A systematic review and meta-analysis of the efficacy of platelet-rich plasma products for treatment of equine joint disease.
Authors: Peng Cong, Yang Luo, Labens Raphael, Gao Yu, Zhu Yiping, Li Jing
Journal: Equine veterinary journal
Summary
# Editorial Summary: Platelet-Rich Plasma for Equine Joint Disease Joint disease remains a leading cause of equine lameness, with osteoarthritis and septic arthritis substantially limiting performance and longevity. Whilst platelet-rich plasma (PRP) has gained considerable popularity amongst equine practitioners as a regenerative therapy, clinical evidence supporting its use has been inconsistent. This systematic review synthesised 21 publications from 2013–2023, conducting meta-analysis on five studies that met criteria for randomised or controlled designs. Results demonstrated a statistically significant treatment effect, with PRP-treated horses showing 15-fold greater odds of improvement compared with controls (OR: 15.32; 95% CI: 3.00–78.15), and notably stronger effects on clinical performance outcomes at 36-fold improvement (OR: 36.64; 95% CI: 3.69–364.30). However, the authors emphasise important limitations: most included studies carried high bias risk, substantial heterogeneity existed between different PRP formulations and application protocols, and the meta-analysis comprised only five trials. The findings support intra-articular PRP as a reasonable treatment option for osteoarthritis with emerging potential in septic arthritis, yet practitioners should recognise that stronger evidence requires standardised PRP classification systems and rigorously designed blinded trials with equivalency or non-inferiority frameworks—meaning future research must directly compare PRP against established benchmarks rather than simply demonstrating superiority over untreated controls.
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Practical Takeaways
- •PRP appears efficacious as an intra-articular treatment for equine osteoarthritis and may help with septic arthritis, though clinical outcomes vary significantly between product types
- •Until standardized PRP classification and higher-quality randomized controlled trials are available, practitioners should carefully evaluate individual product evidence and maintain realistic expectations about treatment variability
- •Consider PRP as part of a multimodal treatment approach for joint disease, but recognize current evidence quality limitations when counseling clients on expected outcomes
Key Findings
- •Meta-analysis of 5 studies showed PRP treatment significantly improved outcomes compared to control (OR: 15.32; 95% CI: 3.00-78.15; p<0.05)
- •Clinical performance outcomes showed even greater improvement with PRP treatment (OR: 36.64; 95% CI: 3.69-364.30; p<0.05)
- •21 publications reviewed demonstrated variable study quality with high risk of bias overall, but consistent treatment benefit
- •PRP shows promise for septic arthritis treatment but evidence base is limited by heterogeneous product types and lack of standardized classification systems