Introduction

• Platelet-rich plasma (PRP) is an autologous biologic therapy obtained from the serum of a venous blood sample taken from the dog or cat being treated.
• There are some commercially available gravity filtration or centrifuge production systems that can be used within the small animal clinic or hospital.
• PRP contains platelets in significantly greater numbers (3-7x) than whole blood. It is necessary to have such high concentrations in order to ensure sufficient platelets to elicit a biological and clinical improvement.
• Platelets contain thousands of growth factors. It is the growth factors that stimulate healing and pain management.
• Scientific evidence indicates that PRP can enhance the cellular repair of musculoskeletal and wound lesions.
• Injection of autologous PRP is safe for the patient with minimal side effects.

Indications

• PRP in humans and animals has a wide range of clinical applications.
• Management of osteoarthritic joints has become a key area for PRP in the small animal, as a sole or multi-modal therapy protocol.
• Post-surgical or medically managed musculoskeletal tissue injuries, particularly elbow and cruciate joints, but can be injected into any non-infectious inflamed or damaged joint structure. In addition, it is used in conjunction with or without surgical intervention for soft tissue musculoskeletal tendon, ligament and muscles.
• PRP has been used in conjunction with biosynthetic scaffolds in osteochondral repair in humans, and is used in veterinary medicine for canine patients.
• PRP gel has been used to enhance surgical wound healing in human suffering from large wounds or chronic ulcers, including diabetic pressure ulcer to prevent amputation and restore tissue and blood flow.
• It can be used for chronic indolent ulcers of the cornea.

Advantages

• Autologous - minimal risk of patient reaction.
• Non-invasive collection procedure.
• Rapid preparation usually only 30 minute procedure.
• Sterile if using a filtration system.
• No extra equipment required using filter system.
• Less expensive than IRAP (Interleukin-1 receptor Antagonist Protein).
• Significantly less expensive than Stem Cells.

Disadvantages

• Lack of regulatory control means each commercial PRP system needs to be assessed and validated on its own in vitro and clinical published data. Each product should be assessed on its own independently published data not by extrapolation of other PRP system's clinical evidence.
• Recent PRP analysis of competitor products in the equine world showed significant variation between the marketing values and true tested concentrations.
• The lack of standardized protocol for PRP production can lead to inconsistent results and the platelet concentration can vary widely between different preparation systems. Follow each commercial kit steps accurately.
• Judge a PRP system on its own clinical data, not all PRP systems are proven.
• Administration of PRP requires knowledge of anatomy, especially when injecting into joints. Some chronic osteoarthritic joints may not have significant synovial fluid.

Action

Production

PRP storage

Administration

Aftercare

Further Reading

Publications

Refereed papers

• Recent references from PubMed and VetMedResource.
• Fahrie M, Ortolano G A, Guercio V et al (2013) A randomized controlled trial of the efficacy of autologous platelet therapy for the treatment of osteoarthritis in dogs. JAVMA 243 (9), 1291-1297 PubMed.
• Mishra A, Tummala P, King A et al (2009) Buffered platelet-rich plasma enhances mesenchymal stem cell proliferation and chondrogenic differentiation. Tissue Eng Part C Methods 15 (3), 431-435 PubMed.
• Kajikawa Y, Morihara T, Sakamoto H et al (2008) Platelet-rich plasma enhances the initial mobilization of circulation-derived cells for tendon healing. J Cell Physiol 215 (3), 837-845 PubMed.
• Mehta S, Watson J T (2008) Platelet rich concentrate: basic science and current clinical applications. J Orthop Trauma 22 (6), 432-438 PubMed.
• van den Dolder, Mooren R, Vloon A P et al (2006) Platelet-rich plasma: quantification of growth factor levels and the effect on growth and differentiation of rat bone marrow cells. Tissue Eng 12 (11), 3067-3073 PubMed.

Other sources of information

• Fahrie M et al (2012) Clinical outcome using canine platelet enhancement therapy (C-PET). Veterinary Orthopaedic Society 39th Annual Conference March 2012.
• Schaffer J et al (2012) Securos C-PET Field Trial Study on 137 lame dogs. March 2012.