Platelet‐rich plasma is safe for intra‐articular and peri‐articular cervical facet joint injections in the horse

Summary Background No safety study has been conducted regarding platelet‐rich plasma (PRP) usage in cervical facet joints. Objectives To determine whether intra‐ and/or peri‐articular injections of PRP in cervical facet joints in the horse are safe. Study design Prospective, multi‐centre, safety study. Methods PRP was injected via ultrasound guidance into the cervical and/or cervicothoracic facet joints in horses with diagnosed cervical complaints. Data recorded for each case included: breed, sex, age, primary reason for treatment, list of which facet joints were injected, the volume of PRP injected, whether the PRP was injected intra‐articular or peri‐articular and gauge of needle used. Data were collected at three time points: prior to treatment, 48 h after treatment and a minimum of 30 days after treatment. At each time point, owners/trainers were asked to assess the level of pain the horse was suffering on a 0–10 (no pain to worst) scale. At the final evaluation, the owners/trainers were also asked if the treatment met their expectations on a 0–5 scale. Results No adverse events were reported. The average pain scores prior to treatment, at 48 h and at 30 days were 3.8, 3.4 and 1.1 respectively. At no point did any horse have an increase in its reported pain level. Main limitations Since PRP is not classified as a drug, it does not come with a label indicating items such as dosage or route of administration. Thus, methodologies will vary among veterinarians. This was a nonblinded study; ideally, owners/trainers should be blinded to the intervention. Additionally, this study only involved 17 horses. Conclusions PRP appears to be safe for cervical and/or cervicothoracic facet joint injections in the horse. Evidence for efficacy was also recorded by means of owner/trainer reporting that the injections overwhelmingly met their expectations.