Houston Methodist. Leading Medicine

Ankle FAQ

Question:

I went to a large university hospital for help with my Achilles tendon rupture. I figured if anyone has the latest treatment, it would be them. They didn't disappoint me -- they are now offering something called "blood injections" into the ruptured area (along with surgery to repair the torn tendon). How much faster is this treatment? How long before I'm back on my feet?

Answer:

Blood injection therapy is a medical treatment being used for a wide range of musculoskeletal problems. It is also referred to as platelet-rich plasma (PRP) therapy because a sample of serum (blood) plasma that has much more than the normal amount of platelets is used. Blood is taken from the patient and prepared for use by removing the platelets and injecting them in a higher concentration into the damaged area. This treatment enhances the body’s natural ability to heal itself. It is used to improve healing and shorten recovery time from acute and chronic soft tissue injuries. Recovery time may vary depending on the area of the body affected. In the case of the Achilles tendon, this particular tendon does not heal well. It takes a long time to recover from an Achilles tendon rupture. And the risk of rupturing it again is fairly high. For all those reasons, finding a more effective treatment with better long-term results would be a great boon to all. Post-operative care for a repaired ruptured Achilles tendon is fairly standard with or without platelet-rich plasma (blood) injections. The patient is placed in a short leg cast (below the knee but covering the lower leg, ankle, and foot). The foot and ankle are placed in a slightly plantar flexed position (toes pointing down). This position takes pressure and load off the healing Achilles tendon. After three and a half weeks, the foot and ankle were re-cast in a more neutral position. At the end of seven weeks post-op, usually no further casting is needed. Patients wear shoes with a slight heel (again to avoid overstretching the healing tendon) for a month. During all this time, they are allowed to put as much weight on the leg and foot as they can comfortably tolerate. When all casting is completed, a physical therapy rehab program comes next. The therapist helps patients regain normal motion, sensory awareness of joint movement, and strength. A major part of the recovery process involves a home exercise program. Activities are progressed according to each patient's abilities and response to treatment. You'll move through toe raises and balance exercises to jumping and jogging activities. Sports athletes report being back at full capacity in their sport of choice by the end of five months. If the university where you are having treatment is running studies on the use of platelet-rich plasma for Achilles tendon healing, they may have some data collected that offer more specific timelines for you. Be sure and ask them the same questions you posed here and good luck! Thorsten Schepull, MD, et al. Autologous Platelets Have No Effect on the Healing of Human Achilles Tendon Ruptures. In The American Journal of Sports Medicine. January 2011. Vol. 39. No. 1. Pp. 38-47.

*Disclaimer:* The information contained herein is compiled from a variety of sources. It may not be complete or timely. It does not cover all diseases, physical conditions, ailments or treatments. The information should NOT be used in place of visit with your healthcare provider, nor should you disregard the advice of your health care provider because of any information you read in this topic.
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