scholarly journals A placebo-controlled study comparing the efficacy of intra-articular injections of hyaluronic acid and a novel hyaluronic acid-platelet-rich plasma conjugate in a canine model of osteoarthritis

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Mun-Ik Lee ◽  
Jun-Hyung Kim ◽  
Ho-Hyun Kwak ◽  
Heung-Myong Woo ◽  
Jeong-Hee Han ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Range Of Motion ◽  
Platelet Rich Plasma ◽  
Cruciate Ligament ◽  
Treated Group ◽  
Canine Model ◽  
Controlled Study ◽  
Radiographic Examination ◽  
Time Points ◽  
Stifle Joint

Abstract Background The objective of this study was to assess the efficacy of intra-articular injections of hyaluronic acid (HA) and a novel, on-site conjugate of HA with autologous fibrinogen in platelet-rich plasma (HA-PRP) in a canine model of osteoarthritis (OA) Methods Twelve beagle dogs underwent a unilateral resection of the cranial cruciate ligament (CrCL) of the stifle joint. Clinical and radiographic signs of OA were confirmed in all dogs 8 weeks following CrCL resection and prior to treatment. The dogs were randomized into three groups: saline (n = 4), HA (n = 4), and HA-PRP (n = 4). Each dog received intra-articular injections of the respective substance into the affected joint at pre-determined time points. The dogs were assessed for adverse effects for 3 days after each injection and for lameness, pain, range of motion, kinetics, and radiographic OA severity prior to treatment and 3 months after injection. OA severity as determined by radiographic examination was not significantly different among the groups at any time point. The dogs were then humanely euthanatized and the stifle joint assessed by gross and histological examinations. Results Dogs treated with four weekly injections of HA or two biweekly injections of HA-PRP were significantly (p < 0.05) better than dogs treated with four weekly injections of saline at 2-, 4-, and 12-week time points based on a comfortable range of motion (CROM) and clinical lameness score. Gait analysis measuring symmetry and weight distribution on pressure sensor walkway showed significantly (p < 0.05) improved limb function for dogs treated with HA and HA-PRP compared with dogs treated with saline yet with better clinical outcome for the HA-PRP-treated group at 12 and 20 weeks follow-up. Gross and histological analysis of synovium and articular cartilage demonstrated significant (p < 0.05) improvement by both treatments groups compared to controls. There was however significantly (p < 0.05) less damage to the cartilage in the HA-PRP group compared to the HA-treated group. Conclusions These data suggest that while injection of HA and HA-PRP may be sufficient for short-term amelioration of the symptoms associated with OA, treatment with HA-PRP conjugates may be superior, providing significantly better long-term cartilage preservation.

Patellar Bone–Tendon–Bone Autografts versus Quadriceps Tendon Allograft with Synthetic Augmentation in a Canine Model

2019 ◽  
Vol 33 (12) ◽  
pp. 1256-1266 ◽  
Author(s):  
Patrick A. Smith ◽  
James P. Stannard ◽  
Chantelle C. Bozynski ◽  
Keiichi Kuroki ◽  
Cristi R. Cook ◽  
...  
Keyword(s):  
Acl Reconstruction ◽  
Platelet Rich Plasma ◽  
Cruciate Ligament ◽  
Donor Site ◽  
Quadriceps Tendon ◽  
Canine Model ◽  
Tendon Graft ◽  
Donor Site Morbidity ◽  
Tendon Allograft ◽  
Internal Brace

