• Humans
• Tendinopathy/physiopathology
• Tendinopathy/therapy
• Tendinopathy/etiology
• Achilles Tendon/physiopathology
• Quality of Life/psychology

• Achilles Tendon
• Exercise Therapy
• Rehabilitation
• Tendinopathy

• Military Personnel
• Musculoskeletal disorders
• REHABILITATION MEDICINE
• SPORTS MEDICINE

• Achilles
• corticosteroids
• high-volume injection
• tendinopathy

• Humans
• Tendinopathy/therapy
• Achilles Tendon
• Anesthetics, Local/administration & dosage
• Adrenal Cortex Hormones/administration & dosage
• Platelet-Rich Plasma
• Treatment Outcome
• Injections/methods

• NF‐κB
• biomaterials
• fibrosis
• inflammation
• pain
• tendinopathy

• Humans
• Tendinopathy/drug therapy
• Tendinopathy/therapy
• Fibrosis/drug therapy
• Animals
• Inflammation/drug therapy
• Tendons/drug effects
• Tissue Engineering/methods
• Signal Transduction/drug effects
• Genetic Therapy/methods

• achilles tendon
• sports medicine
• tendinopathy

• Humans
• Tendinopathy/therapy
• Female
• Male
• Achilles Tendon
• Prospective Studies
• Middle Aged
• Social Class
• Adult
• Treatment Outcome
• Severity of Illness Index
• Conservative Treatment
• Low Socioeconomic Status

• Ordinal outcomes
• Proportional odds model
• Randomised controlled trials
• Scoping review

• Humans
• Randomized Controlled Trials as Topic/methods
• Randomized Controlled Trials as Topic/statistics & numerical data
• Data Interpretation, Statistical
• Research Design/statistics & numerical data
• Treatment Outcome
• Models, Statistical
• Endpoint Determination

• ID 1171422 National Health and Medical Research Council
• ID 1035261 National Health and Medical Research Council
• ID 1127984 National Health and Medical Research Council
• 1159225 National Health and Medical Research Council

• Achilles
• physiotherapy
• tendinopathy
• tendon

• Humans
• Tendons
• Tendinopathy/therapy
• Social Media
• Achilles Tendon

• hydrodissection
• lateral elbow tendinopathy
• percutaneous needle tenotomy
• physiotherapy
• ultrasound

• Humans
• Male
• Adult
• Achilles Tendon/surgery
• Tendinopathy/therapy
• Ultrasonography/adverse effects
• Cicatrix/complications
• Adipose Tissue

The effectiveness of Platelet-Rich Plasma (PRP) in the treatment of patients with Achilles tendon rupture (ATR) and Achilles tendinopathy (AT) has been controversial.

To assess PRP injections’ effectiveness in treating ATR and AT.

A comprehensive review of relevant literature was conducted utilizing multiple databases such as Cochrane Library, PubMed, Web of Science, Chinese Science and Technology Journal, EMBASE, and China Biomedical CD-ROM. The present investigation integrated randomized controlled trials that assessed the effectiveness of platelet-rich plasma injections in managing individuals with Achilles tendon rupture and tendinopathy. The eligibility criteria for the trials encompassed publications that were published within the timeframe of January 1, 1966 to December 2022. The statistical analysis was performed utilizing the Review Manager 5.4.1, the visual analogue scale (VAS), Victorian Institute Ankle Function Scale (VISA-A), and Achilles Tendon Thickness were used to assess outcomes.

This meta-analysis included 13 randomized controlled trials, 8 of which were randomized controlled trials of PRP for AT and 5 of which were randomized controlled trials of PRP for ATR. PRP for AT at 6 wk [weighted mean difference (WMD) = 1.92, 95%CI: -0.54 to 4.38, I² = 34%], at 3 mo [WMD = 0.20, 95%CI: -2.65 to 3.05, I² = 60%], and 6 mo [WMD = 2.75, 95%CI: -2.76 to 8.26, I² = 87%) after which there was no significant difference in VISA-A scores between the PRP and control groups. There was no significant difference in VAS scores between the PRP group and the control group after 6 wk [WMD = 6.75, 95%CI: -6.12 to 19.62, I² = 69%] and 6 mo [WMD = 10.46, 95%CI: -2.44 to 23.37, I² = 69%] of treatment, and at mid-treatment at 3 mo [WMD = 11.30, 95%CI: 7.33 to 15.27, I² = 0%] after mid-treatment, the PRP group demonstrated better outcomes than the control group. Post-treatment patient satisfaction [WMD = 1.07, 95%CI: 0.84 to 1.35, I² = 0%], Achilles tendon thickness [WMD = 0.34, 95%CI: -0.04 to 0.71, I² = 61%] and return to sport [WMD = 1.11, 95%CI: 0.87 to 1.42, I² = 0%] were not significantly different between the PRP and control groups. The study did not find any statistically significant distinction between the groups that received PRP treatment and those that did not, regarding the Victorian Institute of Sport Assessment - Achilles scores at 3 mo [WMD = -1.49, 95%CI: -5.24 to 2.25, I² = 0%], 6 mo [WMD = -0.24, 95%CI: -3.80 to 3.32, I² = 0%], and 12 mo [WMD = -2.02, 95%CI: -5.34 to 1.29, I² = 87%] for ATR patients. Additionally, no significant difference was observed between the PRP and the control groups in improving Heel lift height respectively at 6 mo [WMD = -3.96, 95%CI: -8.61 to 0.69, I² = 0%] and 12 mo [WMD = -1.66, 95%CI: -11.15 to 7.83, I² = 0%] for ATR patients. There was no significant difference in calf circumference between the PRP group and the control group after 6 mo [WMD = 1.01, 95%CI: -0.78 to 2.80, I² = 54%] and 12 mo [WMD = -0.55, 95%CI: -2.2 to 1.09, I² = 0%] of treatment. There was no significant difference in ankle mobility between the PRP and control groups at 6 mo of treatment [WMD = -0.38, 95%CI: -2.34 to 1.58, I² = 82%] and after 12 mo of treatment [WMD = -0.98, 95%CI: -1.41 to -0.56, I² = 10%] there was a significant improvement in ankle mobility between the PRP and control groups. There was no significant difference in the rate of return to exercise after treatment [WMD = 1.20, 95%CI: 0.77 to 1.87, I² = 0%] and the rate of adverse events [WMD = 0.85, 95%CI: 0.50 to 1.45, I² = 0%] between the PRP group and the control group.

