Montano Chiara, Auletta Luigi, Greco Adelaide, Costanza Dario, Coluccia Pierpaolo, Del Prete Chiara, Meomartino Leonardo, Pasolini Maria Pia
Veterinary Teaching Hospital, School of Veterinary Medicine, University of Córdoba, 14004 Córdoba, Spain.
Institute of Biostructure and Bioimaging, National Research Council (IBB CNR), Via T. De Amicis 95, 80145 Napoli, Italy.
Animals (Basel). 2021 Mar 12;11(3):793. doi: 10.3390/ani11030793.
The use of platelet-rich plasma (PRP) to enhance tenodesmic lesion healing has been questioned over the years. The aim of this study was to evaluate current literature to establish the effectiveness of PRP for treating tenodesmic lesions through a systematic review, in accordance with the PRISMA guidelines, and a meta-analysis. Studies comparing PRP with placebo or other treatments for horses with tenodesmic injuries or evaluated PRP effect on tendon and ligament explants were included. Outcomes were clinical, ultrasound, histologic, molecular evaluation, and adverse effects. Two authors independently extracted data and assessed each study's risk of bias. Treatment effects were evaluated using risk ratios for dichotomous data, together with 95% CI. Data were pooled using the random-effects model. The quality of the evidence for each outcome was assessed using GRADE criteria. Twenty-four trials met inclusion criteria for systematic review, while fifteen studies were included in the meta-analysis. Results showed no significant differences in the outcomes between PRP and control groups. Finally, there is no definitive evidence that PRP enhances tendons and ligaments healing. Therefore, there is a need for more controlled trials to draw a firmer conclusion about the efficacy of PRP as a treatment for tenodesmic lesions in the horse.
多年来，使用富血小板血浆（PRP）促进腱性损伤愈合一直受到质疑。本研究的目的是根据PRISMA指南，通过系统评价和荟萃分析，评估现有文献以确定PRP治疗腱性损伤的有效性。纳入了比较PRP与安慰剂或其他治疗方法对患有腱性损伤马匹的疗效的研究，或评估PRP对肌腱和韧带外植体影响的研究。观察指标包括临床、超声、组织学、分子评估及不良反应。两位作者独立提取数据并评估每项研究的偏倚风险。使用二分数据的风险比及95%置信区间评估治疗效果。采用随机效应模型汇总数据。使用GRADE标准评估每个观察指标的证据质量。24项试验符合系统评价的纳入标准，15项研究纳入荟萃分析。结果显示PRP组和对照组在观察指标上无显著差异。最后，没有确凿证据表明PRP能促进肌腱和韧带愈合。因此，需要更多对照试验才能就PRP作为马匹腱性损伤治疗方法的疗效得出更确凿的结论。
