Current Concepts in Orthobiologics for Achilles Tendon Injuries: A Critical Analysis Review.

JBJS Rev · Nov 01 2024 · Review

Gopinatth V, Boghosian T, Perugini JM, Smith MV, Knapik DM

Department of Orthopaedic Surgery, Washington University School of Medicine, St. Louis, Missouri

Sports Medicine Foot & Ankle

SUMMARY — THE REDUCTIONThis critical review finds PRP and hyaluronic acid are low-risk options for Achilles tendinopathy with mixed, lower-quality evidence, while other biologics and exosomes lack high-level evidence and need standardized study protocols.
Abstract, as published

» Platelet-rich plasma and hyaluronic acid are low-risk and potentially high-reward treatments for Achilles tendinopathy, although clinical studies have yielded mixed results with questionable methodological quality» Case series and reports have reported that bone marrow aspirate, stem cells, and amniotic membrane products can improve functional outcomes, alleviate pain, and facilitate return to sport and activities, but high-level evidence studies are lacking» Exosomes are a promising novel biologic with laboratory studies showing improved collagen organization and cell proliferation, greater tendon mechanical properties, and prevention of extracellular matrix breakdown.» Standardization of protocols with clear reporting is necessary for future studies evaluating orthobiologic therapies for Achilles tendon injuries.

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