Intralesional injection of platelet-rich plasma followed by controlled exercise for treatment of midbody suspensory ligament desmitis in Standardbred racehorses.

OBJECTIVE To determine outcome of Standardbred racehorses with moderate to severe midbody suspensory ligament desmitis (MSD) treated by means of ultrasound-guided intralesional injection of a single dose of platelet-rich plasma (PRP) followed by a program of gradually increased exercise. DESIGN Nonrandomized clinical trial. ANIMALS 9 Standardbred racehorses. PROCEDURES Following injection of PRP, horses were allowed a controlled, gradual return to exercise. Race records for the year prior to injury and for 3 consecutive years after horses returned to racing were reviewed. For comparison purposes, race records of 9 Standardbred racehorses with no history of MSD racing at the same time were also reviewed. RESULTS All 9 horses with MSD returned to racing after treatment; median time to return to racing was 32 weeks. All 9 horses raced at least once during the first and second years after returning to racing, but only 5 raced during the third year. When number of starts, total earnings, and earnings per start were compared between case and comparison horses, the only significant differences were number of starts during the third year after case horses returned to racing and earnings per start during the first year after case horses returned to racing, with values being significantly lower for case horses than for comparison horses. CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that horses with moderate to severe MSD treated by means of intralesional injection of a single dose of PRP followed by a program of gradually increased exercise had an excellent prognosis for returning to racing.

[1]  C. Kaeding,et al.  Metacarpophalangeal collateral ligament reconstruction using small intestinal submucosa in an equine model. , 2008, Journal of biomedical materials research. Part A.

[2]  Iñigo Mujika,et al.  Comparison of Surgically Repaired Achilles Tendon Tears Using Platelet-Rich Fibrin Matrices , 2007, The American journal of sports medicine.

[3]  B. Snyder,et al.  Collagen‐platelet rich plasma hydrogel enhances primary repair of the porcine anterior cruciate ligament , 2007, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[4]  N. White,et al.  Outcome of desmoplasty and fasciotomy for desmitis involving the origin of the suspensory ligament in horses: 27 cases (1995-2004). , 2006, Journal of the American Veterinary Medical Association.

[5]  D. Zurakowski,et al.  Use of a collagen‐platelet rich plasma scaffold to stimulate healing of a central defect in the canine ACL , 2006, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[6]  Peter A M Everts,et al.  Platelet-rich plasma preparation using three devices: Implications for platelet activation and platelet growth factor release , 2006, Growth factors.

[7]  P. Aspenberg,et al.  How can one platelet injection after tendon injury lead to a stronger tendon after 4 weeks?: Interplay between early regeneration and mechanical stimulation , 2006, Acta orthopaedica.

[8]  J. J. Smith,et al.  Anabolic effects of acellular bone marrow, platelet rich plasma, and serum on equine suspensory ligament fibroblasts in vitro , 2006, Veterinary and Comparative Orthopaedics and Traumatology.

[9]  J. Granjeiro,et al.  Platelet-rich plasma influence on human osteoblasts growth. , 2005, Clinical oral implants research.

[10]  I. Wright,et al.  Treatment of chronic or recurrent proximal suspensory desmitis using radial pressure wave therapy in the horse. , 2010, Equine veterinary journal.

[11]  A. Kaneps,et al.  Comparison of hematologic values and transforming growth factor-beta and insulin-like growth factor concentrations in platelet concentrates obtained by use of buffy coat and apheresis methods from equine blood. , 2004, American journal of veterinary research.

[12]  F. Kloss,et al.  Effects of platelet-rich plasma on bone healing in combination with autogenous bone and bone substitutes in critical-size defects. An animal experiment. , 2004, Clinical oral implants research.

[13]  P. Aspenberg,et al.  Platelet concentrate injection improves Achilles tendon repair in rats , 2004, Acta orthopaedica Scandinavica.

[14]  S. Werner,et al.  Regulation of wound healing by growth factors and cytokines. , 2003, Physiological reviews.

[15]  C. A. Carter,et al.  Platelet-rich plasma gel promotes differentiation and regeneration during equine wound healing. , 2003, Experimental and molecular pathology.

[16]  J. Dawson,et al.  The biomechanical response to doses of TGF‐β2 in the healing rabbit medial collateral ligament , 2003, Journal of orthopaedic research : official publication of the Orthopaedic Research Society.

[17]  S. Dyson,et al.  Chapter 73 – The Suspensory Apparatus , 2003 .

[18]  G. Murrell,et al.  The Roles of Growth Factors in Tendon and Ligament Healing , 2003, Sports medicine.

[19]  D. Hom,et al.  Growth factor therapy to improve soft tissue healing. , 2002, Facial plastic surgery : FPS.

[20]  F. Rendu,et al.  The platelet release reaction: granules' constituents, secretion and functions , 2001, Platelets.

[21]  J. Douglas,et al.  ENHANCED SUSPENSORY LIGAMENT HEALING IN 100 HORSES BY STEM CELLS AND OTHER BONE MARROW COMPONENTS , 2001 .

[22]  M. Reynolds,et al.  Alveolar ridge and sinus augmentation utilizing platelet-rich plasma in combination with freeze-dried bone allograft: case series. , 2000, Journal of periodontology.

[23]  R. Marx,et al.  Platelet-rich plasma: Growth factor enhancement for bone grafts. , 1998, Oral surgery, oral medicine, oral pathology, oral radiology, and endodontics.

[24]  V. Moulin Growth factors in skin wound healing. , 1995, European journal of cell biology.

[25]  S. Dyson,et al.  Suspensory ligament desmitis. , 1995, The Veterinary clinics of North America. Equine practice.

[26]  S. Dyson Proximal suspensory desmitis in the hindlimb: 42 cases. , 1994, The British veterinary journal.

[27]  L. Gift,et al.  The Influence of Intratendinous Sodium Hyaluronate on Tendon Healing in Horses , 1992, Veterinary and Comparative Orthopaedics and Traumatology.

[28]  C. Mcewen Tendon splitting and other treatments , 1991, Veterinary Record.