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02-02-2012 | Physical rehabilitation | Article

Cell therapy shows potential for treating Achilles tendonitis

Abstract

Free abstract

MedWire News: Injections of skin-derived collagen producing cells may offer a novel treatment for Achilles tendonitis, suggests research published in the Journal of Bone and Joint Surgery.

"These preliminary short-term results demonstrate that the injection of skin-derived fibroblasts for the treatment of Achilles tendinosis is safe," report Haron Obaid and co-authors, from the Royal National Orthopaedic Hospital in Stanmore, Middlesex, UK.

"However, larger studies with a longer duration of follow-up are required to determine the long-term effectiveness before wider clinical application is considered," they emphasize.

The team recruited 32 patients, aged an average of 45.2 years, with a confirmed clinical and radiographic diagnosis of Achilles tendonitis (40 tendons) that did not respond to physiotherapy.

A sample of skin cells was taken using punch biopsy and cultured and expanded in a laboratory.

The patients with unilateral tendonitis were randomly assigned to receive ultrasound-guided injection of skin-derived fibroblasts suspended in autologous plasma (n=12) or a control injection of local anesthetic (n=12). The patients were then given advice on a standardized eccentric-loading physiotherapy and followed-up 1, 3, and 6 months.

Similarly, patients with bilateral tendonitis were also randomly assigned fibroblast or control treatments for each tendon, given physiotherapy advice, and followed up.

All patients completed the study and none of the patients experienced any adverse effects.

Furthermore, the researchers recorded a significant difference in both Victorian Institute of Sport Assessment (VISA) questionnaire for symptoms, function, and ability to play sports, and visual analog scale (VAS) scores for health between patients given fibroblasts and controls at the 6-month check-up.

Small but significant differences were also noted for VISA score after 1 and 3 months for unilateral tendonitis patients, and VAS scores at 1 month.

However, no such significant differences were identified for patients with bilateral tendonitis in either VISA or VAS scores.

While recognizing the many challenges, such as costly preparation and storage, the team says "cell therapy remains an exciting potential treatment for Achilles and other tendon disorders."

The researchers conclude: "Although this novel technique may have a role in ameliorating a patient's symptoms and physical performance, larger studies with longer term follow-up periods are needed to achieve maximum healing potential and determine the long-term effectiveness."

By Lynda Williams

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