The Use of Autologous Protein Solution (Pro-Stride®) and Leukocyte-Rich Platelet-Rich Plasma (Restigen®) in Canine Medicine

Abstract

The use of autologous orthobiologics is an emerging area of interest in veterinary medicine. In this retrospective study, we reviewed the clinical results achieved using two orthobiologics devices to address orthopedic injuries and tissue repair. Leukocyte (White blood cell)-rich platelet-rich plasma (L-PRP) devices produce outputs containing high concentrations of growth factors from venous blood. The Autologous Protein Solution (APS) device produces an orthobiologic containing high concentrations of growth factors and anti-inflammatory cytokines. L-PRP has commonly been used to address soft tissue injuries. APS has been injected into the joint to address osteoarthritis. In the last five years, our practice has treated 35 dogs (38 treatments) with L-PRP and 98 dogs (108 treatments) with APS. Our group has used L-PRP and APS to address orthopedic conditions including osteoarthritis, bursitis, tendinitis, tendon/ligament rupture/repair procedures, post-surgical femoral head osteotomy/tibial-plateau-leveling osteotomy tissue repair, lumbosacral stenosis, patellar luxation, joint laxity, and osteochondral dissecans. The results achieved with L-PRP and APS have been favorable (observed pain improvement and minimal adverse reactions), but sometimes have not achieved complete pain relief or tissue repair. The most common application for L-PRP was patellar luxation and the most common application for APS was injection post-ACL surgery. Canine OA has been successfully managed in several patients with repeat injections of APS over the course of several years. Future studies on specific conditions are ongoing and including efforts to further characterize these products in canine medicine.

Keywords: APS; PRP; anti-inflammatory; canine; orthopedics; osteoarthritis.

Figure 1

The timing and cell types involved in wound repair demonstrating the role of WBC (including neutrophils, macrophages, and lymphocytes) in successful healing.

Figure 2

Blood draw process from canine patients. (A) Blood draw sites were prepared by clipping area over the jugular vein and then the skin was aseptically cleaned. (B) The needle was inserted into the jugular vein and the syringe was slowly pulled back to check for a flash of blood to confirm needle placement. (C) The blood was slowly drawn while rocking syringe to ensure mixture of blood and anti-coagulant.

Figure 3

Representative pictures of 60mL L-PRP device processing: 1) a 18-gauge needle was attached to a 60mL syringe and 5–8mL of ACD-A was withdrawn. 2) The cap was unscrewed on center port of the L-PRP device and the green packaging post was discarded. Blood was slowly loaded into the center port. The syringe was removed and the tethered cap was attached to its port. 3) The L-PRP device was placed into the centrifuge and balanced with a counterbalance. 4) The L-PRP device was spun in centrifuge at 3200 RPM for 15 minutes. 5) The yellow cap was removed on the side port and a 30mL syringe was connected. The device was tilted at an angle, avoiding inverting to keep top blue vent dry, and all of the platelet-poor plasma (PPP) was removed. The yellow cap was replaced. 6) The red cap was removed on the side port and a 10mL syringe was connected. 2mL of PRP was withdrawn and syringe was left attached. With the 10mL syringe attached, the PRP was suspended by gently shaking L-PRP device for 30 seconds. The remaining PRP suspension was extracted into the attached 10mL syringe.

Figure 4

Representative pictures of APS device processing: 1) The APS Concentrator device was gently shaken to ensure beads were evenly distributed across bottom of top chamber. The yellow cap was unscrewed on the APS Concentrator device and filled with the output of L-PRP device from the 10mL syringe. The 10mL syringe was removed and the tether cap on port was attached. The paddle was spun until the cell solution was fully mixed with beads. 2) The concentrator was placed into the centrifuge. The centrifuge was balanced with a counterbalance. The concentrator device was spun for 2 minutes at 2000 RPM. 3) The APS was gently resuspended in the bottom of the APS Concentrator. The red cap was unscrewed and connected to a sterile 10mL syringe. The APS was extracted.