ACHILLES TEARS

Disease Awareness Page for R3 Stem Cell – Achilles Tears

What is Achilles tears?

The Achilles tendon, the largest tendon in the body, joins the calf muscles to the heel bone. This tendon enables one to walk, run and jump. Achilles tendon tears happen when the tendon stretches beyond its capacity. Achilles tendon rupture is characterized by a snapping sound associated with severe pain around the ankle and back of the leg.[1]

Causes: Typical causes of Achilles tendon tear include sudden jumping movements, excessive starting and stopping movements and tripping incidents. Fluoroquinolone antibiotics (e.g. Cipro, Factive, Floxina and Levaquin) are also associated with increased risk of tendinitis and tendon tears.

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Here are answers to many of the frequently asked questions we receive.

Management

Magnetic resonance imaging (MRI) is required to understand the nature of an Achilles tendon tear—partial or full tear. A partial tear can recover with a leg cast, brace, or splint, but may require surgery in some cases. For a full tear of the Achilles tendon, surgery is mandatory.

Symptomatic relief of Achilles tendon tear include rest of the foot, ice at the area, elevation of the foot and over-the-counter pain medications (ibuprofen, acetaminophen and naproxen). Recovery may take between 2 – 6 weeks, depending upon the severity of the tear. Individuals who had an Achilles tear once are at greater risk for similar injury in the future.

During surgery, an incision is made to access the muscle and tendon. Usual risks associated with such surgical interventions include the side effects of anesthesia and a lengthy recovery process.

Innovative Therapies

Platelet Rich Plasma (PRP) is obtained by concentrating the patient’s blood sample to obtain a platelet-rich fraction. It has been shown that soft tissue healing happens most efficiently when platelet concentration is greater than 1,000,000/μl, as compared with a normal platelet count of 200,000/μl (average). Several studies have demonstrated the usefulness of PRP solutions in the healing of tendon injuries and Achilles tendinitis. [2] [3] [4]

Unlike reconstructive surgery that may permanently weaken the tendon and associated structures, PRP therapy aims to rebuild and strengthen tissues. Moreover, patients with partial tendon tears may take anti-inflammatory agents and pain medication to control the swelling and pain, but the side effects of these drugs may be too unpleasant to continue medication use. In this regard, Platelet Rich Plasma therapy offers easy intervention measures for effective and lasting repair as well as as the control of painful symptoms.

A small volume of solution (containing the PRP) is injected around the painful ligament, tendon insertions or adjacent joint spaces. The cells secrete factors, such as platelet-derived growth factor (PDGF), transforming growth factor beta (TGF-b), vascular endothelial growth factor (VEGF) and epithelial growth factor (EGF), which promotes natural repair and regeneration.

R3 Stem Cell has achieved Institutional Review Board (IRB) approval for the following study, please read about it here on ClinicalTrials.gov:

SAFETY AND CLINICAL OUTCOMES WITH AMNIOTIC AND UMBILICAL CORD TISSUE THERAPY FOR NUMEROUS MEDICAL CONDITIONS

[1] Baer GS, Keene JS. Tendon injuries of the foot and ankle. In: DeLee JC, Drez D Jr., Miller MD, eds. DeLee and Drez’s Orthopaedic Sports Medicine. 3rd ed. Philadelphia, Pa: Saunders Elsevier;2009:section D.

[2] Vora A, Borg-Stein J, Nguyen RT. Regenerative injection therapy for osteoarthritis: fundamental concepts and evidence-based review. PM R. 2012 May;4(5 Suppl):S104-9.

[3] de Mos M, van der Windt AE, Jahr H, et al. Can platelet-rich plasma enhance tendon repair? A cell culture study. Am J Sports Med. 2008 Jun;36(6):1171-8. Epub 2008 Mar 7.

[4] Monto RR.Platelet rich plasma treatment for chronic Achilles tendinosis. Foot Ankle Int. 2012 May;33(5):379-85.

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