Clean Run Magazine - June 2010 - 59

This fraction is then mixed with thrombin and calcium-chloride to activate the platelets before injection for therapeutic use. While both methods concentrate platelets, some are better than others in achieving high platelet concentrations with few white blood cells. The PRP used by the Veterinary Orthopedic & Sports Medicine Group (VOSM) is processed by the Regenerative Medicine Laboratory at the Leesburg, Virginia, campus of Virginia Tech, which uses a manual centrifugation method. This laboratory is able to yield platelet counts 7 to 10 times above normal, with few white blood cells present in the product. This process concentrates the platelets as well as the growth factors, which is important in its clinical application because it theoretically amplifies the healing ability of the platelet. Growth factors work to promote healing by signaling cells to differentiate into specific tissue properties and then mature. By treating with PRP at a specific site, it is postulated that healing will not only be hastened, but also the appropriate cells will be involved. Tissue healing is a complex process, and it has

been difficult to define each factor’s role in healing. The advantage of PRP is that all of the growth factors are present in their normal ratio, virtually eliminating the need to determine how much of this or how much of that should be added to the “formula.”

Application
Platelet-rich plasma therapy is a minimally invasive treatment that often can be used on an outpatient basis and generally does not require the dog to be anesthetized. First, 30-60 milliliters of blood is obtained from the jugular vein using a large gauge needle to avoid trauma to the platelets. The blood is then processed and prepared for injection. Once the

PRP is processed, the area to be treated is clipped and aseptically prepared. Ultrasound guidance is recommended for injection accuracy since PRP is most effective when applied directly into the damaged tissue. It can also be injected in a “peppering” manner to cover a wider area. Mild discomfort has been reported in people for 24-72 hours following the injection and can be managed with cold compresses and a synthetic opioid for pain relief. Minimal, if any, discomfort has been noted in horses and dogs following injection. Nonsteroidal antiinflammatory medication and steroids are avoided during the post-injection period. Appropriate rehabilitation therapy is performed weekly for 8-12 weeks, depending on the diagnosed condition.

Clinical Applications of PRP
The field of human sports medicine has seen a particularly large surge of PRP use over the past decade. Tendon and ligament injuries account for nearly 45% of all musculoskeletal injuries in humans seen yearly in the United States. Tendons and ligaments are susceptible to major stress dur-

©JennIfer Brown DVM anD SherMan o. canaPP DVM

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Clean Run Magazine - June 2010

Table of Contents for the Digital Edition of Clean Run Magazine - June 2010