Clinical Evaluation of Intralesional Injection of Platelet-Rich Plasma for the Treatment of Proximal Suspensory Ligament Desmitis in Horses

• Lameness often occurs in the interosseus muscle or suspensory ligament (SL) in horses.
• We consider animals with acute proximal SL desmitis.
• We describe the double-bag technique to prepare the platelet-rich plasma from blood.
• We exanimate the effect of platelet-rich plasma intralesion injection on healing process.
• Increasing information could improve the quality and reduce time of healing after acute SL desmitis.

The study clinically evaluated the effectiveness of autologous platelet-rich plasma (PRP), obtained using a double transfusion bag after an ultrasound-guided intralesion injection into an acute lesion of proximal portion of suspensory ligament (SL). Twenty horses with acute proximal suspensory ligament desmitis were included in the study. An ultrasound evaluation of the proximal region of the SL was carried out, and the cross-sectional area (CSA) percentage and fiber score alignment were determined. Four hundred fifty milliliters of blood was collected, and PRP was obtained by means of the buffy coat method, using a double transfusion bag. The PRP was injected into the lesion using an ultrasound guide. A long-term follow-up was carried out by means of a telephonic interview with the owner. The median CSA of the SL lesion at the first examination was 30%. The median platelet count in the PRP was 1,045 × 103 platelets/μL; the final concentration ranged from six to 20 times higher than the platelet blood count. Sixteen horses returned to activity within a period ranging from 12 to 24 weeks from the last PRP injection, and four animals recidivated in different regions of suspensory ligament: midbody desmitis and medial branch. Clinical results confirm that the use of autologous PRP supports healing and reduces recurrence in acute SL lesions.