Stem cells and platelet-rich plasma for the treatment of naturally occurring equine tendon and ligament injuries: a systematic review and meta-analysis.
Abstract: Platelet-rich plasma (PRP) and mesenchymal stromal or stem cells (MSCs) have been investigated as treatments for equine tendon and ligament injuries, but little consensus exists on the efficacy of these treatments. The study sought to evaluate the efficacy of PRP and MSC treatments by systematic review and meta-analysis. Methods: A systematic review was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Inclusion criteria required an original, peer-reviewed study where horses were administered MSCs or PRP (or both), and a comparator group was described. Studies were assessed for risk of bias and study quality. Random effects meta-analysis with inverse variance weighting was used to calculate pooled estimates of the ORs for the primary outcomes of return to performance and reinjury. Results: The search criteria identified 764 unique studies, and 21 studies met the inclusion criteria for the systematic review. Seventeen studies were further assessed for the primary outcomes of return to performance and reinjury rate within a meta-analysis. Meta-analyses revealed no increase in the likelihood of a return to performance with any of the biologic treatments. However, MSCs and MSCs administered concurrently with PRP provide a reduced risk of reinjury. Conclusions: The current study identified a decrease in reinjury rate in horses administered MSCs or a combination of MSCs and PRP for tendinopathy and desmopathy. However, results should be interpreted with consideration of the heterogeneity of findings, poor study quality, and high risk of bias in the majority of studies.
Publication Date: 2024-03-16 PubMed ID: 38471305DOI: 10.2460/javma.23.12.0723Google Scholar: Lookup
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- Journal Article
- Systematic Review
- Meta-Analysis
Summary
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This research article systematically reviews and analyzes the effectiveness of stem cells and platelet-rich plasma treatments in healing tendon and ligament injuries in horses.
Research Objective
The research aims to ascertain the efficacy of platelet-rich plasma (PRP) and mesenchymal stem cells or stromal cells (MSCs) in treating tendon and ligament injuries in horses. These proposed treatments are not universally accepted, therefore the study attempts to bring this matter into sharp focus.
Research Methodology
- The study employed a systematic review approach following PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) principles.
- Only peer-reviewed studies which had treated horses with MSCs or PRP and included a control group were included in this examination.
- The researchers appraised each study for risk of bias and study quality to ensure credibility.
- They also ran a meta-analysis using a random effects model and inverse variance weighting to calculate pooled probabilities for the main outcomes – namely, return to performance and rate of reinjury.
Findings
- Out of the 764 unique studies examined, only 21 met the inclusion requirements for the systematic review.
- The researchers were able to further analyze data from 17 of these studies for return to performance and reinjury rates.
- The meta-analysis did not show any increase in the chances of horses returning to their earlier performance levels post any of the biologic treatments.
- However, treatments involving MSCs, or concurrent usage of MSCs and PRP did show a reduced likelihood of reinjury.
Conclusion
The research concludes that treating horses with MSCs or a combination of MSCs and PRP for tendinopathy and desmopathy injuries lead to a reduced reinjury rate. Nevertheless, the researchers warn that these findings should be interpreted with caution due to study heterogeneity, low study quality, and a high risk of bias in the majority of studies.
Cite This Article
APA
M'Cloud WRC, Guzmán KE, Panek CL, Colbath AC.
(2024).
Stem cells and platelet-rich plasma for the treatment of naturally occurring equine tendon and ligament injuries: a systematic review and meta-analysis.
J Am Vet Med Assoc, 262(S1), S50-S60.
https://doi.org/10.2460/javma.23.12.0723 Publication
Researcher Affiliations
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY.
- Oradell Animal Hospital, Paramus, NJ.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY.
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY.
MeSH Terms
- Animals
- Horses / injuries
- Platelet-Rich Plasma
- Tendon Injuries / veterinary
- Tendon Injuries / therapy
- Ligaments / injuries
- Horse Diseases / therapy
- Mesenchymal Stem Cell Transplantation / veterinary
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