship between the mean VISA-A score and the following putative predictors was evaluated: sex, age, physical activity, sport, smoking, metabolic risk factors, BMI, symptoms duration, tendon damage, neovessels, adherence to eccentric training. Finally, the percentage of clinically evident positive outcomes (defined as an increase in VISA-A score ≥ 20 points) related to each variable was computed.

Results

At final follow-up, using the General Linear Model for Repeated Measures procedure, male sex (0.02), age ≤ 40 (0.05) and adequate eccentric training (0.02) were found to be independently associated with a significant increase in the mean VISA-A score. Moreover, the clinically evident positive outcomes, as previously defined, were significantly associated with male sex (0.01), age ≤ 40 (0.000), BMI ≤ 25 (0.001), symptoms duration ≤ 12 months (0.02) and good adherence to eccentric training (0.004).

Conclusion

Younger age, male sex and good adherence to eccentric training can be considered predictors of better results after platelet-rich plasma therapy in Achilles tendinopathy

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Authors and Affiliations

  1. Department of Medicine and Science of Aging, University G. D’Annunzio, Chieti-Pescara, Via dei Vestini 31, 66013, Chieti Scalo, CH, Italy

    Michele Abate & Luigi Di Carlo

  2. Division of Orthopedics and Traumatology, Santa Maria Delle Croci Hospital, Ravenna, Italy

    Alberto Belluati

  3. Division of Orthopedics and Traumatology, San Raffaele Hospital, Milan, Italy

    Vincenzo Salini

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  1. Michele Abate
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  2. Luigi Di Carlo
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  4. Vincenzo Salini
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Correspondence to Michele Abate.

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Abate, M., Di Carlo, L., Belluati, A. et al. Factors associated with positive outcomes of platelet-rich plasma therapy in Achilles tendinopathy. Eur J Orthop Surg Traumatol 30, 859–867 (2020). https://doi.org/10.1007/s00590-020-02642-1

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