Return to the original sport at only 3 months after an Achilles tendon rupture by a combination of intra-tissue injection of freeze-dried platelet-derived factor concentrate and excessively early rehabilitation after operative treatment in a male basketball player: A case report.

Published on May 28, 2021in Regenerative Therapy2.286
· DOI :10.1016/J.RETH.2021.05.002
Abstract null null Background null Achilles tendon rupture is one of the most common serious injuries in athletes. Various studies to accelerate the healing process of the Achilles tendon have been performed as it takes a longer time to repair the tissue compared to other tendons. Here, we report a case of an acute Achilles tendon rupture in a male basketball player treated by a combination of an intra-tissue injection of freeze-dried platelet-derived factor concentrate, which included a platelet-derived growth factor with an early rehabilitation protocol after the operative treatment to facilitate the biological healing of the injured tendon tissue. To the best of our knowledge, this case is the first instance that enabled the athlete to return to original sport activity at only 3-months after the injury. null null null Case report null A 23-year-old male basketball player who belonged to a university basketball team sustained an Achilles tendon rupture during running in a training match. The remaining time period until the final tournament of the university league as a senior player was only 3 months. The patient received a combination of an intra-tissue injection of freeze-dried platelet-derived factor concentrate and early rehabilitation protocol after operative treatment. Surgery was performed 4 days after the injury and the early rehabilitation protocols were applied postoperatively. A freeze-dried platelet-derived factor concentrate was injected into the ruptured site of the Achilles tendon under ultrasound guide at 4 weeks postoperatively. The patient could return to play at the pre-injury level without any symptoms and disfunctions at 3 months after surgery. At two years postoperatively, the patient could play basketball without symptoms or rerupture. null null null Conclusions null We reported a case of an Achilles tendon rupture which was treated by a combination of intra-tissue injection of freeze-dried platelet-derived factor concentrate and an early rehabilitation protocol after the operative treatment. The patient could return to play basketball at the pre-injury activity level at only 3-months after the injury, suggesting that the role of applying excessively early rehabilitation of mechanical loading could facilitate tendon tissue healing when combined with an intra-tissue injection of freeze-dried platelet-derived factor concentrate.
#1Olivera Evrova (UZH: University of Zurich)H-Index: 6
#2Damian Kellenberger (ETH Zurich)H-Index: 2
Last. Johanna Buschmann (UZH: University of Zurich)H-Index: 21
view all 5 authors...
Cell-based tendon therapies with tenocytes as a cell source need effective tenocyte in vitro expansion before application for tendinopathies and tendon injuries. Supplementation of tenocyte culture with biomolecules that can boost proliferation and matrix synthesis is one viable option for supporting cell expansion. In this in vitro study, the impacts of ascorbic acid or PDGF-BB supplementation on rabbit Achilles tenocyte culture were studied. Namely, cell proliferation, changes in gene expressi...
6 CitationsSource
#1Tomohiko Shirata (Nihon University)H-Index: 2
#2Yuki KatoH-Index: 7
Abstract Freeze-drying methods not only enable the delivery of growth factors using platelets, but also extend the shelf-life of platelet concentrates. The present study shows the clinical results of treating knee osteoarthritis with freeze-dried platelet-derived factor concentrate (PFC). While it improved pain, activities of daily living, sports and recreational activities, and knee-related quality of life, it did not significantly improve symptoms other than pain, such as restricted range of m...
3 CitationsSource
#1Linying ShiH-Index: 2
#2Rongjuan LiH-Index: 1
Last. Guiqiu ShanH-Index: 2
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: : Freeze-drying is an effective means of storing platelets. In this study, we investigated the effects of a protective agent on freeze-dried platelet-rich plasma (FD-PRP) after a 12-week preservation period. Platelet structure was measured by transmission electron microscopy (TEM), and the expression levels of procaspase activating compound (PAC)-1 and CD62P were measured by flow cytometry. The levels of transforming growth factor-beta (TGF-β), platelet-derived growth factor (PDGF) and vascula...