AbstractPatellar bone–tendon–bone (pBTB) autografts are often considered the “gold standard” for complete anterior cruciate ligament (ACL) reconstruction and are also associated with significant complications and early-onset knee osteoarthritis (OA). A novel quadriceps tendon allograft with synthetic augmentation, or “internal brace” (QTIB), has been reported to have potential advantages for ACL reconstruction based on animal model data. In this preclinical canine comparison study, we hypothesized that QTIB allograft compared with pBTB autograft would provide superior durability for knee stability, function, and prevention of OA. Under approval from our Institutional Animal Care and Use Committee, adult purpose-bred research hounds (n = 10) underwent arthroscopic complete transection of the ACL followed by either an arthroscopic-assisted all-inside ACL reconstruction using the QTIB allograft (n = 5) or pBTB autograft (n = 5). Contralateral knees were used as nonoperated controls (n = 10). Radiographic and arthroscopic assessments were performed at 2 and 6 months, respectively, after surgery. Anterior drawer, internal rotation, lameness, kinetics, pain, effusion, and comfortable range of knee motion were measured at 2, 3, and 6 months. Biomechanical and histologic assessments were performed at 6 months. All reconstructed knees were stable and had intact ACL grafts 6 months after surgery. At 6 months, QTIB reconstructed knees had significantly less lameness, lower pain, less effusion, and increased range of motion when compared with BTB knees (p < 0.05). BTB knees had significantly higher radiographic OA scores than QTIB knees at 6 months (p < 0.05). Superior outcomes associated with QTIB allograft may be due to the lack of donor site morbidity, the use of a robust tendon graft, and/or protection of the graft from the synthetic augmentation. Robust tendon grafts combined with a synthetic internal brace and platelet-rich plasma (PRP) may allow for more rapid and robust tendon–bone healing and graft “ligamentization,” which protects the graft from early failure and rapid OA development that can plague commonly-used allografts.

Tibial plateau levelling osteotomy in an alpaca

2009 ◽  
Vol 22 (04) ◽  
pp. 332-335 ◽  
Author(s):  
N. M. Girard ◽  
J. O’Riordan ◽  
N. Fitzpatrick ◽  
T. J. Smith
Keyword(s):  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Clinical Signs ◽  
Acute Onset ◽  
Radiographic Examination ◽  
Tibial Osteotomy ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Pelvic Limb ◽  
The Right

SummaryIn this report, a case of cranial cruciate ligament (CrCL) rupture treated by tibial plateau levelling osteotomy (TPLO), in a 36-month-old male breeding alpaca, is described. The alpaca was presented with the complaint of acute onset of right pelvic limb lameness. The findings of our clinical and radiographic examinations were consistent with CrCL insufficiency of the right stifle joint. The right tibial plateau angle measured prior to surgery was 19°. A TPLO was performed and this eliminated cranial tibial thrust. Culture of a swab taken from the surgical site prior to wound closure was positive for Pseudomonas aeruginosa. Enrofloxacin was administered parenterally for two weeks postoperatively. There were not any clinical signs of infection noted. Outcome assessments included veterinary examination (two and six weeks) and owner assessment (28 months). At two weeks the animal walked with a grade 2/5 lameness, and at six weeks radiographic examination showed progression of bone healing at the site of tibial osteotomy. A return to full breeding fitness occurred by eight weeks after the surgery. The alpaca remained free from lameness 28 months later, according to the owner.

scholarly journals Platelet-Rich Plasma and Hyaluronic Acid Are Not Synergistic When Used as Biological Adjuncts with Autologous Osteochondral Transplantation

Cartilage ◽  
2017 ◽  
Vol 9 (3) ◽  
pp. 321-328 ◽  
Author(s):  
Niall A. Smyth ◽  
Keir A. Ross ◽  
Amgad M. Haleem ◽  
Charles P. Hannon ◽  
Christopher D. Murawski ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Platelet Rich Plasma ◽  
Treated Group ◽  
Saline Control ◽  
Osteochondral Lesions ◽  
Published Data ◽  
Osteochondral Transplantation ◽  
Autologous Osteochondral Transplantation ◽  
Histological Score ◽  
The Mean

Introduction Autologous osteochondral transplantation (AOT) is a treatment for osteochondral lesions with known concerns, including histological degradation of the graft and poor cartilage integration. Platelet-rich plasma (PRP) and hyaluronic acid (HA) have been described has having the potential to improve results. The aim of this study was to evaluate the effect of PRP and HA on AOT in a rabbit model. Methods Thirty-six rabbits underwent bilateral knee AOT treated with either the biological adjunct (PRP, n = 12; HA, n = 12; PRP + HA, n = 12) or saline (control). PRP and HA were administered as an intra-articular injection. The rabbits were euthanized at 3, 6, or 12 weeks postoperatively. The graft sections were assessed using the modified International Cartilage Repair Society (ICRS) scoring system. The results from the PRP alone group is from previously published data. Results The mean modified ICRS histological score for the PRP-treated group was higher than its control ( P = 0.002). The mean modified ICRS histological score for the HA-treated group showed no difference compared with its control ( P = 0.142). The mean modified ICRS histological score for the PRP + HA–treated group was higher than its control ( P = 0.006). There was no difference between the mean modified ICRS scores of the PRP- and the PRP + HA–treated grafts ( P = 0.445). Conclusion PRP may decrease graft degradation and improve chondral integration in an animal model. In this model, the addition of HA was not synergistic for the parameters assessed. Level of Evidence. Basic science, Level V. Clinical Relevance. PRP can be used as an adjunct to AOT, which may decrease graft degeneration and improve clinical outcomes. HA may not influence AOT.

