The Use of Platelet-Rich Plasma for Treatment of Tenodesmic Lesions in Horses: A Systematic Review and Meta-Analysis of Clinical and Experimental Data

Abstract

The use of platelet-rich plasma (PRP) to enhance tenodesmic lesion healing has been questioned over the years. The aim of this study was to evaluate current literature to establish the effectiveness of PRP for treating tenodesmic lesions through a systematic review, in accordance with the PRISMA guidelines, and a meta-analysis. Studies comparing PRP with placebo or other treatments for horses with tenodesmic injuries or evaluated PRP effect on tendon and ligament explants were included. Outcomes were clinical, ultrasound, histologic, molecular evaluation, and adverse effects. Two authors independently extracted data and assessed each study’s risk of bias. Treatment effects were evaluated using risk ratios for dichotomous data, together with 95% CI. Data were pooled using the random-effects model. The quality of the evidence for each outcome was assessed using GRADE criteria. Twenty-four trials met inclusion criteria for systematic review, while fifteen studies were included in the meta-analysis. Results showed no significant differences in the outcomes between PRP and control groups. Finally, there is no definitive evidence that PRP enhances tendons and ligaments healing. Therefore, there is a need for more controlled trials to draw a firmer conclusion about the efficacy of PRP as a treatment for tenodesmic lesions in the horse.

Systematic review and meta-analysis of positive long-term effects after intra-articular administration of orthobiologic therapeutics in horses with naturally occurring osteoarthritis

“…All controlled studies treated with different placebos [saline (86,89), other potentially regenerative agents (77), cortisone and hyaluronic acid (87)]. Compared to other meta-analysis and systematic reviews, the lack of an adequate placebo group was also the main point of criticism (70,110). From an animal welfare perspective, it is unethical to not treat animals suffering from jointrelated pain.…”

Autologous Platelet and Extracellular Vesicle-Rich Plasma as Therapeutic Fluid: A Review

“…There are contradictory statements in the scientific literature about the effectiveness of the use of PVRP in the treatment of ligament and tendon injuries in veterinary medicine. Some researchers claimed that PVRP was effective for treatment of ligament and tendon injuries [ 250 , 251 , 252 , 253 ], while others found no evidence about the effectiveness of PVRP [ 254 , 255 ].…”

“…A systematic review and meta-analysis of clinical and experimental data about the use of PVRP for treatment of tenodesmic lesions in horses found no evidence that PVRP enhances the healing of tendon and ligament injuries [ 254 ]. In the future, further unbiased, blinded and controlled studies are needed to clarify the efficacy of this platelet concentrate in the treatment of equine tendon and ligament injuries [ 254 ].…”