Use of platelet-rich plasma in the treatment of desmitis of distal interphalangeal joint collateral ligament in a horse

ABSTRACT

Background: Platelet-rich plasma (PRP) has been increasingly used to hasten healing of tendonitis and desmitis, allowinghorse athletes to go back to practicing sports in a shorter period of time. However, its use has rarely been reported in thetreatment of desmitis of the collateral ligaments of the distal interphalangeal joint (CL-DIP), which is based on the useof horseshoes and rest for at least six months. This paper describes the use of PRP as an aid in the treatment of CL-DIPin a horse athlete.Case A male Criollo horse, 450 kg, about 15-year-old, used for paleteada. The animal had a month-long history of lameness, and a visual inspection revealed an increase in volume in the lateral dorsal region of the limb proximal to the coronaryband of the hoof. A specific examination of the locomotive system showed Grade III, Category 5 claudication, which became evident the beginning of the exercise and ceased after a short period. A radiographic evaluation of the distal phalanxrevealed no clinically relevant changes. Therefore, and in view of the location of the increased volume, an ultrasound scanwas performed, which showed an image compatible with an extensive hematoma in the region underlying the periopliccorium, while the CL-DIP presented swelling with large areas of hypoechogenicity. Considering the findings of the image,the physical examination and the history of the horse, desmitis of the collateral ligaments of the distal interphalangeal jointwas diagnosed. The treatment plan consisted of rest, application of a therapeutic horseshoe, and infiltration of the lesionwith platelet-rich plasma (PRP). First, however, warm compresses were applied to reduce the swelling. The PRP wasobtained by collecting whole blood from the external jugular vein, subjecting it to double centrifugation, and separatingthe supernatant blood plasma. The end product was applied to the lesion by ultrasound-guided infiltration. The horseshoewas a model...