E López-Gavito1, L A Gómez-Carlín, P Parra-Téllez, J Vázquez-Escamilla. 1. Instituto Nacional de Rehabilitación, Ortopedia, Jefatura de la División de Ortopedia Pediátrica y Deformidades Neuromusculares, 4o Piso, Calzada México-Xochimilco Núm. 289, Col. Arenal de Guadalupe, C.P 14389, México, DF. egavito@hotmail.com
Abstract
INTRODUCTION: Non-surgical treatment of Achilles tendinopathies ad plantar fasciitis has shown good results in up to 90% of cases. However, the remaining 10% of patients with these conditions represent a true challenge for the orthopedic surgeon. New technologies for the development of orthobiologic materials make it possible to use platelet-rich plasma (PRP) as an alternative to treat cases that have been refractory to prior treatment and that have a chronicity exceeding 12 months. MATERIAL AND METHODS: Prospective, analytical study. Patients with diagnosis of Achilles tendinopathy, plantar fasciitis or both, with a course of more than 12 months, previously treated with non-surgical alternatives, without any clinical improvement. The AOFAS hindfoot scale was used, together with the Visual Analog Scale (VAS) for pain, and photographic documentation at 2, 4, 8 and 12 months after infiltration. A treatment program that included immobilization, NSAIDs, eccentric exercises for the Achilles-calcaneal-plantar system and strengthening of the sural triceps was established. The statistical analysis included measurements of the central trend and scatter with the SPSS 15. RESULTS: A sample consisting of 10 patients (12 feet) that met the diagnostic and inclusion criteria was obtained. Mean age at the time of presentation was 43 years (range 23-56), with females being predominant (70%) and 50% laterality for the right and left feet. The initial AOFAS score was 39 (range 28-68) and the VAS score was 9 (range 7-10). By week 16 the AOFAS score had increased to 97 (range 88-99) and the VAS score was 2 (range 1-4). All patients resumed independent gait. CONCLUSION: The use of PRP in patients with Achilles tendinopathy and plantar fasciitis is an effective and safe alternative for the management of patients with a poor response to conventional non-surgical treatment. Other non-surgical modalities are recommended besides PRP for the treatment of these patients to achieve appropriate results.
INTRODUCTION: Non-surgical treatment of Achilles tendinopathies ad plantar fasciitis has shown good results in up to 90% of cases. However, the remaining 10% of patients with these conditions represent a true challenge for the orthopedic surgeon. New technologies for the development of orthobiologic materials make it possible to use platelet-rich plasma (PRP) as an alternative to treat cases that have been refractory to prior treatment and that have a chronicity exceeding 12 months. MATERIAL AND METHODS: Prospective, analytical study. Patients with diagnosis of Achilles tendinopathy, plantar fasciitis or both, with a course of more than 12 months, previously treated with non-surgical alternatives, without any clinical improvement. The AOFAS hindfoot scale was used, together with the Visual Analog Scale (VAS) for pain, and photographic documentation at 2, 4, 8 and 12 months after infiltration. A treatment program that included immobilization, NSAIDs, eccentric exercises for the Achilles-calcaneal-plantar system and strengthening of the sural triceps was established. The statistical analysis included measurements of the central trend and scatter with the SPSS 15. RESULTS: A sample consisting of 10 patients (12 feet) that met the diagnostic and inclusion criteria was obtained. Mean age at the time of presentation was 43 years (range 23-56), with females being predominant (70%) and 50% laterality for the right and left feet. The initial AOFAS score was 39 (range 28-68) and the VAS score was 9 (range 7-10). By week 16 the AOFAS score had increased to 97 (range 88-99) and the VAS score was 2 (range 1-4). All patients resumed independent gait. CONCLUSION: The use of PRP in patients with Achilles tendinopathy and plantar fasciitis is an effective and safe alternative for the management of patients with a poor response to conventional non-surgical treatment. Other non-surgical modalities are recommended besides PRP for the treatment of these patients to achieve appropriate results.