Pain in the back of the heel affects 150,000 people annually leading to walking difficulties. The most common cause is Achilles tendinopathy (disease of an Achilles tendon). Tendons are split into two areas based on composition, 1, the mid-substance containing dense fibrous connective tissue and 2, the tendon-bone insertion, containing many different cell types as it makes its transition to bone where it is attached. Tendinopathy in the mid-substance of Achilles tendon occurs due to the failure of the tendon to repair properly. As a result, the condition can cause debilitating pain. Achilles tendinopathy is managed with advice, painkillers, specific exercises, electrotherapy, injections or surgery, but there is no single best treatment. An Arthritis Research UK group has identified a new type of injection as potentially helpful. This new treatment involves taking a small sample of the participant's own blood, which is spun to separate out the components of the blood. The component, plasma contains a high number of platelets that play an important role in the repair processes within tendons. It is the platelet rich plasma that is to be injected into the painful tendon of the participant. The clinical trial plans to test whether platelet rich plasma injection help increase healing and reduce pain in patients with painful Achilles tendons, by trialling the platelet rich injection against injecting the participant with a placebo imitation injection. Participants will be asked to provide information about their pain, ability to perform activities and complications. This information will be collected at 3 month and 6 month intervals.
The ATM Trial Protocol was published online by BMJ Open in February 2020 an is available here.