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BMC veterinary research2016; 12(1); 191; doi: 10.1186/s12917-016-0826-1

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.

Abstract: Regenerative and anti-inflammatory effects on tendinopathies have been attributed to blood-derived biologicals. To date the evidence for the efficacy of autologous platelet-rich plasma (PRP) treatment of naturally occurring equine tendinopathies is limited. The purpose of this placebo-controlled clinical trial was to describe the effect of a single treatment of equine superficial digital flexor tendon (SDFT) disease with PRP on clinical and ultrasonographic parameters. Twenty horses with naturally occurring tendinopathies of forelimb SDFTs were randomly assigned to the PRP-treated group (n = 10) or control group (n = 10) after clinical and ultrasonographic examination. The SDFTs received an intralesional treatment with autologous PRP or were injected with saline, respectively (day 0). All horses participated in a standardized exercise programme and were re-examined clinically, with B-mode ultrasonography (5 times at regular intervals) and ultrasound tissue characterization (week 12 and 24 after treatment) until week 24. Long-term performance was estimated via telephone inquiry. Results: Compared to day 0, lameness decreased significantly by week 8 after treatment with PRP and by week 12 in the control group. Ultrasonographically there was no difference in the summarized cross sectional area between the groups at any time point. Ultrasound tissue characterization showed that echo types representing disorganized matrix decreased significantly throughout the observation period in the PRP-treated group. Echo type II, representing discontinuous fascicles, not yet aligned into lines of stress was significantly higher 24 weeks after PRP treatment. Eighty percent of the PRP treated horses reached their previous or a higher level of performance after 12 months compared to 50 % in the CG. After 24 months these proportions were 60 % and 50 %, respectively. Conclusions: A single intralesional treatment with PRP up to 8 weeks after onset of clinical signs of tendinopathy contributes to an earlier reduction of lameness compared to saline treatment and to an advanced organization of repair tissue as the fibrillar matrix is getting organized into fascicles while remodelling continues. Long term, PRP treatment has the potential to increase the number of horses reaching their previous level of performance. Earlier treatment of tendinopathy with PRP should be considered to enhance these effects.
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Publication Date: 2016-09-07 PubMed ID: 27604193PubMed Central: PMC5015224DOI: 10.1186/s12917-016-0826-1Google Scholar: Lookup
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  • Journal Article
  • Randomized Controlled Trial

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research paper reports the effects of Platelet-Rich Plasma (PRP) as a treatment for tendon damage in horses. The study demonstrated that PRP treatment contributes to faster recovery and better reorganization of damaged tissue compared to a control group receiving a saline injection.

Introduction and Objective

  • The primary goal of this study was to evaluate the effect of equine superficial digital flexor tendon (SDFT) disease treatment with Platelet-Rich Plasma (PRP) and examine its impact on clinical and ultrasonographic parameters.
  • Previous studies suggested regenerative and anti-inflammatory effects of blood-derived biological products on tendon injuries, but there was limited evidence demonstrating the effectiveness of autologous PRP treatment for naturally occurring equine tendinopathies.

Methodology

  • Twenty horses with naturally occurring tendinopathies of forelimb SDFTs participated in the study. The sample was randomly divided into two groups of ten: one group treated with PRP (PRP group) and the other treated with saline (control group). The division followed a clinical and ultrasonographic examination.
  • The treatment involved injecting the SDFTs with either autologous PRP or saline.
  • All participating horses underwent a standardized exercise program. They were then re-examined clinically and through B-mode ultrasonography (five times at regular intervals) and ultrasound tissue characterization (at week 12 and 24 after treatment) over 24 weeks.

Results

  • The results revealed a significant reduction in lameness by week 8 in the PRP group and by week 12 in the control group when compared to the initial state.
  • Ultrasonographic examination showed no difference in the summarized cross-sectional area of the tendons between the two groups at any given time.
  • Echo types representing a disorganized matrix significantly dropped throughout the study in the PRP-treated group, evident in the ultrasound tissue characterization. The echo representing discontinuous fascicles, not yet aligned into lines of stress, was significantly higher 24 weeks after PRP treatment.
  • Regarding performance, 80% of PRP-treated horses reached their previous or a higher level of performance after 12 months compared to 50% in the control group. The proportions dropped to 60% and 50% respectively after 24 months.

Conclusion

  • The study concluded that a single intralesional treatment with PRP up to 8 weeks after the onset of tendinopathy symptoms led to faster recovery compared to saline treatment.
  • The PRP treatment also led to better organization of repair tissue during recovery, showing its potential to increase the number of horses returning to their prior level of performance in the longer term.
  • The researchers recommended considering PRP treatment at an earlier stage of tendinopathy to enhance the beneficial effects revealed in the study.

Cite This Article

APA
Geburek F, Gaus M, van Schie HT, Rohn K, Stadler PM. (2016). 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. BMC Vet Res, 12(1), 191. https://doi.org/10.1186/s12917-016-0826-1

Publication

BMC veterinary research
ISSN: 1746-6148
NlmUniqueID: 101249759
Country: England
Language: English
Volume: 12
Issue: 1
Pages: 191

Researcher Affiliations

Geburek, Florian
  • Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany. florian.geburek@tiho-hannover.de.
Gaus, Moritz
  • Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany.
van Schie, Hans T M
  • Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 112, 3584 CM, Utrecht, Netherlands.
Rohn, Karl
  • Institute for Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, Foundation, Bünteweg 2, 30559, Hannover, Germany.
Stadler, Peter M
  • Clinic for Horses, University of Veterinary Medicine Hannover, Foundation, Bünteweg 9, 30559, Hannover, Germany.

MeSH Terms

  • Animals
  • Horse Diseases / diagnostic imaging
  • Horse Diseases / therapy
  • Horses
  • Injections, Intralesional / veterinary
  • Lameness, Animal / etiology
  • Lameness, Animal / therapy
  • Platelet-Rich Plasma
  • Prospective Studies
  • Tendinopathy / complications
  • Tendinopathy / diagnostic imaging
  • Tendinopathy / therapy
  • Tendinopathy / veterinary
  • Treatment Outcome
  • Ultrasonography / veterinary

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