Authors: Seabaugh Kathryn A, Thoresen Merrilee, Giguère Steeve
Journal: Frontiers in veterinary science
Summary
# Editorial Summary Extracorporeal shockwave therapy (ESWT) and platelet-rich plasma (PRP) represent two well-established but mechanistically distinct approaches to soft tissue healing in equine practice; this 2017 investigation explored whether combining them might amplify therapeutic benefit by triggering greater growth factor release from platelets. Using in vitro methodology, researchers exposed PRP samples from six horses to different shockwave protocols—a standard probe delivering medium energy across a 2 cm focal width and a power probe with high energy over 1 cm—then quantified two key growth factors (TGF-β1 and PDGF-ββ) using ELISA analysis. Both shockwave applications significantly elevated TGF-β1 concentrations (46% and 33% above untreated controls for standard and power probes respectively) and more substantially increased PDGF-ββ concentrations (219% and 190% respectively), though neither matched the robust response from freeze-thaw activation. The findings suggest a synergistic potential for sequential PRP injection followed by local shockwave therapy, where mechanical stimulation could trigger additional growth factor release directly within the injured tissue rather than relying solely on the initial injection dose. For practitioners considering combination protocols in tendon and ligament injuries, this biochemical evidence supports the rationale for combining modalities, though clinical validation through in vivo studies would be necessary to confirm whether these laboratory gains translate to measurably superior healing outcomes in clinical cases.
Read the full abstract on PubMed
Practical Takeaways
- •Combining PRP injection with ESWT post-injection may amplify growth factor release at the injury site compared to either therapy alone
- •Both standard and power probe settings effectively stimulate growth factor release from PRP, offering flexibility in clinical application
- •This in vitro evidence supports further clinical investigation of combination PRP+ESWT protocols for equine tendon and ligament injuries, though in vivo efficacy remains to be demonstrated
Key Findings
- •Shockwave application to PRP increased TGF-β1 concentration by 33-46% compared to untreated controls
- •Shockwave application to PRP increased PDGF-ββ concentration by 190-219% compared to untreated controls
- •Standard probe (ESWT-S) and power probe (ESWT-P) both significantly increased growth factor release, with power probe producing slightly lower increases
- •Freeze-thaw cycle produced the highest growth factor concentrations, exceeding shockwave treatments