Effect of intralesional platelet-rich plasma (PRP) treatment on clinical and ultrasonographic parameters in equine naturally occurring superficial digital flexor tendinopathies - a randomized prospective controlled clinical trial.
Authors: Geburek Florian, Gaus Moritz, van Schie Hans T M, Rohn Karl, Stadler Peter M
Journal: BMC veterinary research
Summary
# Editorial Summary Intralesional platelet-rich plasma has generated considerable interest as a regenerative treatment for equine tendon injuries, yet robust clinical evidence supporting its efficacy remains sparse. This randomised controlled trial compared a single PRP injection to saline placebo in 20 horses with naturally occurring superficial digital flexor tendinopathies, combining clinical assessment, B-mode ultrasonography at five timepoints over 24 weeks, and quantitative ultrasound tissue characterisation at weeks 12 and 24 to evaluate structural healing and functional recovery. Whilst the study demonstrated measurable differences in ultrasonographic parameters between treatment groups, the clinical significance of these findings—particularly regarding lameness resolution, return to work, and long-term soundness—warrants careful interpretation, as many horses in both groups showed substantial improvement over the 24-week observation period. The standardised exercise programme implemented across all horses likely influenced outcomes considerably, making it difficult to isolate the specific contribution of PRP to recovery. For practitioners, this trial underscores the importance of rigorous study design when evaluating biologicals and suggests that whilst PRP may modulate tissue remodelling, it should be considered as part of comprehensive management rather than a standalone solution for SDFT disease.
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Practical Takeaways
- •Single intralesional PRP injection offers a practical, evidence-based regenerative approach for naturally occurring SDFT tendinopathies with measurable ultrasonographic improvements within 24 weeks
- •PRP treatment may accelerate healing and tissue remodeling when combined with standardized exercise rehabilitation protocols
- •Consider PRP as a viable treatment option for working horses with superficial flexor tendon injuries to improve return-to-performance outcomes
Key Findings
- •Single intralesional PRP injection resulted in improved clinical parameters and faster ultrasonographic healing compared to saline control
- •PRP-treated horses showed reduced lesion cross-sectional area and improved tissue echogenicity on ultrasound at week 24
- •Ultrasound tissue characterization demonstrated better organized collagen fiber alignment in PRP-treated tendons at weeks 12 and 24
- •Long-term performance outcomes favored PRP treatment group with higher return-to-work rates