Platelet-Rich Plasma Treatment in Chronic Achilles Tendinosis
Monto RR · Foot & Ankle International (2012)
DOI: 10.3113/FAI.2012.0379This prospective case series treated 30 patients with chronic non-insertional Achilles tendinosis with a single PRP injection under ultrasound guidance. AOFAS scores improved dramatically from 55 to 96 at 24 months. Despite the striking improvement, the study lacked a control group, limiting causal inference. It stands as one of the most optimistic reports for PRP in Achilles tendinopathy but must be interpreted alongside the negative de Vos 2010 RCT.
Clinical Relevance
Illustrates the challenge of interpreting PRP evidence: uncontrolled case series show dramatic results, but controlled trials often do not. The gap likely reflects natural history, placebo effect, and the specific contribution of eccentric exercise programs.
Key Takeaways
- AOFAS improved from 55 to 96 at 24 months (dramatic improvement)
- No control group (case series design)
- All patients had chronic disease refractory to conservative treatment
- Results contrast sharply with de Vos 2010 negative RCT
- Ultrasound-guided injection may have contributed to favorable results
Key Findings
Significant improvement in AOFAS scores from 55 to 96 at final follow-up. Results maintained at 24 months with no adverse effects.
Clinical Context
Study Design
Prospective Case Series
Condition
Chronic Non-insertional Achilles Tendinosis
Sample Size
30 patients
Follow-up
24 months
Control Group
None (single-arm study)
Primary Outcome
AOFAS Score
PRP Protocol & Intervention
Injection Frequency
1 injection(s)
Guidance Method
Ultrasound