scholarly journals Tibial plateau angle: methods of measurement, value, applicability

2017 ◽  
Vol 73 (9) ◽  
pp. 532-537
Author(s):  
Adam Przeworski ◽  
Joanna Głodek ◽  
Zbigniew Adamiak
Keyword(s):  
Measurement Errors ◽  
Tibial Plateau ◽  
Cruciate Ligament ◽  
Clinical Importance ◽  
Angle Measurement ◽  
Radiographic Examination ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Maximum Tolerance ◽  
Cranial Cruciate Ligament Disease

The tibial plateau angle measurement and its applicability have been reviewed based on the literature. The measurement was made on radiographs of the stifle joint with superimposition of the femoral condyles (with maximum tolerance of 2.0-4.0mm). Due to great variation among dog populations (size, breed), mean tibial plateau angles were found to be between 16.9° and 34°, but an excessive angle was described as >35°. An appropriate measurement of the tibial plateau angle can be made at about 108 days of age. The influence on the magnitude of the measured tibial plateau angle were the limb position during radiographic examination, the measurement technique (with modifications) and the experience level of the observer. Differences in magnitudes of the tibial plateau angles in dogs with and without cranial cruciate ligament rupture were not observed. The tibial plateau angle is commonly used in osteotomy of the tibia and its magnitude in order to select the proper surgical technique. The significance of the tibial plateau angle on the aetiopathogenesis of cranial cruciate ligament disease is questionable. Other measurements of the proximal tibia were attained to determine the risk factor of cranial cruciate ligament insufficiency. Knowledge of the tibial plateau angle and factors influencing measurement errors have great clinical importance.

scholarly journals Platelet-rich plasma versus hyaluronic acid injections for knee osteoarthritis: a propensity-score analysis

2018 ◽  
Vol 108 (4) ◽  
pp. 329-337 ◽  
Author(s):  
J. A. Annaniemi ◽  
J. Pere ◽  
S. Giordano
Keyword(s):  
Hyaluronic Acid ◽  
Visual Analogue Scale ◽  
Propensity Score ◽  
Knee Osteoarthritis ◽  
Range Of Motion ◽  
Analogue Scale ◽  
Propensity Score Analysis ◽  
Platelet Rich Plasma ◽  
Score Analysis

Background and Aims:Intra-articular injections of viscosupplements have been an option in the treatment of knee osteoarthritis. Platelet-rich plasma is an experimental treatment in osteoarthritis. Previous studies have shown that platelet-rich plasma reduces osteoarthritis symptoms in similar proportions as viscosupplements. The aim of this study was to compare platelet-rich plasma versus viscosupplements in terms of symptoms’ relief and time to arthroplasty.Material and Methods:A total of 190 patients included in this retrospective study received either intra-articular injections of platelet-rich plasma (94 patients) or hyaluronic acid (86 patients) between January 2014 and October 2017. Western Ontario and McMaster Universities Osteoarthritis Index, Visual Analogue Scale, and range of motion were measured before injection, at 15 days, 6 months, 12 months, and at last follow-up. We compared outcomes between these two groups using propensity score analysis for risk adjustment in multivariate analysis and for one-to-one matching.Results:Hyaluronic acid–treated patients experienced a higher arthroplasty rate (36.0% vs 5.3%, p < 0.001), lower range of motion, worse Visual Analogue Scale and Western Ontario and McMaster Universities Osteoarthritis Index scores, and increased risk of any arthroplasty occurrence (log-rank < 0.001) than platelet-rich plasma patients. Cox proportional hazards analysis revealed a tendency to decrease the risk of knee arthroplasty for the patients treated by platelet-rich plasma (hazard ratio = 0.23, 95% confidence interval, 0.05–1.05, p = 0.058). When the treatment method was adjusted for propensity score in the propensity score–matched pairs (n = 78), we found that platelet-rich plasma group still showed significant improvement over the hyaluronic acid group in arthroplasty rate (12.8% vs 41.0%, p = 0.010), Visual Analogue Scale and Western Ontario and McMaster Universities Osteoarthritis Index scores, but not in the range of motion, during the mean follow-up of 16.7 months.Conclusion:Intra-articular injections of platelet-rich plasma associated with better outcomes than hyaluronic acid in knee osteoarthritis. Platelet-rich plasma might prolong the time to arthroplasty and provide a valid therapeutic option in selected patients with knee osteoarthritis not responding to conventional treatments. Further larger studies are needed to validate this promising treatment modality.

