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Autologous conditioned plasma does not improve function after Achilles rupture

No significant differences in complications were found between injected patients and the control group.

Issue: April 2012

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Use of autologous conditioned plasma for Achilles tendon rupture showed no statistically significant impact on functional outcomes compared with a nonoperative control group, according to a study presented by Kevin N. Willits, MD, at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting in San Francisco.

“At 1-year follow-up, we found no difference in range of motion, strength, calf circumference or Leppillahti functional score. However, there was no complications from the injected [autologous conditioned plasma] ACP, and we did have a slightly lower rate of re-rupture and had fewer complications,” Willits said during his presentation.

The study included 73 patients with an average age of 40.8 years who were clinically diagnosed with fresh Achilles tendon ruptures. One cohort received two ACP injections at the rupture site — once at initial presentation and another injection 2 weeks later.

The control and experimental groups underwent similar rehabilitation protocols. Outcome measures for the study included strength, range of motion, calf circumference and Leppilahti score.

The researchers noted three re-ruptures in the control group and two in the ACP group, Willits said. The investigators found no statistically significant difference in the rate of complications between the groups. At 1 year, the team found no statistically significant differences between the groups in terms of dorsiflexion, strength, calf circumference or Leppilahti score.

Willits noted that ACP may have implications for aggressive rehabilitation protocols.

“Biologically, ACP has the potential to advance Achilles tendon healing, and we are looking at more in depth ways to measure that. Perhaps we can arrive at a more aggressive rehabilitation approach that can meet the needs of patients who receive ACP injections and as a result may be healing at a faster rate. There is much more work to be done to determine the role of products like ACP in helping to optimize healing” Willits said. – by Renee Blisard

Reference:

• Kaniki N, Willits K, Fung V, Bryant D. Autologous conditioned plasma for nonoperative treat­ment of Achilles tendon ruptures. Paper #58. Presented at the American Academy of Orthopaedic Surgeons 2012 Annual Meeting. Feb. 7-11. San Francisco.

For more information:

• Kevin N. Willits, MD, can be reached at Fowler Kennedy Sport Medicine Clinic, 3M Centre, University of Western Ontario, London ON N6A 3K7, Canada; 519-661-3011; email: kwillits2001@yahoo.ca.
• Disclosure: Willits receives research support from Arthrex Inc. and Smith & Nephew.