Recent advancements in our understanding of the body’s ability to heal itself has resulted in a rapid expansion in the field of Regenerative Medicine. Stem Cell therapy has been successfully used in veterinary medicine to treat a large number of orthopedic and soft tissue injuries. In addition to stem cell therapy, there are other useful Regenerative Medicine therapies available to the clinician.
Platelet Rich Plasma (PRP) is being used extensively in equine medicine to treat joint disease as well as ligament and tendon injuries. PRP, as the name implies, is a highly concentrated solution of platelets. Aside from their function in blood clotting, platelets also contain an enormous quantity of pro-healing natural chemicals known as cytokines or growth factors. In Regenerative Medicine we are most interested in harvesting these growth factors which we can inject into arthritic joint or into soft tissue injuries.
The process for PRP administration is straight forward. First whole blood is collected in an anti-coagulant for processing. Most systems use a dual centrifugation technique where the red blood cells and the white blood cells are removed from the blood and then the platelets are concentrated. Other systems use specialized filters to isolate the platelets. The important thing is to remove as much of the red and white blood cells from the sample as possible since these cells can cause inflammation. Also it is important to get as many platelets as possible in the final product. There is a great deal of difference in the quality of the final product depending on which method or system is used.
Some systems also “activate” the platelets before injection. This process stimulates the platelets to de-granulate which releases the growth factors from the cells before injection. There is much controversy as to whether or not this is beneficial or even necessary.
Once the final product is processed we typically have 2-4ccs of PRP. The PRP can be used to treat not only arthritis, but also ligament or tendon injuries. I have found it to be very useful in speeding healing and decreasing pain. I have also been impressed with the results when using PRP to treat open wounds and corneal ulcers.
In most stem cell treatment I add PRP to the final product to further stimulate healing. The rationale is that PRP will serve to activate dormant stem cells and thus make the treatment more efficacious.
The take home message is that PRP is a simple, cost effect tool to add to our Regenerative Medicine tool box.
– Dr. Joseph G. Yocum, Green Tree Animal Hospital