Stem cell and PRP treatment for partial knee ligament tears in dogs

Abstract

OBJECTIVE: To evaluate outcomes in 36 dogs with a partial cranial cruciate ligament (CCL) tear treated with autologous bone marrow aspirate concentrate (BMAC) or adipose-derived progenitor cells (ADPC) with platelet-rich plasma (PRP) combination. MATERIALS AND METHODS: Medical records of client-owned dogs diagnosed with an early partial (&#x2264;50%) tear of the craniomedial band of the CCL that was treated with BMAC-PRP or ADPC-PRP were reviewed from 2010 to 2015. Signalment, medical history, physical and orthopedic examination, objective temporospatial gait analyses, radiographs, day 0 and day 90 diagnostic arthroscopy findings, treatment, and outcome were among the data collected. A functional owner questionnaire, including the validated Helsinki chronic pain index (HCPI), was sent to owners whose dog was known to not have had a tibial plateau leveling osteotomy (TPLO). Statistical analysis was performed on data, where significance was established at&#x2009;<&#x2009;0.05. RESULTS: Stifle arthroscopy findings at 90&#x2009;days posttreatment were available on 13 of the 36 dogs. In nine dogs, a fully intact CCL with marked neovascularization and a normal fiber pattern was found with all previous regions of disruption healed. One dog revealed significant improvement and received an additional injection. The remaining three dogs had a >50% CCL tear, and a TPLO was performed. Four additional dogs were known to have had a TPLO performed elsewhere. Baseline and day 90 posttreatment objective gait analyses were available on 11 of the 36 dogs. A significant difference was found between the treated limb total pressure index percent (TPI%) at day 0 and day 90 (&#x2009;=&#x2009;0.0124), and between the treated limb and contralateral limb TPI% at day 0 (&#x2009;=&#x2009;0.0003). No significant difference was found between the treated limb and contralateral limb TPI% at day 90 (&#x2009;=&#x2009;0.7466). Twelve questionnaires were returned, of which eight were performance/sporting dogs. Seven of the eight had returned to sport; the remaining dog had just begun a return to sport conditioning program 6&#x2009;months posttreatment. All 12 respondents believed that their dog had an excellent or very good quality of life and rated their dog's procedural outcome as excellent or good. CONCLUSION: The use of BMAC-PRP and ADPC-PRP shows promise for the treatment of early partial CCL tears in dogs. Further studies are needed and should be randomized, blinded, and controlled.