scholarly journals Effects of platelet-rich plasma injection on pain, range of motion, and disability in adhesive capsulitis: A prospective, randomized-controlled study

2021 ◽  
Vol 67 (4) ◽  
pp. 462-472
Author(s):  
Çağlar Karabaş ◽  
Havva Talay Çalış ◽  
Ulaş Serkan Topaloğlu ◽  
Çiğdem Karakükçü
Keyword(s):  
Range Of Motion ◽  
External Rotation ◽  
Platelet Rich Plasma ◽  
Adhesive Capsulitis ◽  
Controlled Study ◽  
Control Group ◽  
Plasma Injection ◽  
Active Flexion ◽  
Home Based ◽  
Significant Difference

Objectives: In this study, we aimed to investigate the effectiveness of intra-articular platelet-rich plasma (PRP) injection in adhesive capsulitis. Patients and methods: Between January 2019 and December 2019, a total of 40 patients (21 males, 19 females; mean age: 57.1±6.5 years; range, 44 to 72 years) with idiopathic adhesive capsulitis were included. The patients were randomly assigned into two equal groups as the PRP and the control group. The PRP group received two doses of PRP via intra-articular route biweekly under ultrasound guidance. No injection was performed to the control group. In both groups, stretching and Codman exercises were applied as a home- based program. The Visual Analog Scale (VAS), range of motion (ROM), and Shoulder Pain and Disability Index (SPADI) scores were evaluated before the treatment and at 2, 6 and 12 weeks after the treatment. Results: There were significant differences in all VAS, SPADI, and ROM scores at all time points after treatment compared to baseline in both groups. At the end of the study, there were significant differences in the active flexion, passive flexion, active abduction, passive abduction, and active external rotation scores at 12 weeks between the groups (p=0.012, p=0.015, p=0.008, p=0.019, and p=0.040, respectively). No significant difference was observed between the groups in terms of VAS and SPADI scores and the other parameters (active and passive extension, active and passive internal rotation, passive external rotation) at 2, 6, and 12 weeks (p>0.05). Conclusion: The addition of PRP to exercise treatment can improve patients' joint mobility, but not pain and disability in patients with adhesive capsulitis.

scholarly journals Comparison of the Effectiveness of Intraarticular Ozone Therapy and Platelet Rich Plasma Treatment in Patients with Knee Osteoarthritis

2020 ◽  
Vol 5 (04) ◽  
Author(s):  
Ümit Yalçın
Keyword(s):  
Hyaluronic Acid ◽  
Platelet Rich Plasma ◽  
Pain Scale ◽  
Controlled Study ◽  
Womac Pain ◽  
Ozone Therapy ◽  
Knee Oa ◽  
Randomized Controlled ◽  
Vas Score ◽  
Long Time

Background: Platelet rich plasma (PRP) has been applied for a long time in osteoarthritis (OA). Although there are studies about PRP that examining the effectiveness with agents such as hyaluronic acid and corticosteroid, there are few published literature comparing with ozone therapy (OT). The aim of this study is to compare the pain severity and functional status of OA patients undergoing intraarticular ozone and PRP injections. Methods: In a study which is made as prospective, randomized controlled study (RCS), 49 patients were included the study. In the first group (n = 24) OT, in the second group (n = 25) PRP injections were administered intraarticularly 3 times in total with one week intervals. Visual pain scale (VAS) and severity of pain were compared with Western Ontario McMaster Osteoarthritis Index (WOMAC). Results: In the PRP group, WOMAC pain, physical function and WOMAC total score were significantly lower than the OT group (p ˂ 0.05). Although VAS score decreased significantly (p ˂ 0.05) after treatment in both groups compared to pretreatment, the VAS score in the PRP group was significantly (p ˂ 0.05) lower than the OT group after treatment. Conclusion: Our study contributes to the literature in terms of limited publication about OT. However, this study shows that the results of PRP treatment are superior to OT in the treatment of knee OA.

