Carmona Jorge U, López Catalina
Grupo de Investigación Terapia Regenerativa, Departamento de Salud Animal, Universidad de Caldas, Calle 65 No 26-10, Manizales 170004, Colombia.
Grupo de Investigación Patología Clínica Veterinaria, Departamento de Salud Animal, Universidad de Caldas, Calle 65 No 26-10, Manizales 170004, Colombia.
Vet Sci. 2025 Apr 18;12(4):382. doi: 10.3390/vetsci12040382.
(1) Background: Tendon and ligament injuries are a leading cause of lameness in horses, with significant economic implications. Platelet-rich plasma (PRP) has gained attention for its regenerative potential, but its efficacy remains uncertain due to inconsistent study designs and reporting. (2) Methods: This systematic review, following the PRISMA guidelines, evaluated 22 studies (clinical and experimental) to assess the safety and efficacy of PRP in treating equine tendon and ligament injuries. The risk of bias was analyzed using the ROBINS-I and RoB 2.0 tools. (3) Results: PRP demonstrated a favorable safety profile, with no severe adverse effects reported. Clinical outcomes included improved lameness scores, ultrasonographic tissue organization, and return-to-work rates. However, variability in PRP formulations (e.g., leukocyte-rich vs. leukocyte-reduced) and activation methods (e.g., calcium chloride, thrombin) contributed to inconsistent results. Experimental studies supported PRP's role in collagen synthesis and neovascularization, but comparative trials with stem cells or other therapies (e.g., extracorporeal shockwave) showed mixed results. The methodological quality of studies varied, with only 27% achieving "good" scores for PRP reporting. (4) Conclusions: PRP is a safe and potentially effective treatment, but its clinical application is hindered by a lack of standardization. Future research should focus on large, randomized controlled trials with uniform PRP protocols, long-term (≥2 years) efficacy assessments, comparative studies with MSC combinations, and cost-effectiveness analyses.
(1) 背景：肌腱和韧带损伤是马匹跛行的主要原因，具有重大经济影响。富血小板血浆（PRP）因其再生潜力而受到关注，但其疗效因研究设计和报告不一致而仍不确定。(2) 方法：本系统评价遵循PRISMA指南，评估了22项研究（临床和实验性），以评估PRP治疗马肌腱和韧带损伤的安全性和疗效。使用ROBINS-I和RoB 2.0工具分析偏倚风险。(3) 结果：PRP显示出良好的安全性，未报告严重不良反应。临床结果包括跛行评分改善、超声组织结构改善和重返工作率提高。然而，PRP制剂（如富白细胞与白细胞减少）和激活方法（如氯化钙、凝血酶）的差异导致结果不一致。实验研究支持PRP在胶原蛋白合成和新血管形成中的作用，但与干细胞或其他疗法（如体外冲击波）的对比试验结果不一。研究的方法学质量各不相同，只有27%的PRP报告获得“良好”评分。(4) 结论：PRP是一种安全且可能有效的治疗方法，但其临床应用因缺乏标准化而受到阻碍。未来的研究应集中在采用统一PRP方案的大型随机对照试验、长期（≥2年）疗效评估、与间充质干细胞组合的对比研究以及成本效益分析上。
