of low-level laser therapy, platelet-rich plasma, and their combination on the
healing of Achilles tendon in rabbits.

Allahverdi A, Sharifi D, Takhtfooladi MA, Hesaraki S, Khansari M, and Dorbeh SS. Lasers Med Sci. 2015. [Epub Ahead of Print].

Home Message: Both
platelet-rich plasma and
low-level laser therapies
are effective treatments for Achilles
tendon injury. In the present study however, combining PRP and LLLT
demonstrated an increase in healed tendon strength and histological function in
a rabbit model.

Tendon injury is common among those who participate in sports. While many
treatments such as platelet-rich plasma (PRP) and low-level laser therapies
(LLLT) exist, no research has been completed on the effectiveness of combining
therapies. If combining therapies together yields better tissue healing results,
clinicians may utilize this gold standard to expedite return to play.
Therefore, Allahverdi and colleagues completed an animal study to investigate
if combining LLLT and PRP are more effective than LLLT or PRP alone.
Seventy-two male New Zealand white rabbits were equally divided into 4
treatment groups (control, PRP only, LLLT only, and LLLT+PRP). All rabbits
underwent surgical Achilles tendon weakening (10 full-thickness incisions
mid-way between calcaneal insertion and musculotendinous junction) before
undergoing the specified treatment for 15 days. Rabbits treated with PRP were
injected with autologous PRP with platelet concentration 400% of the peripheral
blood count at 1, 8, and 15 days post injury. The rabbits in the LLLT group
were treated for 15 consecutive days post-injury. The 18 rabbits in the
combination group received both treatments described above. After 30 days the
rabbits were sacrificed and tendons were harvested for examination. Histological
examinations focused on the presence of inflammation, arrangement of collagen
fibers, and adhesion formation. Biomechanical testing assessed breaking
strength and tensile strength of the healed tendon as compared with the
contralateral tendon. Biomechanical testing and histological assessment
revealed better outcomes in all of the treated groups compared with the control
group. Furthermore, the combination group had better results than either single
treatment groups.

Overall, the combination of PRP and LLLT lead to superior treatment
outcomes than either PRP or LLLT alone. This data should be especially interesting
for those clinicians who have access to PRP and LLLT. By combining these 2
treatment options outcomes can be improved. It should also be noted that both
PRP and LLLT lead to significantly better outcomes than the control group,
which would support the use of either treatment individually. It will be
interesting to see if these results can be replicated in humans. This study can
also offer clinicians some additional clinical insight. The current study
demonstrated that combining therapies might help shorten recovery timelines and
yield better overall outcomes. Clinicians should always consider if combinations
of treatments may lead to improved results or merely take more time. Clinical
trials often assess one treatment option at a time and similarly clinicians often
focus on the gold-standard treatment for a particular injury rather than seeking
efficient and effective combinations of treatments.

Questions for Discussion:
What combination treatments have you found to be particularly useful for tendon
injuries? How do you choose and assess treatment combinations in your clinical

Written by: Kyle Harris
Reviewed by: Jeffrey Driban

Related Posts:

Low-level Laser Therapy for Achilles TendinitisLow-level Laser Therapy with Exercise Improves Shoulder PainPlatelet-Rich Plasma Stimulates Tendon Cells from Tendons with Degenerative TearsPlatelet-Rich Plasma, is it Beneficial in Shoulder Surgery?Platelet Rich Plasma Injections Do Not Improve Achilles Tendon HealingThe Positive Effects of Different Platelet-Rich Plasma Methods on Human Muscle, Bone, and Tendon Cells

Allahverdi A, Sharifi D, Takhtfooladi MA, Hesaraki S, Khansari M, & Dorbeh SS (2015). Evaluation of low-level laser therapy, platelet-rich plasma, and their combination on the healing of Achilles tendon in rabbits. Lasers in Medical Science, 30 (4), 1305-13 PMID: 25759233