The Combined Use of Triamcinolone and Platelet-Rich Plasma in Equine Metacarpophalangeal Joint Osteoarthritis Treatments: An In Vivo and In Vitro Study.
Authors: Guidoni Kübra, Chiaradia Elisabetta, Pepe Marco, Di Meo Antonio, Tognoloni Alessia, Seccaroni Matteo, Beccati Francesca
Journal: Animals : an open access journal from MDPI
Summary
# Editorial Summary Intra-articular corticosteroid injections such as triamcinolone acetonide (TA) remain a mainstay for managing osteoarthritic pain in performance horses, yet their catabolic effects on chondrocyte function raise concerns about long-term joint health. Guidoni and colleagues investigated whether sequential intra-articular administration of TA followed by platelet-rich plasma (PRP) could mitigate these deleterious effects whilst maintaining therapeutic benefit, using both laboratory and clinical approaches in racehorses with metacarpophalangeal joint osteoarthritis. In vitro work demonstrated that whilst TA substantially suppressed chondrocyte viability, co-treatment with PRP not only prevented this cellular damage but actively promoted proliferation, suggesting a protective synergy between the regenerative and anti-inflammatory agents. A clinical trial of 32 affected racehorses showed that whilst single TA injection improved flexion at one week, only the combined TA+PRP protocol maintained improved flexion and lameness scores at the two-week assessment point. These findings indicate that sequencing a PRP injection after corticosteroid therapy may offer clinicians a practical strategy to preserve chondrocyte health and extend clinical benefit, though practitioners should await larger prospective trials to fully characterise safety profiles and optimal dosing intervals before widespread adoption.
Read the full abstract on PubMed
Practical Takeaways
- •Consider combining PRP with triamcinolone injections for MCP joint OA in racehorses to potentially mitigate the cartilage-damaging effects of corticosteroids while maintaining pain relief benefits.
- •TA+PRP appears to provide longer-lasting improvements in flexion and lameness compared to TA alone, potentially reducing treatment frequency and improving athletic performance return.
- •While in vitro results are promising, further clinical trials are needed before widespread adoption; use cautiously and monitor individual horse response.
Key Findings
- •Triamcinolone acetonide alone dramatically reduced chondrocyte viability in vitro, but this reduction was prevented by the addition of PRP, which also increased cell proliferation.
- •Both TA and TA+PRP groups showed improved flexion assessments at one week post-treatment, but only TA+PRP maintained improvement at two weeks.
- •TA+PRP demonstrated improved lameness scores at two weeks post-treatment, whereas TA alone did not maintain this benefit.