Use of platelet-rich plasma as an adjuvant on treatment of meniscal lesion and tendinosis of calcaneus in a dog
Keywords:
Meniscus, calcaneal, canine, platelet rich plasma, orthopedicsAbstract
The aim of this paper is to report the case of a dog with meniscal lesion associated with calcaneal tendinosis treated with single application of intra-articular and intratendinous platelet rich plasma (PRP). A dog of the Boxer racer with difficulty walking was treated three months ago. Grade II/IV lameness was observed in both pelvic limbs, bilateral muscle atrophy, pain and slight crepitation in the left knee, slight instability to the drawer and cranial tibial tests, with intense medial fibrosis to the joint and right calcaneal tendon thickening/stiffness. The radiographic study showed moderate arthrosis in the left knee, and ultrasound examination revealed areas of hypoechogenicity in the left medial meniscus and rupture of the right calcaneal tendon muscle fibers. Thus, the patient was diagnosed with chronic cranial cruciate ligament insufficiency, periarticular fibrotic stability, and left meniscal injury and right calcaneal tendinosis. Chondroprotectors, diacerein, physiotherapy and an application of intra-articular and intratendinous PRP were prescribed. For the PRP concentration, 50mL of autologous blood were collected and deposited in vials containing sodium citrate. A double centrifugation was performed, the first strength of 120g and the second 240g, both for ten minutes. At the end, 2mL of PRP was obtained with 246.000 platelets/μL (before concentration the blood had 141.000 platelets/μL). The application occurred aseptically, under general anesthesia and guided by ultrasound. We injected 1ml intra-articular in the left knee, 0.25mL in the perilesional region and 0.75mL intralesional in the right calcaneal tendon. After 14 days, I/IV lameness and slight muscle strengthening were noted. Clinical treatment with physiotherapy and chondroprotectors was maintained, with periodic returns to follow the evolution. It was concluded that the use of PRP was an important adjuvant in the clinical therapy employed.
References
AKATSU, Y.; YAMAGUCHI, S.; MUKOYAMA, S.; MORIKAWA, T.; YAMAGUCHI,
T.; TSUCHIYA, K.; IWASAKI, J.; AKAGI, R.; MURAMATSU, Y.; KATSURAGI, J.;
FUKAWA, T.; ENDO, J.; TAKAHASHI, K.; SASHO, T. Accuracy of high-resolution
ultrasound in the detection of meniscal tears and determination of the visible area of menisci.
Journal of Bone and Joint Surgery, v.97, p.799-806, 2015.
ARNAULT, F.; CAUVIN, E.; VIGUIER, E.; KRAFT, E.; SONET, J.; CAROZZO, C.
Diagnostic value of ultrasonography to asses stifle lesions in dog after cranial cruciate
ligament rupture: 13 cases. Veterinary and Comparative Orthopaedics and Traumatology,
v.6, p.479-485, 2009.
CARR, B.J.; JR, S.O.C.; MASON, D.R.; COX, C.; HESS, T. Canine Platelet-Rich Plasma
Systems: A prospective analysis. Frontiers in Veterinary Science, v.2, p.1-8, 2016.
COOK, J.L.; SMITH, P.A.; BONZYNSKI, CC.; KUROKI, K.; COOK, C.R.; ATOKER,
A.M.; PFEIFFER, F.M. Multiple injections of leukoreduced platelet rich plasma reduce pain
and functional impairment in a canine model of ACL and meniscal deficiency. Journal of
Orthopaedic Research, v.34, n.4, p.607-615, 2016.
DEL RIO, L.A.; LEVY, R.; BASILE, R.C. Tendinose em equinos. Investigação, v.17, n.5,
p.18-23, 2018.
DENNY, H.R.; BUTTERWORTH, S.J. Tarso. In: DENNY, H.R.; BUTTERWORTH, S.J.
Cirurgia ortopédica em cães e gatos. São Paulo: 4ª ed., Roca, p.19-23, 2006.
GEBUREK, F.; GAUS, M.; VAN SCHIE, H.T.M.; ROHN, K.; STADLER, P.M. Effect of
intralesional platelet-rich plasma (PRP) treatment on clinical and ultrasonographic
parameters in equine naturally occurring superficial digital flexor tendinopathies – a
randomized prospective controlled clinical trial. BMC Veterinary Research, v.12, n.191, p.1-
, 2016.
LAMB, C.; DUVERNOIS, A. Ultrasonographic anatomy of the normal canine calcaneal
tendon. Veterinary Radiology and Ultrasound, v.46, n.4, p.326-330, 2005.
MARQUES, D.R.C.; IBANES, J.F.; NOMURA, R. Principais osteotomias para o tratamento
da ruptura do ligamento cruzado cranial em cães- revisão de literatura. Arquivos de Ciências
Veterinárias e Zoologia da UNOPAR, v.17, n.4, p.253-260, 2014.
