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.
Highlights
Cruciate ligament rupture (CR) is a common naturally occurring degenerative condition of the canine stifle
Two dogs had a subtle cranial drawer of the partial cruciate ligament rupture (CR) stifle with
In partial CR stifles, cruciate ligament (CrCL) magnetic resonance (MR) signal intensity is correlated with histologic synovitis, as is radiographic OA and arthroscopically assessed CrCL fiber damage [25]
Summary
Cruciate ligament rupture (CR) is a common naturally occurring degenerative condition of the canine stifle. It is an economically important disabling disease that causes ~20% of lameness in dogs [1]. Grade I sprains have mild fiber damage and no associated joint laxity. Grade II ligament sprains have moderate fiber damage such that joint laxity is just appearing due to damageinduced loading. Grade III ligament sprains have severe disruption of ligament fibers and joint laxity that is obvious [4]. Grade III CR stifle joints are unstable clinically. Stifles with partial CR are clinically stable with Grade I sprains with associated ligament fiber rupture evident using arthroscopic examination [5]
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