Regenerative Medicine for Soft Tissue Injury & Osteoarthritis

This article discusses regenerative medicine therapies, specifically platelet-rich plasma (PRP) and stem cell therapy, for treating soft tissue injuries and osteoarthritis in veterinary medicine. 

Key Points

1. Platelet-Rich Plasma (PRP) Therapy:
   • PRP is an autologous fluid concentrate of platelets and growth factors.
   • It aids in tissue healing by supplying growth factors and other bioactive compounds.
   • PRP has shown efficacy in managing various orthopedic conditions.
   • The ideal PRP product should have a 4- to 7-fold increase in platelets.
   • PRP therapy is minimally invasive and typically performed as a series of 1-3 injections.
2. Stem Cell Therapy:
   • Stem cells can regenerate and heal injured tissue, decrease inflammation, and stimulate healing.
   • Sources include bone marrow-derived (BM-MSCs) and adipose-derived stem cells.
   • Adipose-derived stem cells may be preferred in dogs due to ease of access and high yield.
   • Stem cell therapy can be performed using stromal vascular fraction (SVF) or cultured-expanded cells.
3. Applications:
   • Both therapies have shown efficacy in treating osteoarthritis and soft tissue injuries in dogs.
   • They are often used as adjuncts to surgical, medical, and/or rehabilitation therapy.
4. Procedure:
   • Both PRP and stem cell therapies are typically outpatient procedures.
   • They may require sedation or anesthesia depending on the injection site.
   • Ultrasound or fluoroscopic guidance may be used for accurate injection.
5. Rehabilitation:
   • A dedicated rehabilitation program is recommended after therapy.
   • Certain therapies (e.g., therapeutic ultrasound, electrostimulation) should be avoided for a period after treatment.
   • Patients typically return to normal activity within 4-6 months of treatment.
6. Considerations:
   • A definitive diagnosis is crucial before pursuing regenerative medicine therapies.
   • The composition of PRP products can vary between commercial systems.
   • More research is needed to determine optimal cell numbers and compare efficacy between different stem cell sources.

Dr. Carr and Dr. Canapp emphasize the importance of proper diagnosis, appropriate patient selection, and incorporation of rehabilitation therapy for optimal results from regenerative medicine treatments.