MCCREAD, D.J.; NESS, M.G. Diagnosis and management of meniscal injury in dogs with
cranial cruciate ligament rupture: a systematic literature review. Journal of Small Animal
Practice, v.57, p.59-66, 2016.
MESSORA, M.R.; NAGATA, M.J.H.; FURLANETO, F.A.C.; DELIBERADOR, T.M.;
MELO, L.G.N.; GARCIA, V.G.; BOSCO, A.F. Análise da eficiência do protocolo de dupla
centrifugação para o preparo do plasma rico em plaquetas (PRP) – estudo experimental em
coelhos. Revista Sul-Brasileira de Odontologia, v.6, n.3, p.291-296, 2009.
Ciência Animal, v.30, n.1, p.145-153, 2020.
*Endereço para correspondência:
igor_113@hotmail.com
MISTIERI, M.L.A.; PASCON, J.P.E.; DUARDE, C.A. Diagnostic ultrasonography of the
shoulder in dogs – scan techniques and common findings. Semina: Ciências Agrárias, v.36,
n.5, p.3245-3256, 2015.
MOSTAFA, A.A.; BAKR, E.; ALI, M.A. Extra-articular stabilization of cranial cruciate
ligament-deficient stifle in dogs: a new tibial suture anchor point. The International Journal
of Applied Research, v.11, n.3, p.212-222, 2013.
MUIR, P.; JOHNSON, K. A.; COOLEY, A. J.; MANLEY, P. A. Force-plate analysis of gait
before and after surgical excision of calcified lesions of the supraspinatus tendon in two
dogs. Veterinary Record, v.139, n.6, p.137-139, 1996.
ORDUÑA, J.F.G.; CAVIEDES-BUCHELI, J.; CÉSPEDES, M.C.M.; JIMENO, E.B.;
BIEDMA, B.M.; SEGURA-EGEA, J.J.; LÓPEZ-LÓPEZ, J. Use of Platelet-rich plasma in
endodontic procedures in adults: regeneration or repair? A report of 3 cases with 5 years of
follow-up. Journal of Endodontics, v.43, n.8, p.1294-1301, 2017.
PENHA, E.M.; JULIÃO, L.R.; CAVALCANTE, P.B.; BARRETO, L.C.; LARANGEIRA,
D.F.; SOARES, M.P.B.; BARROUIN-MELO, S.M. Uso do plasma rico em plaquetas no
tratamento da doença articular degenerativa em cão: relato de caso. Arquivos de Ciências
Veterinárias e Zoologia da UNOPAR, v.17, n.2, p.139-144, 2014.
PLAKSINA, J.; ILGAŽS, A. The efficacy of platelet-rich plasma use as a treatment for the
osteoarthritis. Research for Rural Development, v.1, p.120-124, 2016.
PRADA, T.C.; MINTO, B.W.; PEREIRA, N.W.; KARCHER, D.E.; DIAS, L.G.G.G.
Tratamento clínico da osteoartrite do joelho em cães. Investigação, v.17, n.1, p.16-23, 2018.
REZENDE, M.U.; SILVA, R.B.B.; BASSIT, A.C.F.; TATSUI, N.H.; SADIGURSKY, D.;
NETO, R.B. Effect of platelet-rich plasm on impact-induced chondrocyte apoptosis. Acta
Ortopédica Brasileira, v.19, n.2, p.102-105, 2011.
ROFFI, A.; MATTEO, B.D.; KRISHNAKUMAR, G.S.; KON, E.; FILARDO, G. Plateletrich
plasma for the treatment of bone defects: from pre-clinical rational to evidence in the
clinical practice. A systematic review. International Orthopaedics, v.41, p.221-237, 2017.
ROSSETO, L.P.; MORAES, P.C.; CAMPLESI, A.C.; FACIN, A.C.; DIAS, L.G.G.G.
Alternativas no tratamento da osteoartite. Investigação, v.17, n.3, p.06-12, 2018.
SILVA, R.F.; CARMONA, J.U.; REZENDE, C.M.F. Intra-articular injections of autologous
platelet concentrates in dogs with surgical reparation of cranial cruciate ligament rupture.
Veterinary and Comparative Orthopaedics and Traumatology, v.26, p.285-290, 2013.
SOUZA, A.N.A.; SALADINO, A.O.; BIASI, C.; MATERA, J.M. Uso dos condroprotetores
na afecção articular degenerativa: revisão. Revista Acadêmica: Ciências Agrárias e
Ambientais, v.8, n.3, p.281-289, 2010.
VENDRUSCOLO, C.P.; CARVALHO, A.M.; MORAES, L.F.; MAIA, L.; QUEIROZ,
D.L.; WATANABE, M.J.; YAMADA, A.L.M.; ALVES, AL.G. Avaliação da eficácia de
diferentes protocolos de preparo do Plasma Rico em Plaquetas para uso em Medicina
Equina. Pesquisa Veterinária Brasileira, v.32, n.2, p.106-110, 2012.
