Chronic midportion Achilles tendinopathy is caused by a breakdown of the cartilage in the middle of the Achilles tendon, resulting in painful swelling and limited physical activity. Current treatments include nonsteroidal anti-inflammatory drugs, exercise to strengthen and stretch the tendon, and injections to help the tendon heal. Autologous platelet-rich plasma (PRP) is often injected into the tendon to infuse the Achilles tendon with a high concentration of growth factors to promote regeneration of the tendon. Randomized trial data, however, for PRP injections are limited. In order to understand whether PRP injections are helpful, researchers in the U.K. conducted a randomized trial in 240 adult patients with chronic midportion Achilles tendinopathy. Patients were randomized in a 1:1 ratio, but of the 221 patients who completed the trial from April 2016 to February 2020, 121 received PRP injections into the tendon and 119 received sham injections (dry injections under the skin but not the tendon). At the three- and six-months follow-up visits, there were no differences in a composite measure of tendinopathy (encompassing pain, function, and activity) between groups. These data do not support using PRP injections to treat patients with chronic midportion Achilles tendinopathy. More research is needed to find the best treatment for these patients with chronic, painful tendinopathy.
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