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Management of post-surgical Achilles tendon complications with a preparation rich in growth factors: A study of two-cases Long Island

The incidence of Achilles tendon ruptures is rising among active individuals regardless of age. Although operative reconstruction is a standard approach to rupture care, it is accompanied by a non-trivial risk of complications.11 Overall, open repair is specially indicated for active people since it re-establishes fiber continuity, reducing re-rupture risk and improving long-term functional outcome.16 When post-surgical complications arise, their management is demanding, particularly in extensively diseased tendons. Although relatively infrequent, deep infection along with tendon necrosis can be a devastating complication requiring repeated surgery. Determining optimal treatment for this entity is a significant challenge to the orthopaedic surgeon.[14] and [17]

The emergence of platelet-rich technologies has created new therapeutic opportunities by combining an understanding of the biology of tendon injury and repair with surgical principles.[6] and 22 M. Sanchez, E. Anitua, J. Azofra, I. Andía, S. Padilla and I. Mujika, Comparison of surgically repaired Achilles tendon tears using PRGF, Am J Sports Med 35 (2) (2007), pp. 245–251. View Record in Scopus | Cited By in Scopus (21)[22] Our group is investigating the use of the versatile autologous preparation termed preparation rich in growth factors (PRGF) in different medical conditions.[3] and [21] PRGF has been shown to enhance and accelerate soft tissue repair in cutaneous ulcers,6 to improve bone repair in oral implantology7 and non-unions in orthopaedics,23 to ameliorate intra-articular conditions in select osteoarthritis (OA) patients22 and to enhance soft tissue healing and remodeling in anterior cruciate ligament (ACL) reconstructive surgery as well as ruptured Achilles tendons in professional athletes.[20] and [23]

This report describes PRGF-assisted management of major complications in two recreational athletes after initial surgical management of acute Achilles tendon rupture. To our knowledge, this is the first article reporting the use of platelet-rich preparations in severe complications after primary Achilles repair. The biosafety, versatility and ease of preparation of platelet-based formulations in combination with our promising clinical results moved us to share our experience in hopes of inspiring awareness and further investigation of this novel therapeutic option.

Published on 05-27-2009
Authors: Mikel Sancheza, Eduardo Anituab, Alejandro Colec, Alejandra Da Silvac, Juan Azofraa and Isabel Andiab
Source: Injury Extra Volume 40, Issue 1, January 2009, Pages 11-15