I had kind of an experimental treatment for a torn tendon that didn't work. It was an injection of platelet-rich plasma into the injured Achilles tendon. I'm a pretty quick healer and I was so sure this was the answer. If it worked for other people, why didn't it work for me?

The use of platelet-rich plasms (PRP) as a potential treatment for tendon and ligament healing is fairly new. Scientists have discovered that human blood contains key ingredients for healing. The plasma portion of human blood (the clear liquid) has parts called components that may come to our aid.

In particular, tiny platelets circulate every minute of every day in the blood -- they are always there in case of an injury. Platelets help form blood clots to stop bleeding. When the body signals that there is a need for platelets, they become activated and rush to the area of injury. Once there, they clump together to form a clot and then release tiny chemicals called growth factors.

It's those growth factors that turn stem cells into tendons. Stem cells are basic cells that haven't formed a specific type of cell (e.g., heart, muscle, joint, organ). The body can turn a stem cell into any kind of cell needed including tenocytes (tendon cells).

Injecting blood plasma with its rich supply of platelets into a damaged tendon has been shown to stimulate the growth of new tendon cells. But there are more things we don't know about it than things we do know about it. We know that it does help soft tissues like tendons and ligament heal. Scientists are still trying to unravel the 'why' and the 'how' of it.

There aren't a lot of studies out yet to give us an answer for your particular situation that is certain. Some studies have shown that a single injection may not be enough to get the healing response needed.

There's a difference between making more tenocytes (tendon cells) and having enough that are strong and able to withstand mechanical forces placed on the area when walking, running, or jumping. In other words, more may not be enough unless there is mechanical strength to the new cells.

And it's clear that platelet-rich plasma needs a place to hang its hat. Just injecting this solution into the damaged area without a scaffold for it won't work either. The cells need a place to cling to -- without such a place, the cells dissipate or scatter and disappear without the intended effect.

With only one injection behind you, it may be time to head back to the physician treating you and see what is the next step. It could be that a series of injections is planned and you've only completed the first step. Or perhaps a different dosage of platelet-rich plasma is needed for the type of healing your Achilles tendon needs.

This is a new treatment that probably won't always work 100% in every patient the first time. Until we know who is likely to benefit the most and what dosage is needed for each type and degree of injury, it's likely that some trial-and-error will occur.

Reference: 

Jianying Zhang, PhD, and James H.-C. Wang, PhD. Platelet-Rich Plasma Releasate Promotes Differentiation of Tendon Stem Cells into Active Tenocytes. In The American Journal of Sports Medicine. December 2010. Vol. 38. No.12.Pp.2477-2486.

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