Title: Comparison of surgically repaired Achilles tendon tears using platelet-rich fibrin matrices.
Authors: Mikel Sanchez, Eduardo Anitua, Juan Azofra, Isabel Andia, sabino Padilla and Inigo Mujika
Source: American Journal of Sports Medicine 35:2 (Feb 2007): p 245(7).
PODIATRIC RELEVANCE:
Achilles tendon injuries are seen more and more in the podiatric environment, and with the ever growing population and the desire to be healthy the prevalence of this injury will only increase. Due to the poor vascular supply of the Achilles tendon’s “watershed area”, healing can be difficult and time to full recovery arduous. The goal of Achilles tendon reconstruction is early range of motion to limit post operative complications. This study demonstrates that the additions of growth factors potentates healing and earlier return to activity and thus the ultimate goal of tendon reconstruction.
METHODS:
Retrospective study of twelve athletes with unknown age and complete spontaneous rupture of their Achilles tendon were available for this study. Exclusion criteria were previous tendon injury, diabetes mellitus, platelet abnormality, hematologic abnormality, Serum hemoglobin <11g/d or hematocrit <34%, use of cortisone, and current use of anticoagulants. Six of the 12 athletes with the same mechanism of injury, matched by age, gender and physical activities were treated with the same surgical reconstruction with the addition of preparation rich in growth factors (PRGF). The remaining 6 were treated with surgical reconstruction only.
RESULTS:
Patients receiving the PRGF regained their range of motion earlier by an average of 4 weeks, showed no wound complications and returned to gentle running in less time. Also, an ultrasound cross sectional comparative analysis was obtained between the reconstructed tendon and the contralateral asymptomatic tendon of both groups. There was a 200% difference in cross sectional area between the PGRF and control group.
COMMENTS:
In the modern age, patients want to be active sooner rather than later and anything that can augment primary repair of an essential tendon is prudent in this day and age. Since Achilles tendon ruptures tend to have a long recovery time with increased risk of re-rupture, treatment modalities that speed up the lengthy process are ever more prudent. This study demonstrates that there are treatment options that can accomplish this goal. Although the patient population is small, the results are excellent and illustrate the potential of growth factors in combination with good surgical technique.
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Disclaimer:
Scientific Abstract Monthly postings are submitted by podiatric surgical residents. The ideas presented are not the opinions of the American College of Foot and Ankle Surgeons (ACFAS), nor are they presented as facts. ACFAS presents this information without any warranty of any kind, expressed or implied, and is not liable for its accuracy nor for any loss or damage caused by the user's reliance on information obtained in these areas.