Factors associated with positive outcomes of platelet-rich plasma therapy in Achilles tendinopathy

被引:10
作者
Abate, Michele [1 ]
Di Carlo, Luigi [1 ]
Belluati, Alberto [2 ]
Salini, Vincenzo [3 ]
机构
[1] Univ G DAnnunzio, Dept Med & Sci Aging, Via Vestini 31, I-66013 Chieti, CH, Italy
[2] Santa Maria Delle Croci Hosp, Div Orthoped & Traumatol, Ravenna, Italy
[3] Osped San Raffaele, Div Orthoped & Traumatol, Milan, Italy
关键词
Achilles tendinopathy; Outcomes; Platelet-rich plasma; Ultrasound; AGE-RELATED-CHANGES; GROWTH-FACTOR CONCENTRATIONS; PATELLAR TENDINOPATHY; BODY-COMPOSITION; GENE-EXPRESSION; SEX-HORMONES; MAIN BODY; TENDON; TESTOSTERONE; INJECTION;
D O I
10.1007/s00590-020-02642-1
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
BackgroundThe efficacy of platelet-rich plasma in the treatment for Achilles tendinopathy is debated. Therefore, it is important to know which factors, related to the subjects and/or the disease, are associated with positive or negative outcomes. Aim of this study was to evaluate in a large cohort of patients with Achilles mid-portion tendinopathy which variables were independently associated with a positive outcome after platelet-rich plasma treatment.Material and methodsEighty-four subjects with Achilles tendinopathy were evaluated by means of VISA-A score and ultrasound and treated with a single platelet-rich plasma injection once a week for 3 weeks. Afterward, a rehabilitation program, based on eccentric training, was implemented. At 3 and 6 months, the relationship between the mean VISA-A score and the following putative predictors was evaluated: sex, age, physical activity, sport, smoking, metabolic risk factors, BMI, symptoms duration, tendon damage, neovessels, adherence to eccentric training. Finally, the percentage of clinically evident positive outcomes (defined as an increase in VISA-A score >= 20 points) related to each variable was computed.ResultsAt final follow-up, using the General Linear Model for Repeated Measures procedure, male sex (0.02), age <= 40 (0.05) and adequate eccentric training (0.02) were found to be independently associated with a significant increase in the mean VISA-A score. Moreover, the clinically evident positive outcomes, as previously defined, were significantly associated with male sex (0.01), age <= 40 (0.000), BMI <= 25 (0.001), symptoms duration <= 12 months (0.02) and good adherence to eccentric training (0.004).ConclusionYounger age, male sex and good adherence to eccentric training can be considered predictors of better results after platelet-rich plasma therapy in Achilles tendinopathy
引用
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页码:859 / 867
页数:9
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