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. 2023 Apr 6;12(7):2747.
doi: 10.3390/jcm12072747.

Return to Sports and Functional Outcomes after Autologous Platelet-Rich Fibrin Matrix (PRFM) and Debridement in Midportion Achilles Tendinopathy: A Case Series with 24-Month Follow-Up

Venanzio Iacono  1 , Simone Natali  1 , Luca De Berardinis  2 , Daniele Screpis  1 , Antonio Pompilio Gigante  2 , Claudio Zorzi  1
Affiliations

Return to Sports and Functional Outcomes after Autologous Platelet-Rich Fibrin Matrix (PRFM) and Debridement in Midportion Achilles Tendinopathy: A Case Series with 24-Month Follow-Up

Venanzio Iacono et al. J Clin Med. .

Abstract

(1) Background: Achilles tendinopathy (AT) is characterized by load-induced tendon pain, stiffness, and functional impairment that may affect the tendon midportion or insertion. Platelet-rich fibrin matrix (PRFM) is a promising adjunctive therapy for AT. We analyzed 24-month pain and functional outcomes in a cohort of patients managed by tendon debridement and autologous PRFM application to determine whether the combined treatment ensured an early return to sports/work and satisfactory clinical outcomes and functional scores. (2) Methods: The 24-month outcomes of 32 sport-practicing patients with chronic midportion AT treated with debridement and autologous PRFM were evaluated in terms of time to return to sports/work. The AOFAS and VISA-A were computed preoperatively and at 6 and 24 months. Blazina scores were evaluated preoperatively and at 6 months; ankle range of motion was assessed at 1, 6, 12, 24 months; and patient satisfaction was assessed at 24 months. (3) Results: Altogether, all patients had resumed their sport(s) activity, at the same or higher level, after 25.41 days (±5.37). Regarding work, all patients were able to return to their jobs after 16.41 days (±2.43). Ankle dorsiflexion and plantarflexion increased significantly: the AOFAS rose from 54.56 (±6.47) to 97.06 (±4.06) and 98.88 (±2.21) at 6 and 12 months, respectively, and the mean VISA-A score rose from 69.16 (±7.35) preoperatively to 95.03 (±4.67) and 97.28 (±2.43) at 6 and 12 months, respectively, after treatment. There were no complications. Most (90.62%) patients were very satisfied. (4) Conclusions: In symptomatic midportion AT, surgical debridement and autologous PRFM ensured a fast return to sports/work (4 weeks), significantly improving AOFAS and VISA-A and Blazina scores already at 6 months and providing excellent clinical outcomes at 24 months.

Keywords: Achilles tendon; athletes; autologous PRFM; return to sports; return to work; tendinopathy.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Sagittal fat-saturated (A) and axial T1 (B) show midportion Achilles tendinopathy.
Figure 2
Figure 2
Patient eligibility.
Figure 3
Figure 3
The autologous platelet-rich fibrin matrix (PRFM).
Figure 4
Figure 4
Surgical procedure: (A) access to the Achilles tendon; (B) debridement of the tendon midportion; (C) application of autologous PRFM; (D) suture of the fascia; (E) suture of the skin.
Figure 5
Figure 5
Blazina scores of the 32 patients before surgery and at 6 months.
See this image and copyright information in PMC

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