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Current Reviews in Musculoskeletal Medicine
Published in: Current Reviews in Musculoskeletal Medicine 1/2015

01-03-2015 | Biological Adjuvants in Orthopedic Surgery (J Dines and D Grande, Section Editors)

Biologics in Achilles tendon healing and repair: a review

Authors: Evan Shapiro, Daniel Grande, Mark Drakos

Published in: Current Reviews in Musculoskeletal Medicine | Issue 1/2015

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Abstract

Injuries of the Achilles tendon are relatively common with potentially devastating outcomes. Healing Achilles tendons form a fibrovascular scar resulting in a tendon which may be mechanically weaker than the native tendon. The resulting strength deficit causes a high risk for reinjury and other complications. Treatments using biologics aim to restore the normal properties of the native tendon and reduce the risk of rerupture and maximize tendon function. The purpose of this review was to summarize the current findings of various therapies using biologics in an attempt to improve the prognosis of Achilles tendon ruptures and tendinopathies. A PubMed search was performed using specific search terms. The search was open for original manuscripts and review papers limited to publication within the last 10 years. From these searches, papers were included in the review if they investigated the effects of biological augmentation on Achilles tendon repair or healing. Platelet-rich plasma may assist in the healing process of Achilles tendon ruptures, while the evidence to support its use in the treatment of chronic Achilles tendinopathies remains insufficient. The use of growth factors such as hepatocyte growth factor, recombinant human platelet-derived growth factor-BB, interleukin-6, and transforming growth factor beta as well as several bone morphogenetic proteins have shown promising results for Achilles tendon repair. In vitro and preclinical studies have indicated the potential effectiveness of bone marrow aspirate as well. Stem cells also have positive effects on Achilles tendon healing, particularly during the early phases. Polyhydroxyalkanoates (PHA), decellularized tendon tissue, and porcine small intestinal submucosa (SIS) are biomaterials which have shown promising results as scaffolds used in Achilles tendon repair. The application of biological augmentation techniques in Achilles tendon repair appears promising; however, several techniques require further investigation to evaluate their clinical application.
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Metadata
Title
Biologics in Achilles tendon healing and repair: a review
Authors
Evan Shapiro
Daniel Grande
Mark Drakos
Publication date
01-03-2015
Publisher
Springer US
Published in
Current Reviews in Musculoskeletal Medicine / Issue 1/2015
Electronic ISSN: 1935-9748
DOI
https://doi.org/10.1007/s12178-015-9257-z

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