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Review
. 2022 Mar 9;12(3):399.
doi: 10.3390/life12030399.

Application of Orthobiologics in Achilles Tendinopathy: A Review

Luciano C Ramires  1 , Madhan Jeyaraman  2   3 , Sathish Muthu  4 , Navaladi Shankar A  3 , Gabriel Silva Santos  5 , Lucas Furtado da Fonseca  5   6 , José Fábio Lana  5 , Ramya Lakshmi Rajendran  7 , Prakash Gangadaran  7   8 , Manasi P Jogalekar  9 , Alfredo A Cardoso  10 , Alex Eickhoff  11
Affiliations
Review

Application of Orthobiologics in Achilles Tendinopathy: A Review

Luciano C Ramires et al. Life (Basel). .

Abstract

Orthobiologics are biological materials that are intended for the regeneration of bone, cartilage, and soft tissues. In this review, we discuss the application of orthobiologics in Achilles tendinopathy, more specifically. We explain the concepts and definitions of each orthobiologic and the literature regarding its use in tendon disorders. The biological potential of these materials can be harnessed and administered into injured tissues, particularly in areas where standard healing is disrupted, a typical feature of Achilles tendinopathy. These products contain a wide variety of cell populations, cytokines, and growth factors, which have been shown to modulate many other cells at local and distal sites in the body. Collectively, they can shift the state of escalated inflammation and degeneration to reestablish tissue homeostasis. The typical features of Achilles tendinopathy are failed healing responses, persistent inflammation, and predominant catabolic reactions. Therefore, the application of orthobiologic tools represents a viable solution, considering their demonstrated efficacy, safety, and relatively easy manipulation. Perhaps a synergistic approach regarding the combination of these orthobiologics may promote more significant clinical outcomes rather than individual application. Although numerous optimistic results have been registered in the literature, additional studies and clinical trials are still highly desired to further illuminate the clinical utility and efficacy of these therapeutic strategies in the management of tendinopathies.

Keywords: Achilles tendinopathy; orthobiologics; regenerative medicine.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Pathogenesis of Achilles tendinopathy. Created with BioRender.com (accessed on 23 February 2022).
Figure 2
Figure 2
Pathophysiology of fibrosis in chronic Achilles tendinopathy. Created with BioRender.com (accessed on 23 February 2022).
Figure 3
Figure 3
Potential mechanism of action of orthobiologics in Achilles tendinopathy. Created with BioRender.com (accessed on 23 February 2022).
See this image and copyright information in PMC

References

    1. Li H.-Y., Hua Y.-H. Achilles Tendinopathy: Current Concepts about the Basic Science and Clinical Treatments. BioMed Res. Int. 2016;2016:6492597. doi: 10.1155/2016/6492597. - DOI - PMC - PubMed
    1. Waldecker U., Hofmann G., Drewitz S. Epidemiologic investigation of 1394 feet: Coincidence of hindfoot malalignment and Achilles tendon disorders. Foot Ankle Surg. 2012;18:119–123. doi: 10.1016/j.fas.2011.04.007. - DOI - PubMed
    1. A Fenwick S., Hazleman B.L., Riley G.P. The vasculature and its role in the damaged and healing tendon. Arthritis Res. Ther. 2002;4:252–260. doi: 10.1186/ar416. - DOI - PMC - PubMed
    1. Yang G., Rothrauff B.B., Tuan R.S. Tendon and ligament regeneration and repair: Clinical relevance and developmental paradigm. Birth Defects Res. Part C Embryo Today Rev. 2013;99:203–222. doi: 10.1002/bdrc.21041. - DOI - PMC - PubMed
    1. Dhillon M.S., Behera P., Patel S., Shetty V. Orthobiologics and platelet rich plasma. Indian J. Orthop. 2014;48:1–9. doi: 10.4103/0019-5413.125477. - DOI - PMC - PubMed

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