Gait Changes Vary among Horses with Naturally Occurring Osteoarthritis Following Intra-articular Administration of Autologous Platelet-Rich Plasma.
Authors: Mirza Mustajab H, Bommala Prakash, Richbourg Heather A, Rademacher Nathalie, Kearney Michael T, Lopez Mandi J
Journal: Frontiers in veterinary science
Summary
# Editorial Summary: Platelet-Rich Plasma Response in Equine Osteoarthritis Intra-articular platelet-rich plasma (PRP) has gained considerable traction in equine practice as a regenerative therapy for osteoarthritis, yet individual response rates remain unpredictable. Mustajab and colleagues used kinetic gait analysis—a more objective measure than traditional lameness assessment—to evaluate 12 horses with unilateral forelimb OA before and after PRP injection, with follow-up measurements at 6 and 16 weeks; a response was defined as ≥5% improvement in peak vertical force, vertical impulse, or breaking impulse. Of the 10 horses that initially responded to intra-articular anaesthesia, only three showed sustained improvement with PRP at both time points and four improved at just one assessment, whilst notably one horse unresponsive to anaesthesia responded favourably to PRP throughout. Neither platelet concentration (despite significant increases following filtration) nor radiographic OA severity predicted clinical response, and critically, a horse's response to the diagnostic anaesthetic block did not reliably predict its response to PRP treatment. For practitioners, these findings underscore that kinetic gait analysis provides a more reproducible baseline than lameness scoring when evaluating intra-articular therapies, though the substantial variability in PRP response—even among horses with comparable radiographic changes—suggests individualised assessment remains essential and that further research is needed to identify biomarkers predicting which horses will truly benefit.
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Practical Takeaways
- •PRP response varies considerably between individual horses with OA — lack of response to joint anesthesia does not predict PRP failure, and vice versa
- •Higher platelet concentrations in PRP do not guarantee better clinical outcomes for lameness in OA joints
- •Kinetic gait analysis may help objectively measure response to intra-articular therapies, but radiographic OA severity alone cannot predict which horses will benefit from PRP
Key Findings
- •Only 3 of 10 horses that responded to intra-articular anesthesia also responded to PRP at both follow-up timepoints (6 and 16 weeks)
- •Response to PRP was not associated with response to intra-articular anesthesia, platelet concentration, or radiographic OA severity
- •Filtration significantly increased platelet concentration in PRP preparations
- •Kinetic gait changes following PRP were highly variable among horses with moderate to severe forelimb osteoarthritis