Platelet-Rich Plasma Treatment in Chronic Achilles Tendinopathy: A Double-Blind Randomized Placebo-Controlled Trial
de Vos RJ · JAMA (2010)
DOI: 10.1001/jama.2009.1986Published in JAMA, this double-blind, placebo-controlled RCT randomized 54 patients with chronic midportion Achilles tendinopathy to PRP or saline injection, both combined with an eccentric exercise program. At 24 weeks, there was no significant difference in VISA-A scores between groups. This landmark negative study established that PRP does not add benefit beyond eccentric exercise for Achilles tendinopathy, making it one of the most cited studies in the field.
Clinical Relevance
A defining study for Achilles tendinopathy management. Clinicians should prioritize eccentric exercise programs and not expect PRP to provide additional benefit. PRP cannot substitute for proper rehabilitation.
Key Takeaways
- No PRP benefit over saline when both groups performed eccentric exercises
- Double-blind, JAMA-published, high methodological quality
- Both groups improved significantly, confirming eccentric exercise is the primary driver
- Eccentric exercise alone is the evidence-based standard for midportion Achilles tendinopathy
- PRP may not add value when the baseline rehabilitation program is already effective
Key Findings
PRP injection did not result in greater improvement compared to saline at 6-month or 1-year follow-up. Both groups improved with eccentric exercise.
Clinical Context
Study Design
Randomized Controlled Trial (Double-Blind)
Condition
Chronic Midportion Achilles Tendinopathy
Sample Size
54 patients
Follow-up
6 months
Control Group
Saline Placebo
Primary Outcome
VISA-A
PRP Protocol & Intervention
Injection Frequency
1 injection(s)
Guidance Method
Ultrasound