Adipose cellular injection in the treatment of an intrasubstance achilles tendon tear

Introduction: We describe a case report of a patient who presented with chronic right Achilles tendon pain and weakness. Without contrast, magnetic resonance imaging of the right Achilles tendon revealed significant expansion of the Achilles tendon in the traverse and anteroposterior dimension with extensive increased T2 signal consistent with large partial-thickness Achilles tendon tear. A musculoskeletal ultrasound using a linear transducer demonstrated an anechoic tendon defect measuring 0.97 cm in the longitudinal axis with a total tendon length measuring 1.53 cm, as well as a 0.9 cm defect in the transverse axis surrounded by homogenous tendon fibers consistent with a large defect involving the distal Achilles tendon proximal to the distal insertion. The patient underwent an ultrasound-guided adipose cellular procedure using micronized fat to fill in the defect and facilitate pain reduction and tissue healing.Conclusion: Ultrasound-guided injection of micro-fragmented adipose tissue of Achilles tendon defect can result in significant improvement in pain and function