Regenerative Medicine is an emerging branch of veterinary medicine where the body’s own cells are used to help heal and ultimately regenerate damaged tissues. There have been positive results shown in tendon injuries, ligament injuries, burn wounds, and open wounds, but our main focus has been primarily as an adjunctive treatment for osteoarthritis.
Platelet Rich Plasma (PRP)
- Positive effects on angiogenesis (vessel growth to promote healing) and remodeling
- Recruitment of stem cells
- Potent source of growth factors important in regenerative process
- Cell proliferation and differentiation with matrix/scaffold
Stem Cell Therapy- bone marrow derived
- Contribute to generating new tissue and recruitment of progenitor cells
- Anti-inflammatory, anti-fibrotic, anti-apoptosis (cell death)
- Angiogenesis (new vessel growth)
General Clinical Application Algorithms for Osteoarthritis (OA)
- 1 PRP injection with 14 day follow-up to check improvement. If no improvement, 2nd PRP injection recommended.
- 1 PRP injection with 14 day follow-up to check improvement. If no improvement seen, 2nd PRP recommended. If 3rd necessary at 4 weeks recommended or transition to PRP/Stem Cell.
- PRP injections every other week (2-3 injections) or PRP/Stem Cell combination followed by booster injection 9-12 months as needed.
- Radiographs prior to procedure required to rule out other lesions and definitive diagnosis
- Light sedation for PRP may be necessary and sedation/light anesthesia for bone marrow collection and stem cell administration
- Stop NSAIDs week before and 2 weeks after, Galliprant, tramadol, gabapentin ok
- Can see a flare of joint pain for up to 72 hours after injection from turning on cell recruitment
- Decrease activity for 2 weeks after treatment
- Cold laser therapy extremely synergistic with maximum benefit in reducing pain/inflammation
- Weekly videos extremely important
- Response varies by individual patient: 6 days, 6 weeks, 6 months- some do not respond at all
- Tool in toolbox- continued other medical management, nutrition, rehab, weight as directed
- Approximately 50% of dogs will require more than one injection for significant improvement
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