PATH-2

Platelet rich plasma injection for acute Achilles tendon rupture: PATH-2 randomised, placebo controlled, superiority trial

Keene DJ, Alsousou J, Harrison P, et al. BMJ (Clinical research ed.) 2019 · PMID 31748208 · doi:10.1136/bmj.l6132

Question

Does a PRP injection improve muscle-tendon function after non-operatively treated acute Achilles tendon rupture?

Design

Multicentre, participant- and assessor-blinded, placebo-controlled NIHR-funded RCT in UK hospitals (Oxford-led).

Patients

Adults with acute Achilles tendon rupture managed non-operatively.

Intervention

Single PRP injection into the rupture gap

Comparison

Placebo (imitation/dry needle) injection

Primary outcome

Limb symmetry index of heel-rise endurance (muscle-tendon work) at 24 weeks

Key result

PRP did not improve heel-rise endurance or patient-reported outcomes compared with placebo at 24 weeks.

Limitations

Applies to non-operatively treated ruptures only; a single PRP preparation and injection protocol was tested.

Impact on practice

Provides high-quality UK evidence against using PRP for acute Achilles rupture; non-operative functional rehabilitation without PRP remains standard.