Veterinarians find therapy rich in possibilities - DVM
  • SEARCH:
News Center
DVM Featuring Information from:

ADVERTISEMENT

Veterinarians find therapy rich in possibilities
Platelet-rich plasma therapy is being increasingly used for canine orthopedic and sports medicine applications, but numerous questions remain regarding this promising treatment.


DVM360 MAGAZINE


Efficacy data

In 2013, three studies were published providing initial data regarding efficacy of different PRP preparations in treating naturally occurring disease in dogs. One author performed a blinded, prospective, randomized study comparing the efficacy of intra-articular use of autologous conditioned plasma (ACP Arthrex Vet Systems, Naples, Fla.) to the use of hyaluronan and corticosteroids for treatment of elbow osteoarthritis (OA) in 10 dogs. Significant improvements were identified in both treatment groups based on owner and veterinarian assessments using validated, subjective outcomes measures. Some improvements were greater in the ACP treatment group, and no adverse reactions were recorded in either treatment group, consistent with product safety.4 Although these results are positive, the study did not include force plate data.

Fahie et al. performed a prospective, randomized, controlled study comparing the efficacy of PRP obtained using the Canine Platelet Enhancement Therapy apheresis system (C-PET, Pall Corp., Port Washington, N.Y.) to saline injection for treatment of osteoarthritis in 20 dogs.5 The study included objective force plate data for half the dogs in addition to using validated subjective outcome measures for all dogs. The results demonstrated significant improvements in objective and subjective outcomes over a 12-week follow-up period with intra-articular use of the PRP. No improvement was noted for dogs treated with intra-articular saline injection.

Yet another group published results from a prospective, randomized study assessing the effects of three PRP injections post-intra-articular fascia lata autograft for stabilization of cranial cruciate ligament deficient stifles in 10 dogs.6 Peak vertical force and vertical impulse measured using a force plate improved from preoperative state to day 90 after surgery for the six dogs treated with PRP. No such improvement was noted for the four dogs in the control group. Likewise, force plate data indicated significantly greater weight bearing with the affected limb for dogs treated by PRP compared to the affected limb of control dogs at day 90 after surgery.

Conclusion

PRP has many characteristics that make it appealing for clinical application. It is relatively inexpensive, autologous, safe and may mitigate inflammation and facilitate tissue healing. These attributes, coupled with promising results from the initial clinical studies performed,4-6 warrant further characterization of the PRP products available and investigation of their efficacy for treatment of common orthopedic diseases and injuries. Such studies would ideally compare PRP to standard of care treatments as well as other regenerative medicine treatments, such as stem cell therapy, which is more involved and more expensive. These data should be increasingly available in the next few years, offering practitioners guidance on when and how to use PRP to benefit their patients.

Dr. Sam Franklin is a board-certified surgeon and sports medicine and rehabilitation specialist at the University of Georgia.

References

1. Perazzi A, Busetto R, Martinello T, et al. Description of a double centrifugation tube method for concentrating canine platelets. BMC Vet Res 2013;9:146.

2. Sundman EA, Cole BJ, Fortier LA. Growth factor and catabolic cytokine concentrations are influenced by the cellular composition of platelet-rich plasma. Am J Sports Med 2011;39:2135-2140.

3. Arnoczky SP, Shebani-Rad S. The basic science of platelet-rich plasma (PRP): what clinicians need to know. Sports medicine and arthroscopy review 2013;21:180-185.

4. Franklin SP, Cook JL. Autologous conditioned plasma versus hyaluronan plus corticosteroid for treatment of chronic elbow osteoarthritis in dogs. Can Vet J 2013;54:881-884.

5. Fahie MA, Ortolano GA, Guercio V, et al. A randomized controlled trial of the efficacy of autologous platelet therapy for the treatment of osteoarthritis in dogs. J Am Vet Med Assoc 2013;243:1291-1297.

6. Silva RF, Carmona JU, Rezende CM. Intra-articular injections of autologous platelet concentrates in dogs with surgical reparation of cranial cruciate ligament rupture: a pilot study. Vet Comp Orthop Traumatol 2013;26:285-290


ADVERTISEMENT

Source: DVM360 MAGAZINE,
Click here