Platelet-Rich Plasma Injection vs Sham Injection and Tendon Dysfunction in Chronic Midportion Achilles Tendinopathy

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Platelet-Rich Plasma Injection vs Sham Injection and Tendon Dysfunction in Chronic Midportion Achilles Tendinopathy

To the Editor The authors of a recent JAMA article1 concluded that a single injection of intratendinous PRP was not superior to subcutaneous dry-needle insertion. Although this study provided valuable results, we believe some methodological concerns should be considered.

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First, standardized ultrasound-guided injection should have been done to improve PRP efficacy. Studies have shown a higher degree of pain with intratendinous vascularity in pathologic tendons.2 Additionally, the authors should have provided the exact anatomical locations of injections, such as midportion of Achilles tendon, peritendinous tissue, or Karger fat pad, because structural damage may cause different effects on pain and local sensitization.

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