Abstract
Compare the clinical and pressure walkway gait evolution of dogs after a tibial plateau leveling osteotomy (TPLO) for a cranial cruciate ligament rupture (CrCLR) and treatment with either a 1-month course of non-steroidal anti-inflammatory drugs (NSAIDs) or a single postoperative intra-articular (IA) injection of allogeneic neonatal mesenchymal stromal cells (MSCs). Prospective, double-blinded, randomized, controlled, monocentric clinical study. Sixteen client-owned dogs. Dogs with unilateral CrCLR confirmed by arthroscopy were included. Allogeneic neonatal canine MSCs were obtained from fetal adnexa retrieved after C-section performed on healthy pregnant bitches. The dogs were randomly allocated to either the "MSCs group," receiving an IA injection of MSCs after TPLO, followed by placebo for 1 month, or the "NSAIDs group," receiving IA equivalent volume of MSCs vehicle after TPLO, followed by oral NSAID for 1 month. One of the three blinded evaluators assessed the dogs in each group before and after surgery (1, 3, and 6 months). Clinical score and gait and bone healing process were assessed. The data were statistically compared between the two groups for pre- and postoperative evaluations. Fourteen dogs (nine in the MSCs group, five in the NSAIDs group) completed the present study. No significant difference was observed between the groups preoperatively. No local or systemic adverse effect was observed after MSCs injection at any time point considered. At 1 month after surgery, bone healing scores were significantly higher in the MSCs group. At 1, 3, and 6 months after surgery, no significant difference was observed between the two groups for clinical scores and gait evaluation. A single IA injection of allogeneic neonatal MSCs could be a safe and valuable postoperative alternative to NSAIDs for dogs requiring TPLO surgery, particularly for dogs intolerant to this class of drugs.
Highlights
Cranial cruciate ligament rupture (CrCLR) in dogs is one of the most common orthopedic diseases in veterinary medicine [1], leading to stifle joint instability and inflammation and inevitably resulting in the development of stifle osteoarthritis (OA) [2,3,4]
One dog was dropped from the study after enrollment for reasons unrelated to the tested product (NSAIDs group); two dogs were dropped from the study because of postoperative infection at the site of surgical implant, both from the non-steroidal anti-inflammatory drugs (NSAIDs) group; and three dogs were dropped from the study because of tendonitis or pain in the contralateral limb requiring NSAID treatment or surgical treatment
At baseline (D0), no difference between mesenchymal stromal cells (MSCs) and NSAIDs groups was observed on either FH/TP (P = 0.52), FH/NS (P = 0.35), Symmetry indices (SI)/% (P = 0.6), SI/TP (P = 0.61) or SI/NS (P = 0.61)
Summary
Cranial cruciate ligament rupture (CrCLR) in dogs is one of the most common orthopedic diseases in veterinary medicine [1], leading to stifle joint instability and inflammation and inevitably resulting in the development of stifle osteoarthritis (OA) [2,3,4]. Treatment involves surgical joint stabilization and the medical management of pain and inflammation. Tibial plateau leveling osteotomy (TPLO) is one of the most common surgical procedures performed worldwide [4,5,6], delivering quick and good clinical outcomes for a majority of the treated dogs [7,8,9,10,11]. Alternative but less effective treatments, such as tramadol as a sole medication, are commonly used to replace NSAIDs in postoperative management with variable outcomes [14]
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