The effect of platelet-rich plasma on osseous healing in dogs undergoing high tibial osteotomy

PLoS One. 2017 May 16;12(5):e0177597. doi: 10.1371/journal.pone.0177597. eCollection 2017.

Abstract

Objectives: The purpose of this study was to investigate whether platelet-rich plasma (PRP) enhances osseous healing in conjunction with a high tibial osteotomy in dogs.

Study design: Randomized controlled trial.

Methods: Sixty-four client-owned pet dogs with naturally occurring rupture of the anterior cruciate ligament and that were to be treated with a high tibial osteotomy (tibial plateau leveling osteotomy) were randomized into the treatment or control group. Dogs in the treatment group received autologous platelet-rich plasma activated with calcium chloride and bovine thrombin to produce a well-formed PRP gel that was placed into the osteotomy at the time of surgery. Dogs in the control group received saline lavage of the osteotomy. All dogs had the osteotomy stabilized with identical titanium alloy implants and all aspects of the surgical procedure and post-operative care were identical among dogs of the two groups. Bone healing was assessed at exactly 28, 49, and 70 days after surgery with radiography and ultrasonography and with MRI at day 28. The effect of PRP on bone healing was assessed using a repeated measures analysis of covariance with radiographic and ultrasonographic data and using a t-test with the MRI data.

Results: Sixty dogs completed the study. There were no significant differences in age, weight, or gender distribution between the treatment and control groups. Twenty-seven dogs were treated with PRP and 33 were in the control group. The average platelet concentration of the PRP was 1.37x106 platelets/μL (±489x103) with a leukocyte concentration of 5.45x103/μL (±3.5x103). All dogs demonstrated progressive healing over time and achieved clinically successful outcomes. Time since surgery and patient age were significant predictors of radiographic healing and time since surgery was a significant predictor of ultrasonographic assessment of healing. There was no significant effect of PRP treatment as assessed radiographically, ultrasonographically, or with MRI.

Conclusion: The PRP used in this study did not hasten osseous union in dogs treated with a high tibial osteotomy.

MeSH terms

  • Animals
  • Bone and Bones / diagnostic imaging
  • Bone and Bones / pathology*
  • Dog Diseases / diagnostic imaging
  • Dog Diseases / pathology*
  • Dog Diseases / therapy*
  • Dogs
  • Female
  • Multimodal Imaging
  • Osteotomy*
  • Platelet-Rich Plasma*
  • Treatment Outcome
  • Wound Healing*

Grant support

Sam Franklin is a consultant for Arthrex Vet Systems. Sam Franklin is paid to consult on research investigations, products, and is paid (hourly) if teaching veterinary continuing education courses. Sam Franklin is not paid any salary and receives no royalties on any products and has no financial interest in any product. The PRP used in this study was produced using the Angel system (provided by Arthrex Vet Systems) and Arthrex Vet Systems provided materials support for this study. All financial support for this study was provided by the AO Foundation and by Sam Franklin using his New Faculty Startup-Comparative Medical Research Donation Fund; zero financial support was provided by Arthrex Vet Systems. No funding agency, including the AO Foundation or Arthrex, provided any support in the form of salaries for any authors of this study nor did any supporting/funding agency have any role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of all authors are articulated in the ‘author contributions’ section.