Platelet-Rich Plasma Injection in a Traumatic Achilles Tendon Tear with Ultrasound Confirmed Near-Complete Healing: A Case Report

Case Diagnosis: A 47-year-old man with a right midportion Achilles tendon tear.

Case Description or Program Description: The patient presented 4 months after sustaining an Achilles tendon tear while snowboarding, reporting persistent dull, aching pain (5–7/10) and significant morning stiffness. Prior treatments included physical therapy, dry needling, and stem needling. Magnetic resonance imaging revealed a small intrasubstance tear of the mid-Achilles tendon. Given ongoing symptoms, he elected to undergo a platelet-rich plasma (PRP) injection. PRP was prepared from 60 milliliters of autologous blood using a double-spin EmCyte® centrifugation protocol. Under ultrasound guidance, 1 milliliter of PRP was injected into the Achilles tendon following local 0.2% ropivacaine. The patient was advised to wear a controlled ankle motion boot and continue rehabilitation.

Setting: Outpatient sports medicine clinic.

Assessment/Results: After 1 month, the patient reported initial tenderness but noted gradual strength improvement. At 3 months, he described a 35% improvement with ongoing swelling and tenderness. By 7 months, he reported a 70–80% recovery, with ultrasound confirming complete tear resolution. Morning stiffness improved from 500 painful steps to 50, and tenderness went from severe to mild on examination.

Discussion (relevance): While retrospective studies suggest PRP benefits for Achilles tendinopathy, randomized controlled trials (RCTs) and systematic reviews have not consistently demonstrated superiority over placebo. A 2021 Journal of the American Medical Association (JAMA) RCT found no significant benefit of PRP over dry needling. Variability in PRP protocols further complicates efficacy assessment. However, in this case, the patient experienced substantial symptom relief, functional gains, and ultrasound-confirmed healing, highlighting PRP’s potential role in tendon repair and suggesting it may be an effective treatment in select Achilles tendon injuries.

Conclusions: Despite conflicting evidence in the literature, this case demonstrates successful PRP use for an Achilles tendon tear, with an 80% recovery and ultrasound-confirmed healing. These findings support PRP as a potential therapeutic option for Achilles tendon injuries.