Platelet-rich plasma (PRP) treatment of noninsertional Achilles tendinopathy in a two case series: no significant difference in effect between leukocyte-rich and leukocyte-poor PRP
Klaus Hanisch,1 Niels Wedderkopp1,2 1Orthopedic Department, Hospital of Southwestern Jutland, Esbjerg, Denmark; 2Department of Regional Health Research, University of Southern Denmark, Odense, Denmark Background: There is a theoretical basis for the treatment of chronic tendinopathies by platelet-ri...
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doaj-cc0e4e04c23a49eebfe81f5044436d262020-11-24T21:42:22ZengDove Medical PressOrthopedic Research and Reviews1179-14622019-04-01Volume 11556044962Platelet-rich plasma (PRP) treatment of noninsertional Achilles tendinopathy in a two case series: no significant difference in effect between leukocyte-rich and leukocyte-poor PRPHanisch KWedderkopp NKlaus Hanisch,1 Niels Wedderkopp1,2 1Orthopedic Department, Hospital of Southwestern Jutland, Esbjerg, Denmark; 2Department of Regional Health Research, University of Southern Denmark, Odense, Denmark Background: There is a theoretical basis for the treatment of chronic tendinopathies by platelet-rich plasma (PRP), and it can, therefore, be considered a possible treatment of chronic Achilles tendinopathies (CATs), even though the clinical evidence for the use is not clear and, in addition, there is a lack of treatment algorithms and it is unclear which type of PRP is most effective. The objective of this study was through the comparison of two case series to assess: 1) the effect of PRP on CAT and 2) if there is any difference in effect between leukocyte-rich PRP (LR-PRP) and leukocyte-poor PRP (LP-PRP) in the treatment of CAT. Patients and methods: Two separate series of achilles tenodinopathies treated with either LR-PRP or LP-PRP were evaluated with a natural experiment/quasi-experimental study design, with a short-term (2 months) and long-term (8–42 months) follow-up to assess the effect and stability of the treatment. In total, 84 patients with failed basic treatment for CAT for at least 6 months were treated with either Biomet’s GPS III recovery kit with LR-PRP (36 patients) or with Arthrex ACP LP-PRP (48 patients). Results: The overall probability of reaching a minimal clinically important change (MCIC) of at least 30% reduction in visual analog scale (VAS) was in activity (63%) and during rest (81%), and for Victorian Institute of Sport Assessment Scale (VISA-A), it was 61%. There was no statistical difference in change of VISA-A score or VAS between the patients treated with LP-PRP and LR-PRP. Conclusion: PRP seems to be a possible treatment when all other treatment regimens have failed, with a reasonably high probability of reaching MCIC. The choice of either LR-PRP or LP-PRP seems to be up to personal preference as there were no significant differences between patients treated with LR-PRP and LP-PRP. Keywords: platelet-rich plasma, leukocyte-rich PRP, leukocyte-poor PRP, Achilles tendinopathyhttps://www.dovepress.com/platelet-rich-plasma-prp-treatment-of-noninsertional-achilles-tendinop-peer-reviewed-article-ORRPlatelet rich plasmaLeukocyte rich PRPLeukocyte poor PRPAchilles tendinopathy |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Hanisch K Wedderkopp N |
spellingShingle |
Hanisch K Wedderkopp N Platelet-rich plasma (PRP) treatment of noninsertional Achilles tendinopathy in a two case series: no significant difference in effect between leukocyte-rich and leukocyte-poor PRP Orthopedic Research and Reviews Platelet rich plasma Leukocyte rich PRP Leukocyte poor PRP Achilles tendinopathy |
author_facet |
Hanisch K Wedderkopp N |
author_sort |
Hanisch K |
title |
Platelet-rich plasma (PRP) treatment of noninsertional Achilles tendinopathy in a two case series: no significant difference in effect between leukocyte-rich and leukocyte-poor PRP |
title_short |
Platelet-rich plasma (PRP) treatment of noninsertional Achilles tendinopathy in a two case series: no significant difference in effect between leukocyte-rich and leukocyte-poor PRP |
title_full |
Platelet-rich plasma (PRP) treatment of noninsertional Achilles tendinopathy in a two case series: no significant difference in effect between leukocyte-rich and leukocyte-poor PRP |
title_fullStr |
Platelet-rich plasma (PRP) treatment of noninsertional Achilles tendinopathy in a two case series: no significant difference in effect between leukocyte-rich and leukocyte-poor PRP |
title_full_unstemmed |
Platelet-rich plasma (PRP) treatment of noninsertional Achilles tendinopathy in a two case series: no significant difference in effect between leukocyte-rich and leukocyte-poor PRP |
title_sort |
platelet-rich plasma (prp) treatment of noninsertional achilles tendinopathy in a two case series: no significant difference in effect between leukocyte-rich and leukocyte-poor prp |
publisher |
Dove Medical Press |
series |
Orthopedic Research and Reviews |
issn |
1179-1462 |
publishDate |
2019-04-01 |
description |
Klaus Hanisch,1 Niels Wedderkopp1,2 1Orthopedic Department, Hospital of Southwestern Jutland, Esbjerg, Denmark; 2Department of Regional Health Research, University of Southern Denmark, Odense, Denmark Background: There is a theoretical basis for the treatment of chronic tendinopathies by platelet-rich plasma (PRP), and it can, therefore, be considered a possible treatment of chronic Achilles tendinopathies (CATs), even though the clinical evidence for the use is not clear and, in addition, there is a lack of treatment algorithms and it is unclear which type of PRP is most effective. The objective of this study was through the comparison of two case series to assess: 1) the effect of PRP on CAT and 2) if there is any difference in effect between leukocyte-rich PRP (LR-PRP) and leukocyte-poor PRP (LP-PRP) in the treatment of CAT. Patients and methods: Two separate series of achilles tenodinopathies treated with either LR-PRP or LP-PRP were evaluated with a natural experiment/quasi-experimental study design, with a short-term (2 months) and long-term (8–42 months) follow-up to assess the effect and stability of the treatment. In total, 84 patients with failed basic treatment for CAT for at least 6 months were treated with either Biomet’s GPS III recovery kit with LR-PRP (36 patients) or with Arthrex ACP LP-PRP (48 patients). Results: The overall probability of reaching a minimal clinically important change (MCIC) of at least 30% reduction in visual analog scale (VAS) was in activity (63%) and during rest (81%), and for Victorian Institute of Sport Assessment Scale (VISA-A), it was 61%. There was no statistical difference in change of VISA-A score or VAS between the patients treated with LP-PRP and LR-PRP. Conclusion: PRP seems to be a possible treatment when all other treatment regimens have failed, with a reasonably high probability of reaching MCIC. The choice of either LR-PRP or LP-PRP seems to be up to personal preference as there were no significant differences between patients treated with LR-PRP and LP-PRP. Keywords: platelet-rich plasma, leukocyte-rich PRP, leukocyte-poor PRP, Achilles tendinopathy |
topic |
Platelet rich plasma Leukocyte rich PRP Leukocyte poor PRP Achilles tendinopathy |
url |
https://www.dovepress.com/platelet-rich-plasma-prp-treatment-of-noninsertional-achilles-tendinop-peer-reviewed-article-ORR |
work_keys_str_mv |
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