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富血小板血浆单次关节内注射与非甾体类抗炎药作为犬十字韧带断裂和髌骨脱位治疗选择的比较

The Single Intra-Articular Injection of Platelet-Rich Plasma vs. Non-Steroidal Anti-Inflammatory Drugs as Treatment Options for Canine Cruciate Ligament Rupture and Patellar Luxation.

作者信息

Raulinaitė Kristina, Želvytė Rasa, Škėmienė Kristina, Burbaitė Evelina, Karvelienė Birutė, Monkevičienė Ingrida

机构信息

Department of Anatomy and Physiology, Faculty of Veterinary, Veterinary Academy, Lithuanian University of Health Sciences, Tilžės Str. 18, 47181 Kaunas, Lithuania.

Laboratory of Biochemistry, Neuroscience Institute, Lithuanian University of Health Sciences, Eivenių Str. 4, 50161 Kaunas, Lithuania.

出版信息

Vet Sci. 2023 Sep 4;10(9):555. doi: 10.3390/vetsci10090555.

Abstract

Cranial cruciate ligament rupture (CCLR) and patellar luxation (PL) are common pathologies affecting canines. Non-steroidal anti-inflammatory drugs (NSAIDs) are commonly used as a non-surgical treatment plan in these cases. Clinical usage of platelet-rich plasma (PRP) is an emerging area of interest in veterinary medicine. There is a lack of studies comparing those two different treatment methods in veterinary medicine. The main purpose of this study was to evaluate and compare the use of oral NSAIDs and single intra-articular injection of PRP on treatment outcomes in cases of canine CCLR and PL. Dogs diagnosed with CCRL ( = 12) and PL ( = 10) were subgrouped by the severity of pathologies and administered treatment: half of the CCRL and PL groups were orally administered NSAIDs and supplements for 14 days, and the other half received a single intra-articular PRP injection into affected stifle joint. We measured serum TNF-α levels and clinical outcomes (lameness scores, painfulness to manipulations, goniometry of stifle joint in flexion and extension, and muscle strength) before treatment, at day 14 and day 28 of treatment. The results of TNF-α concentration indicates a significant difference between groups of differently treated partial CCLR groups on d14 ( = 0.006). Results of group CCLR-P1 on d14 were decreased, while results of group CCLR-P2 on d14 were increased. When comparing TNF-α concentration between all CCLR cases treated with NSAIDs and treated with PRP, there was a significant difference between those groups on d14 ( = 0.001). The results of TNF-α concentration indicates a significant difference between groups of differently treated PL-III on d28 ( = 0.036). Results of group PL-III1 indicate growth of TNF-α concentration, while at the same d28, results of group PL-III2 indicate decreased levels of cytokine, comparing results between the subgroups at the same time point and within subgroups from baseline. Results indicate a significant difference in muscle strength between group CCLR-P1 and group CCLR-P2 on d28 ( = 0.007), indicating an increment in muscle strength in group CCLR-P1 up to d14 and its reduction up to d28, and muscle strength of group CCLR-P2 increasing up to d28. When comparing the muscle strength between all CCLR cases treated with NSAIDs and treated with PRP, there was a significant difference between those groups on d28 ( = 0.007). In conclusion, a single intra-articular injection of PRP has a superior effect on management of inflammatory processes, has better clinical outcomes, and longer duration of action than oral NSAIDs, in the treatment of canine CCRL or PL.

摘要

颅交叉韧带断裂(CCLR)和髌骨脱位(PL)是影响犬类的常见病症。非甾体抗炎药(NSAIDs)通常作为这些病例的非手术治疗方案。富血小板血浆(PRP)的临床应用是兽医学中一个新兴的研究领域。在兽医学中,缺乏比较这两种不同治疗方法的研究。本研究的主要目的是评估和比较口服NSAIDs与单次关节内注射PRP对犬CCLR和PL病例治疗效果的影响。诊断为CCRL(n = 12)和PL(n = 10)的犬根据病症严重程度进行分组并接受治疗:CCRL组和PL组各一半口服NSAIDs和补充剂14天,另一半在受影响的 stifle 关节进行单次关节内PRP注射。我们在治疗前、治疗第14天和第28天测量血清TNF-α水平和临床结果(跛行评分、手法疼痛程度、stifle关节屈伸角度测量和肌肉力量)。TNF-α浓度结果表明,在第14天,不同治疗的部分CCLR组之间存在显著差异(P = 0.006)。CCLR - P1组在第14天的结果下降,而CCLR - P2组在第14天的结果上升。比较所有用NSAIDs治疗和用PRP治疗的CCLR病例之间的TNF-α浓度时,这些组在第14天存在显著差异(P = 0.001)。TNF-α浓度结果表明,在第28天,不同治疗的PL - III组之间存在显著差异(P = 0.036)。PL - III1组的结果表明TNF-α浓度升高,而在同一第28天,PL - III2组的结果表明细胞因子水平下降,比较同一时间点各亚组之间以及各亚组与基线之间的结果。结果表明,在第28天CCLR - P1组和CCLR - P2组之间的肌肉力量存在显著差异(P = 0.007),表明CCLR - P1组的肌肉力量在第14天之前增加,到第28天下降,而CCLR - P2组的肌肉力量到第28天增加。比较所有用NSAIDs治疗和用PRP治疗的CCLR病例之间的肌肉力量时,这些组在第28天存在显著差异(P = 0.007)。总之,在治疗犬CCRL或PL时,单次关节内注射PRP在炎症过程管理方面具有优于口服NSAIDs的效果,具有更好的临床结果和更长的作用持续时间。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aefd/10537195/bdd0baf499cf/vetsci-10-00555-g001.jpg

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