Intra-articular platelet-rich plasma for advanced carpometacarpal osteoarthritis in an Arabian horse: Long-term clinical outcome

Abstract

Osteoarthritis (OA) is a common degenerative joint disease in horses, characterized by cartilage degradation, synovial inflammation, and progressive lameness. Intra-articular platelet-rich plasma (IA- PRP) therapy has emerged as a promising regenerative treatment, aimed at promoting cartilage repair and reducing inflammation through growth factor release. A 10-year-old Arabian stallion presented with acute carpal lameness, graded 3/5 on the AAEP scale. Initial treatment with phenylbutazone and intra-articular corticosteroid (IA- GCs) injection resulted in temporary improvement, however lameness progressed to grade 5/5. Due to failure of conventional therapy and the inability to pursue further referral, IA- PRP therapy was initiated. The treatment protocol consisted of four IA-PRP injections administered at two-week intervals, followed by a prophylactic booster (fifth IA-PRP injection) six months after the fourth treatment. PRP was prepared using a double-spin centrifugation protocol. Early improvement was observed after PRP initiation, allowing NSAID discontinuation. Lameness progressively improved to near-normal function, with no recurrence of pain or gait abnormalities at the 18-month follow-up. This case highlights the potential of IA-PRP therapy as a steroid-sparing treatment option in the management of equine osteoarthritis.