{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T05:49:06Z","timestamp":1790660946927,"version":"4.1.0"},"reference-count":27,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T00:00:00Z","timestamp":1779840000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background\/Objectives: Platelet-rich plasma (PRP) has been proposed as a biological augmentation strategy in the surgical repair of acute Achilles tendon rupture (ATR). However, clinical evidence remains heterogeneous, and its impact on structural and functional recovery is unclear. This review synthesizes comparative clinical evidence on PRP augmentation in surgical acute ATR repair. Methods: A comprehensive review of comparative clinical studies was conducted using PubMed, MEDLINE, Scopus, and Cochrane Central databases. Seven studies, including three randomized controlled trials, met the inclusion criteria, totaling 207 patients. Methodological quality was assessed using the Modified Newcastle-Ottawa Scale and Cochrane Risk of Bias tool. Results: Several studies reported early functional improvements with PRP. Zou et al. found better range of motion at 24 months (p &lt; 0.001). S\u00e1nchez et al. reported faster recovery of range of motion (7 vs. 11 weeks) and earlier return to running (11 vs. 18 weeks). Hung et al. observed improved range of motion at 6 months, without differences at 24 months (ATRS 92.9 vs. 92.7). Conversely, randomized trials by Yasui, Schepull, and De Carli showed no significant long-term differences in functional outcomes. Conclusions: PRP may enhance early recovery after surgical acute ATR repair, but consistent long-term superiority has not been demonstrated. Heterogeneity in PRP preparation and administration likely contributes to conflicting findings. Further standardized trials are required to define its clinical role.<\/jats:p>","DOI":"10.3390\/jcm15114148","type":"journal-article","created":{"date-parts":[[2026,5,27]],"date-time":"2026-05-27T14:36:56Z","timestamp":1779892616000},"page":"4148","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Outcomes of Acute Achilles Tendon Repair with Platelet-Rich Plasma Augmentation: A Comprehensive Review of Comparative Studies"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8742-5612","authenticated-orcid":false,"given":"Michele","family":"Mercurio","sequence":"first","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery, \u201cMagna Graecia\u201d University, \u201cRenato Dulbecco\u201d University Hospital, 88100 Catanzaro, Italy"},{"name":"Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, \u201cMagna Graecia\u201d University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-8585-2144","authenticated-orcid":false,"given":"Giorgia Lucia","family":"Benedetto","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, \u201cMagna Graecia\u201d University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8145-3623","authenticated-orcid":false,"given":"Elvira Immacolata","family":"Parrotta","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences, \u201cMagna Graecia\u201d University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6313-1866","authenticated-orcid":false,"given":"Giovanni","family":"Cuda","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine, \u201cMagna Graecia\u201d University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"Paola","sequence":"additional","affiliation":[{"name":"Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, \u201cMagna Graecia\u201d University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2445-7753","authenticated-orcid":false,"given":"Erminia","family":"Cofano","sequence":"additional","affiliation":[{"name":"Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, \u201cMagna Graecia\u201d University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4063-9821","authenticated-orcid":false,"given":"Umile Giuseppe","family":"Longo","sequence":"additional","affiliation":[{"name":"Fondazione Policlinico Universitario Campus Bio-Medico, 00128 Roma, Italy"},{"name":"Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Universit\u00e0 Campus Bio-Medico di Roma, Via Alvaro del Portillo, 21, 00128 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simone","family":"Cerciello","sequence":"additional","affiliation":[{"name":"Saint Camillus