Ultrasound-guided microfragmented adipose graft injection to regenerate a large partial-thickness Achilles tendon rupture: a case report

Siddiqui, Imran J.1; Mahadevan, Sanjay2,*; Umesh, Charith1; Desronvilles, Roosevelt J. Jr.2; Dineen, Kyle J.2

1Regenerative Orthopedics and Sports Medicine, Rockville, MD, USA

2Orthobiologics Research Initiative Inc., North Bethesda, MD, USA

*Correspondence to: Sanjay Mahadevan, BA, sanjay@rosm.org or smahade3@alumni.jh.edu.

Abstract

Partial-thickness Achilles rupture appears to be a neglected diagnosis in the medical community and lacks an adequate standard treatment regimen. Currently, conservative treatment options include a combination of rest, physical therapy, bracing, and anti-inflammatory medications. When these conservative measures fail, or in cases where the partial Achilles rupture is large, surgical repair is usually required to regain the function of the gastroc-soleus complex. However, this case represents the second documented circumstance where regenerative medicine was able to fully repair a large partial-thickness Achilles rupture. We present a case report of a 69-year-old man diagnosed with a left large partial-thickness Achilles rupture following an acute sport injury. The patient expressed a desire to return to moderate athletic activity for his age group and was treated with autologous micro-fragmented adipose transfer. He was re-evaluated at 5 weeks and again at 10 weeks post-treatment and demonstrated musculoskeletal sonographic evidence of complete resolution and remodeling of his partial thickness Achilles rupture. This case presents a promising option for patients with partial thickness Achilles ruptures who would like to refrain from or are unable to have surgery. Further research and possible randomized controlled trials are needed to further assess the full efficacy of micro-fragmented adipose transfer in the treatment of partial thickness Achilles ruptures.

超声引导下注射微碎片化脂肪移植促进大面积跟腱部分断裂后再生：病例报告

摘要  

跟腱部分断裂（AR）似乎是医学界忽视的诊断，缺乏适当的标准治疗方案。目前，保守治疗方案包括休息、理疗、支撑和抗炎药物。如果这些保守治疗无效，或者部分 AR 较大，通常需要进行手术修复，以恢复腓肠肌-比目鱼肌复合体的功能。文章报道了1例 69 岁男性患者，他在一次急性运动损伤后被诊断为左侧大面积跟腱部分断裂。患者表示希望恢复同年龄组的中等运动量，并接受了自体微碎片化脂肪移植（MFAT）治疗。他在治疗后 5 和 10 周再次接受了重新评估，结果显示肌肉骨骼声像图显示他的部分厚度 AR 撕裂已完全愈合和重塑。这个病例为希望避免或无法进行手术的大面积跟腱部分断裂患者提供了一个很有前景的选择。要进一步全面评估 MFAT 治疗大面积跟腱部分断裂的疗效，还需要进一步的研究和可能的随机对照试验。