PMID- 37964467
OWN - NLM
STAT- MEDLINE
DCOM- 20240214
LR  - 20240214
IS  - 1944-7876 (Electronic)
IS  - 1071-1007 (Linking)
VI  - 45
IP  - 2
DP  - 2024 Feb
TI  - Outcomes of Platelet-Rich Plasma Infiltration and Weightbearing Cast 
      Immobilization in Distal Tibialis Anterior Tendinopathy: A Prospective Cohort 
      Study.
PG  - 158-165
LID - 10.1177/10711007231210506 [doi]
AB  - BACKGROUND: Distal tibialis anterior tendinopathy (DTAT) is a chronic condition 
      that may lead to functional impairment and secondary forefoot deformities when 
      left untreated. Current clinical practice is mainly guided by case reports and 
      small retrospective case series; little consensus exists on which treatment 
      protocol is most effective. This study aims to assess a conservative treatment 
      for DTAT consisting of PRP infiltration and walking cast immobilization. METHODS: 
      This prospective study included 18 feet in 18 patients, recruited between 
      September 2020 and September 2022 at a single institution. Ultrasonography was 
      performed; leukocyte-poor PRP was infiltrated around the tibialis anterior tendon 
      insertion. Walking cast immobilization was used for 3 weeks after infiltration, 
      followed by eccentric exercises of the DTAT, and gastrocnemius-soleus muscle 
      complex stretching. Clinical findings, visual analog scale (VAS), Foot Function 
      Index (FFI), and American Orthopaedic Foot & Ankle Society (AOFAS) midfoot scores 
      were recorded at inclusion, and 6 and 12 weeks after PRP infiltration. Minimal 
      clinically important difference (MCID) limits were researched to assess clinical 
      relevance of statistical outcomes. Means were determined for age, sex, and body 
      mass index (BMI). One-way repeated measures ANOVA was performed over time for 
      FFI, AOFAS, and VAS scores. RESULTS: Mean age was 65 years with a mean BMI of 25. 
      Tendon thickening and hypoechogenicity were the most commonly reported 
      ultrasonographic findings. Significant improvement from baseline VAS (VAS(rest): 
      4.71 +/- 2.7, VAS(activity): 5.66 +/- 2.5) to 12 weeks follow-up (VAS(rest): 
      2.14 +/- 2.7, VAS(activity): 3.34 +/- 2.5) was found. Both AOFAS and FFI(Total) 
      improved significantly from baseline (AOFAS: 66.9 +/- 3.3, FFI(Total): 32.9 +/- 3.3) 
      to 6-week follow-up (AOFAS(6w): 79.4 +/- 3.3, P = .019; FFI(Total): 19.4 +/- 3.3, 
      P = .011). No statistically significant further improvement was found at 12 weeks 
      compared to 6 weeks' follow-up. Two (11%) patients chose operative treatment 
      because of persisting symptoms. CONCLUSION: We found that PRP infiltration with 
      walking cast immobilization as a first-line treatment was associated with general 
      early symptom improvement. LEVEL OF EVIDENCE: Level IV, case series.
FAU - Desomer, Lies
AU  - Desomer L
AUID- ORCID: 0000-0002-6306-9641
AD  - Department of Orthopedic Surgery, St-Elisabeth General Hospital, Herentals, 
      Belgium.
FAU - van Beek, Nathalie
AU  - van Beek N
AD  - Department of Orthopedic Surgery, St-Elisabeth General Hospital, Herentals, 
      Belgium.
FAU - Van Riet, Anne
AU  - Van Riet A
AD  - Department of Orthopedic Surgery, St-Elisabeth General Hospital, Herentals, 
      Belgium.
FAU - Verfaillie, Stefaan
AU  - Verfaillie S
AD  - Department of Orthopedic Surgery, St-Elisabeth General Hospital, Herentals, 
      Belgium.
LA  - eng
PT  - Comment
PT  - Journal Article
DEP - 20231114
PL  - United States
TA  - Foot Ankle Int
JT  - Foot & ankle international
JID - 9433869
SB  - IM
CON - J Am Acad Orthop Surg. 2016 Feb;24(2):113-22. PMID: 26803546
MH  - Humans
MH  - Aged
MH  - Prospective Studies
MH  - Retrospective Studies
MH  - *Tendinopathy/surgery
MH  - Muscle, Skeletal
MH  - *Platelet-Rich Plasma
MH  - Weight-Bearing
MH  - Treatment Outcome
OTO - NOTNLM
OT  - midfoot
OT  - outcome studies
OT  - platelet-rich plasma
OT  - tendon disorders
OT  - tibialis anterior tendon
COIS- Ethical ApprovalThis study was approved by the Ethics Committee review board of 
      AZ Herentals and UZ Leuven (ref. B322202043314) and was conducted according to 
      the Declaration of Helsinki (2013) and Good Clinical Practice principles. 
      Declaration of Conflicting InterestsThe author(s) declared no potential conflicts 
      of interest with respect to the research, authorship, and/or publication of this 
      article. ICMJE forms for all authors are available online.
EDAT- 2023/11/15 06:43
MHDA- 2024/02/12 15:43
CRDT- 2023/11/15 00:22
PHST- 2024/02/12 15:43 [medline]
PHST- 2023/11/15 06:43 [pubmed]
PHST- 2023/11/15 00:22 [entrez]
AID - 10.1177/10711007231210506 [doi]
PST - ppublish
SO  - Foot Ankle Int. 2024 Feb;45(2):158-165. doi: 10.1177/10711007231210506. Epub 2023 
      Nov 14.