How Effective Is Platelet-Rich Plasma in Dogs With CCL Rupture?

April 17, 2018
JoAnna Pendergrass, DVM

Dr. Pendergrass received her DVM degree from the Virginia-Maryland College of Veterinary Medicine. Following veterinary school, she completed a postdoctoral fellowship at Emory Universitys Yerkes National Primate Research Center. Dr. Pendergrass is the founder and owner ofJPen Communications, a medical communications company.

A new study finds that this regenerative therapy has beneficial, albeit short-lived, effects in dogs with cranial cruciate ligament injuries.

Cranial cruciate ligament rupture (CCLR) is a common orthopedic injury in dogs that causes joint instability, osteoarthritis, and degenerative joint disease. Eventually, this joint degeneration decreases joint function, increases pain, and reduces quality of life. Traditional CCLR treatments include surgery and conservative management.

Platelet-rich plasma (PRP) represents an innovative therapeutic approach to CCLR treatment. Previous studies have reported that PRP’s platelets contain growth factors that promote soft tissue healing and stimulate angiogenesis, among other benefits. Other studies have suggested PRP’s use alone or in combination with surgery to reduce CCLR-induced osteoarthritis. Currently, there is no standard treatment regimen for PRP therapy.

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To date, there have been few objective assessments of PRP’s efficacy for improving CCLR-induced osteoarthritis. In the first study of its kind, a research team used force platform gait analysis and electrogoniometry to objectively assess PRP’s efficacy with lameness secondary to CCLR. Their results, which demonstrated that PRP has a beneficial yet temporary effect on locomotion in dogs with CCLR, were recently published in PLoS ONE.

Analysis

The investigators recruited 22 pet English bulldogs: 12 with CCLR and ipsilateral lameness and 10 healthy controls. To obtain PRP, the investigators collected blood, performed leukocyte and platelet counts, then collected and activated the platelets. The resultant PRP was nearly leukocyte-free to prevent an inflammatory response that could negatively affect healing.

The dogs with CCLR received 4 intra-articular PRP injections at selected time points (days 0, 30, 90, and 180) and were restricted from strenuous exercise. At these time points, the researchers performed kinetic gait analyses using a force platform to measure the following parameters:

  • Peak vertical force: maximum force exerted perpendicular to surface
  • Vertical impulse
  • Stance time

Peak vertical force and vertical impulse were measured as percentages of body weight. Stance time was measured in seconds.

On those same days, the investigators also performed electrogoniometry to measure the stifle joint’s range of angular movement (AROM), recorded in degrees.

Results

Overall, without side effects, PRP therapy improved gait parameters and AROM in dogs with lameness secondary to CCLR. However, these positive effects were temporary—the dogs returned to their initial status by study’s end, 6 months after the first PRP injection.

Following PRP therapy in dogs with CCLR, gait analysis parameters significantly improved at day 30 compared with day 0, then decreased by day 180. Similarly, in dogs with CCLR, AROM improved most significantly at days 30 and 90 compared with day 0, then decreased by day 180.

Throughout the study, with few exceptions, measurements for the dogs with CCLR were generally lower than those of the healthy controls.

Bringing It Together

The beneficial yet temporary effect of PRP therapy in this study was consistent with the findings of previous studies investigating PRP’s efficacy with degenerative cartilage lesions and osteoarthritis. Such positive effects suggest PRP therapy’s use as an alternative treatment option for patients for whom surgery is not an option due to cost or anesthetic risk.

Despite the study’s positive findings, the investigators noted several limitations, such as the use of data only from the affected hindlimb—not the forelimbs or contralateral hindlimb—in dogs with CCLR. Future studies on PRP therapy will be needed, they wrote, including whether the therapy’s efficacy can extend beyond 3 to 6 months.

Dr. JoAnna Pendergrass received her DVM degree from the Virginia-Maryland College of Veterinary Medicine. Following veterinary school, she completed a postdoctoral fellowship at Emory University’s Yerkes National Primate Research Center. Dr. Pendergrass is the founder and owner of JPen Communications, a medical communications company.