Influence of Tendon Location on the Clinical Response to Platelet-Rich Plasma: A Prospective Cohort Study of Rotator Cuff, Achilles and Patellar Tendinopathies

TL;DR

This study found that PRP injections improved function in rotator cuff and Achilles tendinopathies but had less effect on patellar tendinopathy, with better results in women.

Contribution

The study is the first to compare PRP efficacy across three specific tendon locations in a prospective cohort.

Findings

PRP improved function in rotator cuff and Achilles tendinopathies but not patellar tendinopathy.

Women had a higher response rate to PRP treatment than men.

Improvements were significant for rotator cuff and Achilles but not patellar tendons at six months.

Abstract

Background/Objectives: Platelet-rich plasma (PRP) has become a therapeutic option for tendinopathies. Its clinical efficacy depends on several factors, including the target tendon. The aim of this study was to evaluate the PRP efficacy for tendinopathies in the rotator cuff (RC), Achilles tendon (AT), and patellar tendon (PT). Methods: We conducted a prospective cohort study including patients with RC, AT and PT tendinopathies. Each patient received three multitarget PRP (intratendinous and peritendinous) treatments at intervals of two weeks. Clinical outcomes were assessed at baseline and 6 months using tendon-specific scores (DASH for RC, VISA-A for AT and VISA-P for PT). Responders were identified based on the Minimal Clinically Important Improvement (MCII). Comparative statistical tests and multivariate regression were performed for the analysis. Results: A total of 49 patients were included (RC: 15, AT: 18, PT: 16). The number of responders at 6 months was 33 (67.4%), with 11 (73.3%) in the RC Group, 14 (75.0%) in the AT Group and 8 (50.0%) in the PT Group. The RC and AT patients experienced a significant improvement according to their scores (p < 0.001), which was not seen in the PT group (p = 0.065). The percentage of responders was higher in women (12/13, 92.3%) than men (21/36, 58.3%) (p = 0.025). Conclusions: Repeated intratendinous and peritendinous PRP injections in RC, AT, and PT tendinopathy improved joint-related function six months after treatment. This improvement was less pronounced in patients with PT and the proportion of responders was higher among women.

Figures