The Use of Platelet-Rich Plasma for Treatment of Tenodesmic Lesions in Horses: A Systematic Review and Meta-Analysis of Clinical and Experimental Data.
Authors: Montano Chiara, Auletta Luigi, Greco Adelaide, Costanza Dario, Coluccia Pierpaolo, Del Prete Chiara, Meomartino Leonardo, Pasolini Maria Pia
Journal: Animals : an open access journal from MDPI
Summary
# Platelet-Rich Plasma for Equine Tendon and Ligament Injuries: Current Evidence Remains Inconclusive Despite widespread clinical adoption of platelet-rich plasma (PRP) for treating tendon and ligament lesions in horses, rigorous evidence supporting its efficacy has remained elusive. Montano and colleagues conducted a systematic review and meta-analysis of 24 trials (15 included in quantitative synthesis) comparing PRP treatment against placebo or alternative therapies, examining clinical outcomes, ultrasound findings, histological changes, molecular markers, and adverse effects using GRADE methodology to assess evidence quality. Pooled analysis revealed no statistically significant differences between PRP-treated and control groups across any measured outcome, suggesting that the current body of evidence does not support superior healing benefits from PRP administration alone. For practitioners considering PRP injections—whether intra-lesional or as adjunctive therapy—these findings suggest the importance of managing client expectations and recognising that any observed improvements may reflect natural healing trajectories or concurrent rehabilitation protocols rather than PRP-specific effects. Well-designed, adequately powered controlled trials employing standardised injection protocols, consistent outcome measures, and longer follow-up periods are essential before PRP can be confidently recommended as a standalone therapeutic intervention for equine tenodesmic injuries.
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Practical Takeaways
- •PRP shows no proven superiority over placebo or standard treatments for tendon and ligament injuries in horses based on current evidence—consider this when discussing treatment options with clients
- •While PRP is widely marketed for soft tissue injuries, clinicians should manage expectations and counsel that evidence does not yet support its routine use over conventional therapies
- •More rigorous, controlled clinical trials are needed before PRP can be recommended as a standard treatment; highlight this gap when justifying treatment choices
Key Findings
- •Meta-analysis of 15 trials found no significant differences in clinical, ultrasound, histologic, or molecular outcomes between PRP and control groups for tenodesmic lesions in horses
- •24 trials met inclusion criteria for systematic review, but evidence quality was insufficient to support PRP efficacy
- •No definitive evidence that PRP enhances tendon and ligament healing in equine patients
- •Current literature lacks sufficient controlled trials to draw firm conclusions about PRP effectiveness for tenodesmic lesions