Platelet-Rich Plasma in Veterinary Orthopedic Surgery: A Systematic Review and Quality Evaluation on Liquid- and Gel-Based Therapies in Dogs

The clinical use of platelet-rich plasma (PRP) has gained increasing attention as a regenerative strategy in veterinary orthopedic surgery, yet its efficacy beyond osteoarthritis remains unclear. This systematic review aimed to evaluate the therapeutic potential of liquid and gel PRP formulations as adjuncts in canine orthopedic procedures and to assess the methodological quality of the available evidence. A comprehensive search of PubMed, Scopus, and Web of Science was conducted following PRISMA guidelines. Fourteen eligible studies (six experimental in vivo and eight clinical investigations) including in vivo and clinical investigations of fracture and osteotomy repair and tendon or ligament reconstruction were critically analyzed. Overall, PRP demonstrated safety and biological activity, with early-phase improvements in tissue regeneration and inflammatory modulation; however, long-term functional outcomes were often similar to controls. Gel PRP showed practical advantages in handling, local retention, and the sustained release of growth factors, acting as a transient fibrin scaffold. Quality and risk-of-bias assessments following ARRIVE 2.0, CONSORT, and RoB 2.0 guidelines revealed moderate methodological rigor, with frequent omissions in blinding, sample-size calculation, and preregistration. However, the marked heterogeneity in PRP preparations and outcomes across studies, together with weak evidence for consistent long-term benefits, limits the strength of these conclusions. These findings highlight PRP, particularly in gel form, as a promising biological adjuvant for orthopedic repair in dogs, while emphasizing the need for standardized preparation protocols and harmonized outcome measures to advance its translational application.