Laurie's Blogs.

Looking for a quick ‘top up’ of your knowledge on intra-articular injections for osteoarthritis in dogs?  I’ve got you covered!  Here’s a quick pick of 5 research papers and their findings on the subject!  Happy reading!

Alves JC, Santos A, Carreira LM. A Preliminary Report on the Combined Effect of Intra-Articular Platelet-Rich Plasma Injections and Photobiomodulation in Canine Osteoarthritis. Animals (Basel). 2023 Oct 18;13(20):3247. 

•  All treatments produced clinically significant improvements compared to the assessment on treatment day. 

•  The combination of PRP and photobiomodulation produced greater, longer-lasting improvements. 

•  PRP and photobiomodulation can improve objective outcomes and client-reported outcome measures in dogs with OA. 

•  Their combined use leads to greater, longer-lasting, clinically significant improvements.

Miller AV, Carney PC, Markmann A, Frye CW. Retrospective analysis describes safety of therapeutic joint injections in dogs. J Am Vet Med Assoc. 2023 Jan 2;261(3):397-402. 

•  Minor complications were noted in 70 of 283 visits and included transient soreness (18.4%, lasting a median of 2 days; range, 1 to 20 days) and gastroenteritis (6.8%). 

•  One case of septic arthritis (1/505 joints), which possessed risks of a hematogenous source, was the only potential major complication.

•  Larger volumes of injectate normalized to body size were more likely to be associated with transient soreness in the stifle and tarsus. 

•  Across injectates, only stem cells had significantly increased odds of soreness. 

•  Gastroenteritis was not associated with the type of injectate.

Okamoto-Okubo CE, Cassu RN, Joaquim JGF, et al. Chronic pain and gait analysis in dogs with degenerative hip joint disease treated with repeated intra-articular injections of platelet-rich plasma or allogeneic adipose-derived stem cells. J Vet Med Sci. 2021 Jun 2;83(5):881-888. 

•  Compared with baseline Helsinki Chronic Pain Index (HCPI), Canine Brief Pain Inventory (CBPI), Visual Analogue Scale for Pain (VAS-pain), and Pain response to Palpation (VAS-palp) scores reduced 41%, 52%, 51%, and 48% at 60 days in the ADSC group. 

•  In PRP-treated dogs, CBPI, Visual Analogue Scale for Locomotion (VAS-loc), and Descriptive Numeric Scale for pain (DNS) scores decreased by 43%, 43%, and 33% at 60 days, respectively .

•  Based on CBPI data, the rate of success at 60 days was 75% and 25% in the ADSC and PRP groups, respectively.

Volz F, Eberle D, Kornmayer M, et al. Effect of intra-articular platelet-rich plasma or hyaluronic acid on limb function recovery in dogs with TPLO for cranial cruciate ligament rupture: a randomised controlled trial. J Small Anim Pract. 2024 Apr;65(4):223-233. 

•  At all times postoperatively, no differences were observed among groups regarding clinical examinations, osteoarthritis score values, ground reaction forces or owner questionnaires.

•  All dogs treated with tibial plateau levelling osteotomy for cranial cruciate ligament rupture showed improvements in limb function. 

•  No additive effect on faster recovery was demonstrated with the additional intra-articular injection of platelet-rich plasma or hyaluronic acid. 

•  Addition of platelet-rich plasma/hyaluronic acid injections during tibial plateau levelling osteotomy is unnecessary considering the lack of benefit observed up to 6 months postoperatively.

Catarino J, Carvalho P, Santos S, et al. Treatment of canine osteoarthritis with allogeneic platelet-rich plasma: review of five cases. Open Vet J. 2020 Aug;10(2):226-231. 

•  Five dogs. Several breeds. Between 6 and 12 years old. Both genders. OA in the knee, tibiotarsal, elbow, and intercarpal joints. 

•  These dogs were refractory to medical therapy and to physical rehabilitation protocols that included shockwave therapy, laser therapy, electrostimulation, hydrotherapy, and diathermy.

•  Lameness at walk and trot (five grades) and pain (five scores) were evaluated before treatment and 30, 60, and 90 days post-treatment.

•  All animals presented improvements at 30 and 60 days in both parameters. Four dogs showed a decrease of three grades of lameness after 90 days and there was complete absence of lameness in 2 days. Pain was reduced from severe and moderate to mild in all the dogs after 30 days, and among them, three revealed no pain after 90 days.

Take aways:

1. Lasers and PRP is not only safe, it yields superior results to PRP alone.

2. Intra-articular joint injections are typically safe.

3. In chronic hip OA, PRP or Stem cell can be beneficial, but stem cell was a bit better.

4. Adding PRP or Hyaluronic acid at the time of cruciate repair doesn’t seem to provide much benefit.

5. The last study isn’t very strong, but basically, if rehab isn’t doing what you want it to, then give PRP a try!

Until next time…

Cheers!  Laurie