Abstract：
BACKGROUND: Platelet-rich plasma (PRP) and mesenchymal stromal or stem cells (MSCs) have been investigated as treatments for equine tendon and ligament injuries, but little consensus exists on the efficacy of these treatments. The study sought to evaluate the efficacy of PRP and MSC treatments by systematic review and meta-analysis.
METHODS: A systematic review was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Inclusion criteria required an original, peer-reviewed study where horses were administered MSCs or PRP (or both), and a comparator group was described. Studies were assessed for risk of bias and study quality. Random effects meta-analysis with inverse variance weighting was used to calculate pooled estimates of the ORs for the primary outcomes of return to performance and reinjury.
RESULTS: The search criteria identified 764 unique studies, and 21 studies met the inclusion criteria for the systematic review. Seventeen studies were further assessed for the primary outcomes of return to performance and reinjury rate within a meta-analysis. Meta-analyses revealed no increase in the likelihood of a return to performance with any of the biologic treatments. However, MSCs and MSCs administered concurrently with PRP provide a reduced risk of reinjury.
CONCLUSIONS: The current study identified a decrease in reinjury rate in horses administered MSCs or a combination of MSCs and PRP for tendinopathy and desmopathy. However, results should be interpreted with consideration of the heterogeneity of findings, poor study quality, and high risk of bias in the majority of studies.
METHODS: A systematic review was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Inclusion criteria required an original, peer-reviewed study where horses were administered MSCs or PRP (or both), and a comparator group was described. Studies were assessed for risk of bias and study quality. Random effects meta-analysis with inverse variance weighting was used to calculate pooled estimates of the ORs for the primary outcomes of return to performance and reinjury.
RESULTS: The search criteria identified 764 unique studies, and 21 studies met the inclusion criteria for the systematic review. Seventeen studies were further assessed for the primary outcomes of return to performance and reinjury rate within a meta-analysis. Meta-analyses revealed no increase in the likelihood of a return to performance with any of the biologic treatments. However, MSCs and MSCs administered concurrently with PRP provide a reduced risk of reinjury.
CONCLUSIONS: The current study identified a decrease in reinjury rate in horses administered MSCs or a combination of MSCs and PRP for tendinopathy and desmopathy. However, results should be interpreted with consideration of the heterogeneity of findings, poor study quality, and high risk of bias in the majority of studies.
摘要：
目的：已经研究了富血小板血浆（PRP）和间充质基质细胞或干细胞（MSCs）作为马肌腱和韧带损伤的治疗方法，但对这些治疗的疗效几乎没有共识.该研究试图通过系统评价和荟萃分析来评估PRP和MSC治疗的疗效。
方法：使用PRISMA（系统评价和荟萃分析的首选报告项目）指南进行系统评价。纳入标准需要原件，同行评审的研究，其中马匹被给予MSC或PRP（或两者），并描述了一个比较组。评估研究的偏倚风险和研究质量。采用方差逆加权的随机效应荟萃分析来计算恢复表现和再损伤的主要结果的OR的汇总估计值。
结果：搜索标准确定了764项独特研究，21项研究符合系统评价的纳入标准.在荟萃分析中进一步评估了17项研究的主要结局，即恢复表现和再损伤率。荟萃分析显示，任何生物治疗恢复性能的可能性都没有增加。然而,MSC和与PRP同时施用的MSC提供降低的再损伤风险。
结论：目前的研究发现，使用MSCs或MSCs和PRP联合治疗肌腱病和肌腱病的马的再损伤率降低。然而,结果的解释应该考虑到结果的异质性，学习质量差，在大多数研究中，偏倚的风险很高。
方法：使用PRISMA（系统评价和荟萃分析的首选报告项目）指南进行系统评价。纳入标准需要原件，同行评审的研究，其中马匹被给予MSC或PRP（或两者），并描述了一个比较组。评估研究的偏倚风险和研究质量。采用方差逆加权的随机效应荟萃分析来计算恢复表现和再损伤的主要结果的OR的汇总估计值。
结果：搜索标准确定了764项独特研究，21项研究符合系统评价的纳入标准.在荟萃分析中进一步评估了17项研究的主要结局，即恢复表现和再损伤率。荟萃分析显示，任何生物治疗恢复性能的可能性都没有增加。然而,MSC和与PRP同时施用的MSC提供降低的再损伤风险。
结论：目前的研究发现，使用MSCs或MSCs和PRP联合治疗肌腱病和肌腱病的马的再损伤率降低。然而,结果的解释应该考虑到结果的异质性，学习质量差，在大多数研究中，偏倚的风险很高。
