PRP and Cruciate tears?

[K9Rehab]

Hi Laurie and others,
Any experience with PRP injections for partial cruciate tears?
Thanks,
Joanna

[lehughes]

Hey Joanna!

Honestly, we've only seen one... and it didn't work. The problem with doing PRP on a cruciate tear is:
1) if it's a full tear... what are you healing?
2) if it's a partial tear... you need there to be some fibres of the craniomedial band left. If the craniomedial band it totally gone, then the caudolateral band simply won't be able to withstand the forces over the long term. Those ones will become full tears within a year.
3) even if it is a partial tear with some of the craniomedial band left intact, to have the best possible chance of making a difference, the PRP should be injected directly into the tendon / lesioned area. Otherwise, it's a shot in the dark.

Laurie

[David Lane]

PRP has palliative benefit for CrCL deficient knees, the same way it can reduce pain in any OA joint. However, there is no reason to think it will heal the tendon in any meaningful way. There is however, one paper that demonstrates that combining PRP with stem cells in cases of partial cruciate tears (defined as more than 50% of the cranial medial band intact) reduced the chance of progressing to a full tear from 85% in 3 years, to 19% in 2 years (a bit of an apples to oranges comparison, but that is all we have).

From the research: “36 dogs received stem cell injections. Within 2 years, only 7 of them developed progressive cruciate disease and ended up needing surgery.
Of those 36 dogs, 13 received repeat arthroscopy in order to see if healing had occurred. 9 of those 13 showed visible healing of the cruciate tear requiring no further treatment. One showed mild healing and needed repeat stem cell treatment, but the remaining 3 showed progressive tearing and received immediate surgery.
Questionnaires were send to all owners, and of the people that replied, 8 of them owned competition dogs. Of those 8 dogs, 5 of them has returned to sport at the same level of competition, 2 progressed to competing at a higher level and 1 was not able to return to the same level of competition.”

Stem cells need a scaffold, so if the cruciate is torn, there is no regenerative medicine anything that will regrow it. I have used PRP on these knees many times, both with surgery (which greatly improves their post-op weight bearing) and in dogs that cannot receive therapy. I’m skeptical it can consistently help dogs with meniscal tears (my own subjective opinion), and have only done it once on a meniscal tear dog…. and it did substantially improve comfort according to the owner.

David Lane DVM
ACVSMR