Takeaway
- The PATH-2 randomised controlled trial (RCT) finds no benefit from autologous platelet-rich plasma (PRP) injection for acute Achilles tendon rupture.
Why this matters
- Incidence of Achilles tendon rupture is growing and is linked to disability and many months off sports.
- Previous trials have been methodologically flawed.
Study design
- Randomised, placebo-controlled, participant and assessor masked superiority trial known as PATH-2 held at 19 hospitals in the United Kingdom (n=230 adults within 12 days of rupture).
- Main outcome: limb symmetry index (injured/uninjured limb×100) in maximal work done during heel rise endurance test (in which participants stood on each leg in turn and raised and lowered the heel until it fatigued).
- Funding: Medical Research Council; National Institute for Health Research.
Key results
- No difference between groups in limb symmetry index (34.67%±standard deviation, 17.66% vs 38.54%±22.82% in placebo group; adjusted mean difference, −3.87%; 95% CI, −10.45% to 2.71%).
- No differences between groups in secondary outcomes including patient-reported function (Achilles tendon rupture score), quality of life (Short Form-12), pain (visual analogue scale), goal attainment (patient-specific functional scale), and adverse events.
Limitations
Different volumes of whole blood were taken from the 2 groups (55 mL from the platelet-rich plasma group vs5 mL from the placebo group).
References
References
