Diagnosis: Achilles Rupture
Introduction
Patient was a 42-year-old male who ruptured his Achilles tendon on November 12, 2021, while playing with his children at a trampoline park. As he hyper-flexed his foot to climb a wall, he felt a pop in the back of his lower leg and immediately knew it was his Achilles. He had the same injury in the past on the opposite leg. Because he was only vacationing in San Diego and traveling back to Bermuda by plane that day, he wanted to act quickly. His wife searched online and found that Joy Wellness Partners had an urgent care injury service and came in immediately. After consulting with the patient, I performed an ultrasound diagnostic exam of his injured area and confirmed that he had a severely ruptured Achilles tendon, with less than 30% of the fibers intact at the site of the tear.
I gave him his options of just wearing a boot to heal over time or trying Platelet-Rich Plasma (PRP) injections into the Achilles at Joy Wellness Partners to expedite his healing and reduce his pain more quickly. The patient opted to try the PRP to see if it could help him heal faster.
Figure 1. Ruptured Achilles tendon, longitudinal view.
Figure 2. Ruptured Achilles Tendon, cross-sectional view.
Treatment
We drew 30 mL of blood from the patient and used the EmCyte double spin PRP processing system to concentrate the PRP to 6 mL total. We injected 0.5 cc .5% Ropivacaine at the skin surface as a pre-treatment anesthetic injection. Next, using ultrasound guidance, 4 mL PRP was injected into the Achilles tendon, and the remaining 2 mL were used to hydrodissect the surrounding fascial layers. The Achilles was then taped with Cover Roll Stretch and Leukotape. He was provided with a prescription for a couple pain pills for post-procedure pain during the flight home. The patient’s wife helped him to obtain a boot to keep his Achilles immobilized for his flight back to Bermuda, where he was instructed to follow up with his doctor and physical therapy team upon return.
Figure 3. Carol Bender, NP, injecting PRP into the Achilles Tendon under ultrasound guidance.
Figure 4. Needle and PRP flowing into the ruptured tendon.
Follow-up
On November 29, 2022, our clinic had a follow up call with the patient where he reported that his post-procedure pain was minimal, and he only needed pain medication for one day following the treatment. His doctor in Bermuda examined the injury and reported that it was healing well.
On February 17, 2022, the patient’s physical therapist reported that the Achilles tendon was looking strong and performing very well. He was fully free of pain, and very grateful for the treatment.
In conclusion, based on one patient’s case report, PRP may be considered as an option to aid in healing a torn Achilles tendon.
Results
Figure 1. Reduction in Self-Reported Pain on a 1-10 Scale, before and after PRP to the Achilles Tendon.
