Editor-in-Chief: Alaa Abd-Elsayed, MD, PhD
BACKGROUND: Platelet-rich plasma (PRP) has become a main component of regenerative medicine. It is used in various musculoskeletal tendinous and skeletal injuries, however, literature regarding PRP’s use in chronic anterior ankle pain is limited.
OBJECTIVES: To determine the effectiveness of PRP in treating tibialis anterior (TA) tendon pain in patients who have failed traditional conventional therapeutic treatments.
STUDY DESIGN: Retrospective chart review.
SETTING: Outpatient interventional pain clinic at an academic center.
METHODS: Adults (n = 10), aged 18 and older, with greater than 6 months of TA tendon pain who failed conservative therapies. Patients who had undergone previous regenerative injections were excluded. PRP injection was administered with ultrasound guidance. Change in pain score was assessed using the Numeric Rating Scale (NRS-11: 0 = no pain, 10 = excruciating pain), and patient’s self-reported reduction in pain (percentage), pre- and postprocedure. There was a reduction in opioid dosage postprocedure. Adverse effects were recorded.
RESULTS: Average pain score at baseline was 8 ± 1.5 on the NRS-11 scale. The average percent change in pain between baseline and 8 weeks posttreatment was a 36% ± 23.2% reduction in pain. This was a significant reduction in pain score at 8 weeks post-PRP treatment when compared with baseline, P = 0.008. Average reduction in opioid dose between baseline and 8 weeks posttreatment was 17% ± 21.2%, P = 0.063. No patients experienced adverse effects.
LIMITATIONS: Small sample size, and no double-blind randomization with control group.
CONCLUSIONS: PRP use in chronic TA pain 8 weeks post-PRP treatment significantly improved chronic TA pain. There is also a tendency toward lower opioid pain medication dosages after 8 weeks post-PRP treatment, although this was not statistically significant.
KEY WORDS: Platelet-rich plasma, regenerative medicine, pain, ultrasound