Venator Kurt P, Frye Christopher W, Gamble Lauri-Jo, Wakshlag Joseph J
Department of Clinical Sciences, Cornell University College of Veterinary Medicine, Ithaca, NY 14853, USA.
Vet Med (Auckl). 2020 Mar 9;11:31-38. doi: 10.2147/VMRR.S238598. eCollection 2020.
The use of platelet-rich plasma (PRP) to treat canine osteoarthritis has gained support within the scientific community. PRP effects on pain control for degenerative joint disease induced by naturally occurring cranial cruciate ligament instability are limited, particularly in a cohort of dogs with chronic instability and osteoarthritis (>12 months), representing a commonly encountered clinical population that often defaults to medical management. The goal of this study was to assess the effects of a single intra-articular PRP injection into an effected stifle in this cohort, to assess response to treatment, quantitative kinetic data as it relates to percent body weight for peak vertical force (PVF) and vertical impulse (VI) were collected, and symmetry indices related to PVF were determined.
Twelve dogs with unilateral or bilateral osteoarthritis with ruptured, non-stabilized cranial cruciate ligaments over 12 months duration were identified. Unilateral injections of 2.5 mL of a PRP preparation into the most severely affected stifle based on kinetic analysis was performed. Repeat pressure-sensitive walkway analysis was conducted monthly for 3 months. Peak vertical force (PVF) and vertical impulse (VI) were normalized to body weight and identified in all four limbs. Previously published symmetry indices regarding PVF were calculated, comparing the treated limb with the contralateral limb, ipsilateral forelimb, and contralateral forelimb.
After treatment, hind limb symmetry index (SI) regarding PVF showed improved symmetry, suggesting more weight placement at all-time points after injection of the most affected limb (p < 0.01). Further, PVF asymmetry indices assessing contralateral fore (CFL) and hind limb (CHL) as well as ipsilateral forelimb (IFL) revealing a significant decrease from baseline for CHL at week 4 (p = 0.02), but not weeks 8 and 12. The CFL showed decreased differences in symmetry from baseline at each time point (p = 0.03). There were no statistically significant changes in PVF or VI over time in treated dogs.
A single injection of PRP improved kinetics for minimally 4 weeks with some data suggesting an effect for up to 12 weeks. Therefore, PRP might be a viable therapeutic option for instability and inflammation associated with chronic osteoarthritis due to cranial cruciate ligament disease in the non-surgical patient.
使用富含血小板血浆（PRP）治疗犬类骨关节炎已在科学界获得支持。PRP对由自然发生的颅交叉韧带不稳定引起的退行性关节疾病的疼痛控制效果有限，特别是在患有慢性不稳定和骨关节炎（超过12个月）的犬类群体中，这是一个常见的临床群体，通常默认采用药物治疗。本研究的目的是评估在该群体中向受影响的 stifle 关节内单次注射PRP的效果，评估治疗反应，收集与峰值垂直力（PVF）和垂直冲量（VI）相对于体重百分比相关的定量动力学数据，并确定与PVF相关的对称指数。
确定了12只患有单侧或双侧骨关节炎且颅交叉韧带破裂且未稳定超过12个月的犬。根据动力学分析，将2.5 mL PRP制剂单侧注射到受影响最严重的 stifle 关节。在3个月内每月进行一次重复的压敏步道分析。将峰值垂直力（PVF）和垂直冲量（VI）标准化为体重，并在所有四个肢体中进行识别。计算先前发表的关于PVF的对称指数，将治疗肢体与对侧肢体、同侧前肢和对侧前肢进行比较。
治疗后，关于PVF的后肢对称指数（SI）显示对称性改善，表明在注射受影响最严重的肢体后的所有时间点都有更多的体重分布（p < 0.01）。此外，评估对侧前肢（CFL）和后肢（CHL）以及同侧前肢（IFL）的PVF不对称指数显示，第4周时CHL相对于基线有显著下降（p = 0.02），但第8周和第12周没有。CFL在每个时间点相对于基线的对称差异均有下降（p = 0.03）。治疗犬的PVF或VI随时间没有统计学上的显著变化。
单次注射PRP至少在4周内改善了动力学，一些数据表明效果可持续长达12周。因此，对于非手术患者因颅交叉韧带疾病导致的与慢性骨关节炎相关的不稳定和炎症，PRP可能是一种可行的治疗选择。
