Injection of platelet- and leukocyte-rich plasma at the junction of the proximal sesamoid bone and the suspensory ligament branch for treatment of yearling Thoroughbreds with proximal sesamoid bone inflammation and associated suspensory ligament branch desmitis
Authors: Garrett Katherine S., Bramlage Lawrence R., Spike-Pierce Deborah L., Cohen Noah D.
Journal: Journal of the American Veterinary Medical Association
Summary
# Editorial Summary Proximal sesamoid bone inflammation coupled with suspensory ligament branch desmitis represents a common performance-limiting condition in young Thoroughbreds, yet evidence-based treatment options remain limited. Garrett and colleagues conducted a randomised controlled trial in 39 yearling Thoroughbreds with radiographic proximal sesamoid bone changes and ultrasonographic suspensory ligament branch pathology, comparing platelet- and leukocyte-rich plasma (PRP) injection at the sesamoid-ligament junction against saline control, then tracking subsequent racing records through ages two, three and four. Whilst PRP-treated horses showed significantly greater likelihood of racing as two-year-olds compared to controls, this advantage did not persist into the three and four-year-old racing seasons, and no meaningful differences emerged in earnings or race starts across any subsequent age group. These findings suggest that despite its theoretical biological merit and the initial racing advantage, this particular PRP injection protocol does not substantially alter the long-term competitive trajectory or financial performance of affected yearlings, challenging assumptions about therapeutic benefit in this common condition. Practitioners should temper expectations regarding PRP intervention for proximal sesamoid inflammation with suspensory ligament involvement and consider whether delaying racing rather than pursuing early biological treatment might yield comparable or superior outcomes for young horses with this diagnosis.
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Practical Takeaways
- •While PRP injection may facilitate earlier return to racing in 2-year-olds with sesamoid bone inflammation and suspensory ligament branch desmitis, it does not improve long-term racing performance or earnings compared to saline injection
- •This specific PRP protocol should not be relied upon as a definitive treatment for these conditions, and other conservative or regenerative approaches may warrant consideration
- •Early racing commencement does not translate to sustained career success in PRP-treated horses with these lesions
Key Findings
- •PRP-treated yearlings were significantly more likely to start at least one race during the 2-year-old racing year compared to saline controls (p<0.05)
- •No significant differences in racing performance between PRP and saline groups were detected in 3- and 4-year-old racing years
- •No significant differences in earnings between treatment and control groups across any racing year
- •Single PRP injection at the SLB-proximal sesamoid bone junction did not provide sustained performance benefits beyond the 2-year-old racing season