The use of PRP for AT improved the patient’s immediate VAS scores but not VISA-A scores, changes in Achilles tendon thickness, patient satisfaction, or return to sport. Treatment of ATR with PRP injections alone improved long-term ankle mobility but had no significant effect on VISA-A scores, single heel lift height, calf circumference or return to sport. Additional research employing more extensive sampling sizes, more strict experimental methods, and standard methodologies may be necessary to yield more dependable and precise findings.

• Platelet-Rich plasma
• Achilles tendon rupture
• Achilles tendinopathy
• Systematic evaluation
• Randomized controlled trial

• MAPK
• ROS
• fullerenol
• inflammation
• tendinopathy

Chronic Achilles and patellar tendinopathy are a significant burden in physically active populations. High-volume image-guided injection (HVIGI) proposes to strip away associated neovascularity, disrupt painful nerve ingrowth, and facilitate rehabilitation.

To investigate the efficacy of HVIGI with and without steroid relative to placebo.

Randomized controlled trial; Level of evidence, 1.

A total of 62 participants were recruited between May 25, 2016, and March 5, 2020. Participants were men aged 18 to 55 years with Achilles or patellar tendinopathy of at least 6-month chronicity that had not improved with nonoperative management (including physical therapy and shockwave therapy), with ultrasound evidence of neovascularization, tendon thickening, and echogenic changes. They were assigned to the following groups: control (3 mL of subcutaneous 0.5% bupivacaine), HVIGI (10 mL of 0.5% bupivacaine and 30 mL of normal saline, ultrasound-guided between tendon and underlying fat pad), or HVIGI with steroid (HVIGIwSteroid; 0.25 mL of 100 mg/mL hydrocortisone). Clinicians and assessors were blinded. All participants were supervised through a pain-guided progressive loading program for 6 months postinjection. The main outcome measures were the Victoria Institute of Sport Assessments (VISA) for Achilles and patellar tendinopathy and the visual analog scale (VAS) for pain at 6 months postinjection.

The VISA score improved by a mean of 22.8 points (95% CI, 10.4-35.3 points; effect size [ES], 1.51) in the control group (n = 21), 18.6 points (95% CI, 9.1-28.0 points; ES, 1.31) in the HVIGI group (n = 21), and 18.5 points (95% CI, 3.4-33.6 points; ES, 0.88) in the HVIGIwSteroid group (n = 20). VAS pain improved by a mean of 15 points (interquartile range [IQR], –38.75, 8 points; ES, 0.39) in controls, 13 points (IQR,–34.0, 3.75 points; ES, 0.47) in the HVIGI group, and 27 points (IQR,–38.0, –1.0 points; ES, 0.54) in the HVIGIwSteroid group. The main effects were significant for time (P < .001) but not group (P ≥ .48), with no group × time interaction (P = .71). One participant was lost to follow-up from each group, multiple imputation was used for missing data points. No adverse events occurred.

Study findings did not demonstrate superiority of HVIGI over control injection.

EU Clinical Trials Register (EudraCT: 2015-003587-36).

• Humans
• Achilles Tendon
• Outcome Assessment, Health Care
• Prospective Studies
• Randomized Controlled Trials as Topic
• Tendinopathy/therapy
• Consensus Development Conferences as Topic
• Clinical Trials as Topic

• R01 AR072034 NIAMS NIH HHS
• R01AR072034 National Institute Of Arthritis And Musculoskeletal And Skin Diseases of the National Institutes of Health (US)

• Achilles tendinopathy
• high volume injection
• injection
• randomised controlled trial

• Achilles tendon
• Coping
• Neuropathic pain
• Sensitization

• Achilles
• economics
• quality of life
• sociology
• tendinosis