Effectiveness of Platelet-Rich Plasma and Bone Marrow Aspirate Concentrate as Treatments for Chronic Hindlimb Proximal Suspensory Desmopathy

Abstract

This retrospective study aimed to evaluate the clinical effect of bone marrow aspirate concentrate (BMAC) and leukocyte rich PRP (LR-PRP) compared to horses undergoing controlled exercise alone in horses with >3 months proximal suspensory desmopathy in hindlimbs (HPSD). Nighty-three horses were divided into three groups according to the treatment: a control (n = 22), LR-PRP (n = 46), and BMAC (n = 25) group. Lameness and ultrasound scores were recorded before treatment (T0) and at 6 months (T1) post-treatment. Records horses considered sound at evaluation and level of performance were additionally registered at 12 months (T2) and 18 months (T3) after treatment. The BMAC cytology profiles from 22 horses were also analysed and compared to clinical outcomes. The results at T1 showed that 9% (2/22) of the horses in the control group were sound compared to 59% (25/46) and 84% (21/25) in the LR-PRP and BMAC groups, respectively. Additionally, ultrasound scores at T1 in the BMAC and LR-PRP groups were improved in comparison with the control group (p = 0.02). At T2, 68% of the horses in the BMAC group and 39% of the horses in the LR-PRP group had returned to the previous performance level. At T3, a significantly higher percentage of horses in the LR-PRP (43%) and BMAC (72%) group were sound when compared to the control (4.6%) group (p = 0.02). Similarly, at T3, significantly more horses of the BMAC (16/25) and of the LR-PRP (15/46) group had returned to the previous or a higher performance level compared to the control (1/22) group (p = 0.01). No correlation was found between long-term clinical outcome and cytology profiles in the BMAC group. In conclusion, long-term outcomes of treatment with LR-PRP or BMAC are significantly better than conventional treatment of the hindlimb chronic PSD in horses. Additionally, BMAC yielded better lameness scores than LR-PRP at short- and long-term follow-up.

Therapeutic Effect of Equine Musculoskeletal Disease using Autogenous Platelet Rich Plasma

“…PRP is a concentration of platelets containing multiple growth factors that are very important for regeneration and antiinflammatory processes. Treatment with PRP has been used for various conditions in equine veterinary medicine (Gentile et al 2012;McCarrel et al 2012; Holmes et al After PRP treatment, irregular cartilage line was remodelled to normal shape and bone density was improved in radiology 2018; Ortved 2018;Pereira et al 2019;Machado et al 2019;Garbin and Olver 2020;Dawod et al 2021;Maleas and Mageed 2021;Ribitsch et al 2021;Perego et al 2022) and hoof disorders (Carmona et al 2013;Angelone et al 2017;Carmona et al 2018;Cengiz et al 2018;Seidel et al 2021). Renewable treatments that can replace conventional antibiotic treatments range from auto-PRP to auto-stem cells (Pierce et al 1991).…”

Suspensory Ligament Injuries: Pathogenesis, diagnosis, treatment and rehabilitation

“…Maleas i wsp. (20) porównali efektywność zastosowania iniekcji osocza bogatopłytkowego, szpiku kostnego do efektywności samego kontrolowanego ruchu w przypadku przewlekłego uszkodzenia przyczepu początkowego mięśnia międzykostnego w kończynie miednicznej. Przeprowadzili swoje badania na 93 koniach, które podzielili na 3 grupy: pierwsza grupa obejmowała konie rehabilitowane poprzez ruch kontrolowany (22 konie), druga grupa miała przeprowadzoną iniekcję dościęgnową osocza bogatopłytkowego (46 koni), natomiast trzecia grupa miała wykonaną iniekcję dościęgnową szpiku kostnego (25 koni).…”

Microvasculature of the suspensory ligament of the equine hind limb

“…result, numerous treatment strategies have been investigated to promote neovascularization and improve the healing potential, prognosis, and longterm soundness potential of these horses. These include the use of more conservative therapies, such as shockwave therapy, [11][12][13][14] high-intensity laser therapy, 15,16 or injection with biologic agents such as platelet-rich plasma, 17,18 as well as surgical procedures, including microfracture, ligament splitting, and fasciotomy with neurectomy of the deep branch of the lateral plantar nerve. [19][20][21][22] There is a body of literature that supports anatomic study of the microvasculature of tendons and ligaments in human medicine.…”