Use of a platelet-rich plasma-collagen scaffold as a bioenhanced repair treatment for management of partial cruciate ligament rupture in dogs

Abstract

Dogs are commonly affected with cruciate ligament rupture (CR) and associated osteoarthritis (OA), and frequently develop a second contralateral CR. Platelet rich plasma (PRP) is a component of whole blood that contains numerous growth factors, which in combination with a collagen scaffold may act to promote bioenhanced primary repair of ligament. This study tested the hypothesis that treatment of partial stable CR stifles with an intra-articular collagen scaffold and PRP would decrease the disease progression, synovitis and risk of complete CR over a 12-month study period. We conducted a prospective cohort study of 29 client-owned dogs with an unstable stifle due to complete CR and stable contralateral stifle with partial CR. All dogs were treated with tibial plateau leveling osteotomy (TPLO) on the unstable stifle and a single intra-articular application of PRP-collagen in the stable partial CR stifle. Dogs were evaluated at the time of diagnosis, and at 10-weeks and 12-months after treatment. We evaluated correlation between both development of complete CR and time to complete CR with diagnostic tests including bilateral stifle radiographs, 3.0 Tesla magnetic resonance (MR) imaging, and bilateral stifle arthroscopy. Additionally, histologic evaluation of synovial biopsies, C-reactive protein (CRP) concentrations in serum and synovial fluid, and synovial total nucleated cell count, were determined. Results indicated that a single application of PRP-collagen in partial CR stifles of client owned dogs is not an effective disease-modifying therapy for the prevention of progression to complete CR. Radiographic effusion, arthroscopic evaluation of cranial cruciate ligament (CrCL) damage, and MR assessment of ligament fiber tearing in partial CR stifles correlated with progression to complete CR over the 12-month follow-up period. We determined that the best predictive model for development of complete CR in PRP-collagen treated partial CR stifles included variables from multiple diagnostic modalities.

The effect of thermosensitive hydrogel platelet–rich–plasma complex in the treatment of partial tear of anterior cruciate ligament in rat model

“…It was shown that the level of transforming growth factor-β1 of both BMCs and MSCs group was significantly increased when compared with the saline group. In contrast to the findings of the present study, the tensile strength in the BMC group was restored to a near-normal level, whereas a recent 12-month follow-up study on the regeneration of canine partial cranial cruciate ligament tear treated with single intra-articular application of PRP-collagen demonstrated a high likelihood ratio of 19.5 ( P ​= ​0.0015) for progressing to a complete tear within 12-months of diagnosis [ 28 ]. Clinical studies regarding the bioenhanced regeneration of ACL partial tear was also divergent [ 29 ].…”

Correlation between orthopaedic and radiographic examination findings and arthroscopic ligament fibre damage in dogs with cruciate ligament rupture

“…Early diagnosis is potentially useful for a precision medicine approach to patient management. For example, tibial plateau levelling osteotomy (TPLO) or regenerative medicine treatment for partial CR may be associated with improved functional outcomes.…”

Use of Autologous Leucocyte- and Platelet-Rich Plasma (L-PRP) in the Treatment of Aural Hematoma in Dogs

“…In recent years, multiple effects of PRP have been documented in vivo and in vitro in human and veterinary medicine. In dogs, clinical studies are focused on orthopedics uses [35][36][37][38][39] and in dermatology for the treatment of wounds [40] or skin ulcers with extensive tissue loss [41][42][43], chronic ulcers [44], surgically induced wounds [45][46][47][48], alopecia [49] and for antimicrobial effects in infected skin wounds [50]. The results of these studies have been variable which may reflect the lack of standardization of the methods for obtaining the PRP.…”