Functional Anatomy of the Craniomedial and Caudolateral Bundles of the Cranial Cruciate Ligament in Beagle Dogs

2019 ◽  
Vol 32 (03) ◽  
pp. 182-191 ◽  
Author(s):  
Koji Tanegashima ◽  
Kazuya Edamura ◽  
Yuki Akita ◽  
Atsushi Yamazaki ◽  
Shinji Yasukawa ◽  
...  
Keyword(s):  
Range Of Motion ◽  
Fibre Bundle ◽  
Cruciate Ligament ◽  
Functional Anatomy ◽  
Attachment Site ◽  
Anatomical Reconstruction ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Attachment Region ◽  
Objectively Measured

Objective The aim of this study was to investigate detailed functional anatomy of the craniomedial bundle (CrMB) and caudolateral bundle (CdLB) of cranial cruciate ligament (CrCL) for application of intra-articular anatomical reconstruction in dogs. Materials and Methods Twelve stifle joint of 12 Beagle cadavers were used. Anatomical characteristics of femoral attachment regions of the CrCL were determined. Then, the location and area of the footprints of the CrMB and CdLB were objectively measured. Each bundle was equally divided into four fibre bundles, and changes in the fibre arrangement were recorded during stifle range of motion. Additionally, the tension of each fibre bundle at various stifle joint angles was objectively measured. Results The attachment region of the CrCL clearly differed from that reported in humans. The centre of the CdLB attachment site was located craniodistal to that of the CrMB on the femur and slightly caudal to that of the CrMB on the tibia. The area of the CrMB on the femoral and tibial attachment sites was larger than that of the CdLB. During stifle range of motion, each divided fibre bundle in the CrMB and CdLB was twisted intricately. The tension of the CrMB was higher than that of CdLB. The central part of the CrMB was always tense during stifle range of motion. Clinical Significance These results may contribute to the application of anatomical reconstruction surgery for CrCL deficient stifle in dogs.

Treatment of cranial cruciate ligament rupture in the feline stifle

2015 ◽  
Vol 28 (06) ◽  
pp. 401-408 ◽  
Author(s):  
R. De. Sousa ◽  
M. Sutcliffe ◽  
N. Rousset ◽  
M. Holmes ◽  
S.J. Langley-Hobbs
Keyword(s):  
Cruciate Ligament ◽  
Suture Technique ◽  
Radiographic Examination ◽  
Axial Loads ◽  
Cranial Cruciate Ligament ◽  
Stifle Joint ◽  
Significant Difference ◽  
Bone Anchors ◽  
Distal Direction ◽  
Lateral Suture

SummaryObjective: To determine whether a lateral suture placed with bone anchors between quasi-isometric points in a cat is superior to a standard fabella-tibial suture for the stabilization of cranial cruciate ligament (CrCL) rupture compared to an intact stifle joint.Study design: Biomechanical cadaveric study.Methods: Six stifle joints with intact cruciate ligaments from three skeletally mature cats were placed in a loading mounting set and tested with axial loads of 20N and 60N at three different joint angles (75°,130° and 160°). The procedure was repeated with a transected CrCL; a stabilized stifle joint after a combination of three lateral suture techniques (fabella-tibial suture technique [SFT]; femoro-tibial suture technique 1 [FTS-1] and femoro-tibial suture technique 2 [FTS-2]). Radiographic examination of the relative position of the tibia to the fixed femur was compared.Results: Stabilization of the stifle joint with lateral sutures had comparable stability to the intact specimens in the cranio-caudal direction (p = 0.2) but not in the proximo- distal direction for the SFT (p = 0.04) and FTS-2 technique (p = 0.03). There was no significant difference between the three stabilization techniques (p >0.05).Clinical significance: Lateral sutures placed with bone anchors at quasi-isometric points performed better than SFT and FTS-2 in stabilizing the feline stifle after CrCL rupture in the proximo-distal plane. Biomechanical stability in the cranio-caudal plane after placement of a lateral suture across the feline stifle was similar to the intact CrCL.

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