3 CitationsSource
Purpose Platelet-rich plasma (PRP) is currently the most exploited strategy in the clinical practice to provide a regenerative stimulus for tendon healing. The aim of the present study was to systematically review the available evidence on the treatment of the main tendon disorders where PRP is currently applied.
89 CitationsSource
1 CitationsSource
#1Mareen Braunstein (LMU: Ludwig Maximilian University of Munich)H-Index: 8
#2Sebastian F. Baumbach (LMU: Ludwig Maximilian University of Munich)H-Index: 14
Last. Hans Polzer (LMU: Ludwig Maximilian University of Munich)H-Index: 15
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Purpose Surgical repair after acute Achilles tendon rupture leads to lower re-rupture rates than non-surgical treatment. After open repair, early functional rehabilitation improves outcome, but there are risks of infection and poor wound healing. Minimal invasive surgery reduces these risks; however, there are concerns about its stability. Consequently, physicians may have reservations about adopting functional rehabilitation. There is still no consensus about the post-operative treatment after ...
23 CitationsSource
#1Ali Imad El-Akkawi (OUH: Odense University Hospital)H-Index: 1
#2Rajzan Joanroy (OUH: Odense University Hospital)H-Index: 1
Last. Bjarke Viberg (University of Southern Denmark)H-Index: 8
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Abstract Achilles tendon ruptures can be either surgically or conservatively treated with either early functional mobilization or cast immobilization. The purpose of the present study was to conduct a meta-analysis comparing the effect of early versus late weightbearing in conservatively treated adult patients, including only randomized controlled trials (RCTs). The primary endpoint was rerupture, and the secondary endpoints were strength, quality of life during treatment, range of motion, deep ...
9 CitationsSource
#1Olivera Evrova (ETH Zurich)H-Index: 6
#2Johanna Buschmann (UZH: University of Zurich)H-Index: 21
To promote and support tendon healing, one viable strategy is the use or administration of growth factors at the wound/rupture site. Platelet derived growth factor-BB (PDGF-BB), together with other growth factors, is secreted by platelets after injury. PDGF-BB promotes mitogenesis and angiogenesis, which could accelerate tendon healing. Therefore, in vitro studies with PDGF-BB have been performed to determine its effect on tenocytes and tenoblasts. Moreover, accurate and sophisticated drug deliv...
25 CitationsSource
#1Wataru Miyamoto (Teikyo University)H-Index: 13
#2Shinji Imade (Shimane University)H-Index: 8
Last. Masato Takao (Teikyo University)H-Index: 27
view all 5 authors...
Background:Although early accelerated rehabilitation is recommended for the treatment of acute Achilles tendon rupture, most traditional rehabilitation techniques require some type of brace.Methods:We retrospectively analyzed 44 feet of 44 patients (25 male and 19 female) with a mean age of 31.8 years who had an acute Achilles tendon rupture related to athletic activity. Patients had been treated by a double side-locking loop suture (SLLS) technique using double antislip knots between stumps and...
7 CitationsSource
#1Angelo De Carli (Sapienza University of Rome)H-Index: 19
#2Riccardo Maria Lanzetti (Sapienza University of Rome)H-Index: 12
Last. Mario Vetrano (Sapienza University of Rome)H-Index: 16
view all 9 authors...
Purpose Our hypothesis was that the Achilles tendon healing process after surgical treatment would be promoted by PRP with a faster return to sports activities.
28 CitationsSource
Cited By0
OBJECTIVES Acute Achilles tendon rupture (ATR) is a disabling sport-related injury. Its management involves conservative treatment with early weight-bearing or surgical treatment. Platelet-rich plasma (PRP) has raised interest as an adjuvant for treatment, given its properties on tendon repair and its anti-inflammatory effect. We aimed to assess clinical impact of PRP use in surgical or non-surgical treatment of acute ATR: range of motion, muscle strength, function, return to sport and adverse e...