International University of Health and Medical Sciences, 00131 Roma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8256-7697","authenticated-orcid":false,"given":"Giorgio","family":"Gasparini","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic and Trauma Surgery, \u201cMagna Graecia\u201d University, \u201cRenato Dulbecco\u201d University Hospital, 88100 Catanzaro, Italy"},{"name":"Research Center on Musculoskeletal Health, MusculoSkeletalHealth@UMG, \u201cMagna Graecia\u201d University, 88100 Catanzaro, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,27]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Delmastro, E., Colace, S., Longo, U.G., D\u2019Hooghe, P., Marangon, A., Galasso, O., Gasparini, G., and Mercurio, M. (2025). Revision Surgery for Achilles Tendon Rupture: A Comprehensive Review of Treatment Options, Outcomes, and Complications and the Role of Artificial Intelligence. Medicina, 61.","DOI":"10.3390\/medicina61091684"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"e70469","DOI":"10.1002\/jeo2.70469","article-title":"Successful Functional Outcomes and Return to Sport Rate Can Be Achieved after Surgery for Acute Achilles Tendon Rupture: A Systematic Review","volume":"12","author":"Cofano","year":"2025","journal-title":"J. Exp. Orthop."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"20417314231196275","DOI":"10.1177\/20417314231196275","article-title":"Tendon Tissue Engineering: An Overview of Biologics to Promote Tendon Healing and Repair","volume":"14","author":"Citro","year":"2023","journal-title":"J. Tissue Eng."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"105696","DOI":"10.1016\/j.jbspin.2024.105696","article-title":"Biology and Physiology of Tendon Healing","volume":"91","author":"Blanchard","year":"2024","journal-title":"Jt. Bone Spine"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1302\/2046-3758.118.BJR-2021-0576.R1","article-title":"Tendon Healing: A Concise Review on Cellular and Molecular Mechanisms with a Particular Focus on the Achilles Tendon","volume":"11","author":"Stange","year":"2022","journal-title":"Bone Jt. Res."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"103","DOI":"10.1053\/j.jfas.2024.08.011","article-title":"Clinical and Radiological Outcomes of Combined Arthroscopic Microfracture and Mesenchymal Stem Cell Injection Versus Isolated Microfracture for Osteochondral Lesions of the Talus: A Meta-Analysis of Comparative Studies","volume":"64","author":"Mercurio","year":"2025","journal-title":"J. Foot Ankle Surg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"92","DOI":"10.1111\/prd.12538","article-title":"Ten Years of Injectable Platelet-rich Fibrin","volume":"94","author":"Miron","year":"2024","journal-title":"Periodontology 2000"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"818","DOI":"10.1016\/j.arthro.2024.03.046","article-title":"Editorial Commentary: High-Platelet-Dose Platelet-Rich Plasma May Be the Nonoperative Treatment of Choice for Knee Osteoarthritis","volume":"41","author":"Hohmann","year":"2025","journal-title":"Arthroscopy"},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Moher, D., Liberati, A., Tetzlaff, J., Altman, D.G., and The PRISMA Group (2009). Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA Statement. PLoS Med., 6.","DOI":"10.1371\/journal.pmed.1000097"},{"key":"ref_10","doi-asserted-by":"crossref","unstructured":"Schardt, C., Adams, M.B., Owens, T., Keitz, S., and Fontelo, P. (2007). Utilization of the PICO Framework to Improve Searching PubMed for Clinical Questions. BMC Med. Inform. Decis. Mak., 7.","DOI":"10.1186\/1472-6947-7-16"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"581","DOI":"10.1053\/j.jfas.2017.01.039","article-title":"Achilles Tendon Open Surgical Treatment With Platelet-Rich Fibrin Matrix Augmentation: Biomechanical Evaluation","volume":"56","author":"Alviti","year":"2017","journal-title":"J. Foot Ankle Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"2231","DOI":"10.1007\/s00167-015-3580-1","article-title":"Can Platelet-rich Plasma Have a Role in Achilles Tendon Surgical Repair?","volume":"24","author":"Lanzetti","year":"2016","journal-title":"Knee Surg. Sports Traumatol. Arthrosc."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Hung, C.-Y., Lin, S.-J., Yeh, C.-Y., and Yeh, W.