PRP: no, no it's not alphabet soup. It's one of the newer treatment options for equine injuries: Platelet Rich Plasma. As your veterinarian, it gives us a potent weapon against career altering injuries. As sport horse owners, it gives your horse an improved prognosis for returning to competition. At Buckeye Veterinary Service, our lab has the newest equipment to prepare this treatment for your athlete.
One benefit of Platelet Rich Plasma (PRP) is that it is an "autologous" product: that's "vet speak " that means it is made from the horse himself. This reduces the chance of reactions, since no "foreign" material is used. After a surgical scrub, blood is drawn from the jugular vein of the injured horse into an anti-coagulant. That blood is centrifuged and processed and a specific portion is removed for use: Platelet Rich Plasma. This condensed component of the horse's own blood is full of platelets (hence the name) and at least ten different growth factors: it's been described as a "soup" of growth factors (NOT alphabet soup). These growth factors stimulate cell growth and healing, promote formation of new blood vessels, and can help make a fibrin matrix (a scaffold for repair). There are likely benefits that are still unknown..
There are several uses for PRP. It is injected into degenerative joints (arthritis) to help heal cartilage, and used topically during surgery over bone or soft tissues. Non-healing skin wounds may also respond from application of PRP. In humans it is being touted as a cure for baldness! (Injections under the skin of the scalp. OUCH!) In the horse world, we most often think of it as a treatment for supportive soft tissue (tendon or ligament) injuries.
Damaged superficial and deep digital flexor tendons, suspensory ligaments, collateral ligaments, etc. are common causes of lameness. A gradual return to exercise over many months is always the recommended "treatment". Nothing is a substitute for time, (8-12 months is the standard recovery period), but PRP can give a better final result.
After the PRP is harvested from the horse and prepared in our lab, we are ready to treat. (This is all done in a single day.) A needle is guided into the lesion(s) with ultrasound and PRP is injected. The growth factors go to work as rudimentary fibers are quickly laid down, eliminating the "holes". At 30 days post injection, core lesions (black holes) will typically be filled in. These simple strands have little tensile strength, (so you cannot put the horse into work just because it LOOKS good) but they allow healing to occur with straighter, more parallel fibers. This makes the end result stronger, more elastic, and less likely to re-injure. The beneficial effects from PRP injection may last 30-60 days. Shockwave therapy can be used in conjunction with PRP treatment to help with fiber alignment and healing. (We have a new focused shockwave generator that is ready for action.)
The ultrasound images below show a dramatic improvement in a horse with both a superficial digital flexor tendon (SDFT) and a suspensory ligament (SL) injury. Cross-sectional (transverse) images are on the left, longitudinal views are on the right. What you would like to see is a dense, white tendon or ligament, representing tightly packed, normal fibers. Here, abnormal areas can be seen in the "before" pictures. The SDFT has a large area that is less "white" and on longitudinal image, the fibers are cross-hatched and not parallel. The suspensory has a central black hole, a "core lesion". Thirteen weeks after Platelet Rich Plasma injection, damaged areas are more dense and the hole is filled in. Fiber patterns are more parallel and consistent. This is a remarkable change.
Remember, time and a gradual,
controlled return to exercise is essential for tendon/ligament healing.
However, PRP is a valuable tool for maximizing the quality of repair.
INITIAL SDFT INJURY 13 WEEKS POST PRP