Iacono Venanzio, Natali Simone, De Berardinis Luca, Screpis Daniele, Gigante Antonio Pompilio, Zorzi Claudio
Department of Orthopaedics, IRCCS Ospedale Sacro Cuore Don Calabria, 37024 Negrar, Italy.
Clinical Orthopaedics, Department of Clinical and Molecular Sciences, Università Politecnica delle Marche, 60020 Ancona, Italy.
J Clin Med. 2023 Apr 6;12(7):2747. doi: 10.3390/jcm12072747.
(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.
（1）背景：跟腱病（AT）的特征是负荷引起的肌腱疼痛、僵硬和功能障碍，可能影响肌腱中部或附着点。富血小板纤维蛋白基质（PRFM）是一种有前景的AT辅助治疗方法。我们分析了一组接受肌腱清创术和自体PRFM治疗的患者的24个月疼痛和功能结局，以确定联合治疗是否能确保患者早日恢复运动/工作以及获得满意的临床结局和功能评分。（2）方法：评估32例患有慢性中部AT的运动患者接受清创术和自体PRFM治疗24个月后的恢复运动/工作时间。术前以及术后6个月和24个月计算美国足踝外科协会（AOFAS）评分和维多利亚州运动协会跟腱评估（VISA - A）评分。术前以及术后6个月评估布莱齐纳（Blazina）评分；在术后1个月、6个月、12个月和24个月评估踝关节活动范围；在术后24个月评估患者满意度。（3）结果：总体而言，所有患者在25.41天（±5.37）后恢复了同等或更高水平的运动活动。在工作方面，所有患者在16.41天（±2.43）后能够重返工作岗位。踝关节背屈和跖屈显著增加：AOFAS评分在术后6个月和12个月分别从54.56（±6.47）升至97.06（±4.06）和98.88（±2.21），治疗后VISA - A平均评分从术前的69.16（±7.35）分别升至术后6个月的95.03（±4.67）和12个月的97.28（±2.43）。未出现并发症。大多数（90.62%）患者非常满意。（4）结论：在有症状的中部AT患者中，手术清创术和自体PRFM可确保患者快速恢复运动/工作（4周），在术后6个月时AOFAS、VISA - A和Blazina评分即显著改善，并在24个月时提供出色的临床结局。
