Abstract
The objective of this study was to compare treatment options for acute management
of anterior cruciate ligament (ACL) injuries using preclinical models. Twenty-seven
adult purpose-bred research hounds underwent knee surgery (sham control, exposed ACL,
or partial-tear ACL) and were assessed over the following 8 weeks. Dogs were randomized
into three treatment groups: standard of care (i.e., rest and nonsteroidal anti-inflammatory
drugs [NSAIDs]), washout, or leukoreduced platelet-rich plasma (PRP) so that a total
of nine dogs received each treatment. Data from the two ACL-injury groups were pooled
for each treatment (n = 6 per treatment group) and analyzed for treatment effects. The washout and PRP
groups experienced less lameness, pain, and effusion, and greater function and comfortable
range of motion compared with the NSAID group, with the PRP group showing most benefits.
PRP was associated with the lowest severity of ACL pathology based on arthroscopic
assessment. Measurable levels of inflammatory and degradative biomarkers were present
in synovial fluid with significant differences noted over time. Based on these findings,
washout had positive clinical effects compared with the standard-of-care group especially
within the first week of treatment, but became less beneficial over time. A single
injection of leukoreduced PRP was associated with favorable clinical results. However,
no treatment was significantly “protective” against progression toward osteoarthritis
after ACL injury.
Keywords
platelet-rich plasma - autologous conditioned plasma - anterior cruciate ligament
- biomarkers - canine model