-L. (2022). Effect of Platelet-Rich Plasma Augmentation on Endoscopy-Assisted Percutaneous Achilles Tendon Repair. J. Clin. Med., 11.","DOI":"10.3390\/jcm11185389"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e70168","DOI":"10.1002\/jeo2.70168","article-title":"No Significant Impact of Platelet-rich Plasma on Recovery after Achilles Tendon Surgery: A Double-blind Randomized Controlled Trial","volume":"12","author":"Yasui","year":"2025","journal-title":"J. Exp. Orthop."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1177\/0363546506294078","article-title":"Comparison of Surgically Repaired Achilles Tendon Tears Using Platelet-Rich Fibrin Matrices","volume":"35","author":"Anitua","year":"2007","journal-title":"Am. J. Sports Med."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1177\/0363546510383515","article-title":"Autologous Platelets Have No Effect on the Healing of Human Achilles Tendon Ruptures: A Randomized Single-Blind Study","volume":"39","author":"Schepull","year":"2011","journal-title":"Am. J. Sports Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"9364170","DOI":"10.1155\/2016\/9364170","article-title":"A Prospective Study of Platelet-Rich Plasma as Biological Augmentation for Acute Achilles Tendon Rupture Repair","volume":"2016","author":"Zou","year":"2016","journal-title":"BioMed Res. Int."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Chalidis, B., Givissis, P., Papadopoulos, P., and Pitsilos, C. (2023). Molecular and Biologic Effects of Platelet-Rich Plasma (PRP) in Ligament and Tendon Healing and Regeneration: A Systematic Review. Int. J. Mol. Sci., 24.","DOI":"10.3390\/ijms24032744"},{"key":"ref_20","first-page":"e65636","article-title":"Mechanisms, Efficacy, and Clinical Applications of Platelet-Rich Plasma in Tendinopathy: A Comprehensive Review","volume":"16","author":"Kale","year":"2024","journal-title":"Cureus"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"448","DOI":"10.1016\/j.jconrel.2021.03.040","article-title":"Tendon Tissue Engineering: Cells, Growth Factors, Scaffolds and Production Techniques","volume":"333","author":"Ciriza","year":"2021","journal-title":"J. Control. Release"},{"key":"ref_22","first-page":"e92652","article-title":"Effectiveness of Platelet-Rich Plasma Injection for Chronic Achilles Tendinopathy: An Umbrella Systematic Review","volume":"17","author":"Samad","year":"2025","journal-title":"Cureus"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1111\/j.1600-0838.2009.00986.x","article-title":"From mechanical loading to collagen synthesis, structural changes and function in human tendon","volume":"19","author":"Kjaer","year":"2009","journal-title":"Scand. J. Med. Sci. Sports"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"108353","DOI":"10.1016\/j.jbc.2025.108353","article-title":"Molecular Dissection of Tendon Development and Healing: Insights into Tenogenic Phenotypes and Functions","volume":"301","author":"Sakai","year":"2025","journal-title":"J. Biol. Chem."},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Lin, M., Li, W., Ni, X., Sui, Y., Li, H., Chen, X., Lu, Y., Jiang, M., and Wang, C. (2023). Growth Factors in the Treatment of Achilles Tendon Injury. Front. Bioeng. Biotechnol., 11.","DOI":"10.3389\/fbioe.2023.1250533"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"550","DOI":"10.1016\/j.fas.2021.07.009","article-title":"Periprosthetic Ankle Infection: Eradication Rate, Complications, and Limb Salvage. A Systematic Review","volume":"28","author":"Mercurio","year":"2022","journal-title":"Foot Ankle Surg."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"421","DOI":"10.1177\/0363546506294856","article-title":"The Achilles tendon Total Rupture Score (ATRS): Development and validation","volume":"35","author":"Thomee","year":"2007","journal-title":"Am. J. Sports Med."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/11\/4148\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T13:05:37Z","timestamp":1790600737000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/15\/11\/4148"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,27]]},"references-count":27,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2026,6]]}},"alternative-id":["jcm15114148"],"URL":"https:\/\/doi.org\/10.3390\/jcm15114148","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,27]]}}}