Efficacy of platelet-rich plasma injections for treating Achilles tendonitis: Systematic review of high-quality randomized controlled trials

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.