Platelet-rich plasma in orthopedic therapy: a comparative systematic review of clinical and experimental data in equine and human musculoskeletal lesions.
Authors: Brossi Patrícia M, Moreira Juliana J, Machado Thaís S L, Baccarin Raquel Y A
Journal: BMC veterinary research
Summary
# Platelet-Rich Plasma in Equine and Human Musculoskeletal Injury: What the Evidence Actually Shows Platelet-rich plasma (PRP) has become increasingly popular in equine and human orthopedic practice, yet substantial variation exists in how it is prepared, applied and evaluated across published research. Brossi and colleagues systematically reviewed clinical trials, cohort studies and case series in both species alongside relevant experimental work through July 2013, critically appraising study design quality and methodology to determine whether observed benefits reflected genuine efficacy or methodological bias. The analysis revealed a striking inconsistency: whilst experimental studies demonstrated plausible biological mechanisms for PRP's action on tendon, ligament and articular tissues, clinical evidence remained fragmentary, with most equine studies lacking adequate controls and human trials showing modest or equivocal outcomes that often correlated more closely with study design robustness than with PRP itself. The authors' key finding was that methodological rigour substantially influenced reported efficacy rates—poorly controlled studies almost invariably reported positive results, whereas randomised, blinded designs produced considerably more cautious conclusions. For equine practitioners, this work underscores the importance of demanding robust evidence before committing to expensive PRP protocols, and highlights the urgent need for standardised preparation methods, consistent outcome measures and controlled clinical trials that can definitively separate genuine therapeutic benefit from placebo effect and natural healing trajectories.
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Practical Takeaways
- •PRP efficacy varies substantially depending on study design—be cautious when evaluating claims as clinical outcomes may differ from experimental results
- •Current evidence supports PRP use in tendon and ligament lesions, but quality of evidence varies; consider study methodology when selecting treatment protocols
- •Comparative analysis between equine and human studies suggests similar biological mechanisms, potentially allowing cross-species evidence application to clinical practice
Key Findings
- •Systematic review of PRP efficacy in equine and human orthopedic therapy across multiple musculoskeletal lesion types
- •Study design and methodology significantly influence reported efficacy outcomes of PRP treatments
- •Evidence base includes randomized trials in humans, equine clinical studies, and experimental studies across animal species
- •Review critically appraised available data on mechanisms of action and therapeutic effectiveness of PRP in tendons, ligaments, and joints