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Comparative Effectiveness Review of Platelet-Rich Plasma for Treatment of Conditions of the Achilles Tendon and Plantar Fascia

March 1, 2018

Health Problem: Conditions of the Achilles tendon, such as Achilles tendon rupture (ATR) or Achilles tendinopathy (AT), as well as conditions of the plantar fascia (plantar fasciitis [PF]) can result from overuse or can be due to sports, age, and/or a combination of several factors.

Technology Description: Platelet-rich plasma (PRP) is blood plasma with a higher-than-usual concentration of platelets. The injection of autologous PRP is proposed to improve local healing, thereby treating conditions, including ATR, AT, and PF.

Controversy: PRP preparations are not standardized and exhibit wide variability in platelet and white blood cell concentrations, as well as the use of thrombin activators. How these variations in PRP composition may affect clinical outcomes is unclear.

Key Questions:

  • Is PRP effective in treating the functional deficits and pain associated with ATR, AT, or PF?
  • Is PRP safe when used to treat ATR, AT, or PF?
  • How does the efficacy and safety of PRP compare with other treatments for these indications?
  • Have definitive patient selection criteria been identified for use of PRP in conditions of the Achilles tendon and plantar fascia?