Injection Therapies for Achilles Tendinopathy: PRP, High-Volume, and Sham in the Boesen 2017 RCT (ptpodcast.com)

• PRP and high-volume injection improve short-term VISA-A scores compared to sham.
• At 24 weeks, no significant differences remain due to placebo response.
• Sham needling may have mechanical effects and may not be inert.

"This podcast episode reviews the Boesen et al. 2017 RCT comparing platelet-rich plasma (PRP), high-volume injection (with corticosteroid), and sham needling for chronic midportion Achilles tendinopathy. The study found that at 12 weeks, both active treatments improved VISA-A scores over sham, but at 24 weeks there were no significant differences. The discussion highlights the substantial placebo response and questions whether sham needling is truly inert, as needle insertion may have mechanical effects (e.g., tenotomy). Peter Malliaras, a co-author, provides insights on interpreting injection study results and the importance of rehabilitation alongside injections."