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Platelet Rich - Plasma Treatment


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Using Platelet Rich Plasma Treatment In Horses.

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Platelet Rich - Plasma Treatment

  1. 1. Fact Sheet Sponsored by:Platelet-Rich PlasmaLearn what this novel “regenerative therapy” can do for your horse Regenerative medicine describes a group is collected from the patient in special tubesof techniques that uses the body’s natural and the platelets are concentrated—mostability to heal. Stem cell therapy, autolo- commonly through centrifugation. Duringgous conditioned serum, and platelet-rich this process the tubes filled with the horse’splasma (PRP) are all different types of blood are spun, physically separating a ma-regenerative medicine. 1 Each of these jority of the red and white blood cells fromtherapies uses biologic samples (e.g., cells the platelets and plasma, thus forming aor platelets) taken from a sick or injured platelet-rich and processes them to behave in a The system chosen for concentratingcertain way (e.g., concentrate them, stimu- the platelets must be used according tolate them to become a certain cell type, or the manufacturer’s recommendations.produce a certain protein). These “modi- This ensures the growth factors are notfied” biologic products are then injected released from the platelets prematurely, CourTeSy dr. STeven BerkoWITzinto or applied to the horse from which the before they are used on the patient. It issample was originally collected to treat a also imperative to consider bacterial con-specific injury. Thus, these therapies are tamination while preparing the PRP. Onereferred to as “autologous” because the study published in a 2010 edition of thepatient is being treated with a product de- Equine Veterinary Journal found that un-rived from his or her own body. Autologous contaminated PRP could be produced intherapies are safe and associated with min- a clean laboratory environment (i.e., they Indications for PRP use in horses include tendonimal side effects. did not test any of the stall-side methods of and ligament injuries, wound healing, and Regenerative medicine is one of the osteoarthritis treatment (shown). making PRP), but noted that it is essentialmost recent and potentially helpful thera- to perform the procedure following strictpies introduced to the equine industry over in the blood marrow. After they mature, aseptic technique.3the last several years. Several conferences platelets are released into the circulationhave focused on regenerative medicine and where they play a prominent role in blood PRP Use in Horsesmany of the Veterinary Hospitals at univer- clotting (hemostasis). As such, platelets In human medicine, PRP is made usingsities throughout North America have lab- are filled with beneficial growth factors the same principles and is used to treatoratories dedicated to studying stem cells, that help repair connective tissues and various medical conditions such as nerve,autologous conditioned serum, and PRP.2 keep them healthy. These growth factors tendon, and myocardial (heart muscle)However, regenerative medicine remains include platelet- derived growth factor, injury, bone repair and regeneration, cos-in its infancy, leaving many of us unsure transforming growth factor beta, fibro- metic procedures, and dental health. Theexactly what it is and how best to use it. blast growth factor, insulin-like growth major indications for PRP in horses areThis fact sheet will explain what PRP is, factor 1, and vascular endothelial growth musculoskeletal conditions and wounds,how it is made, and how this technology factor.2 as described here:can potentially help your horse. PRP for Tendons and Ligaments Tendons What is PRP and How is it Made? are notoriously slow to heal, and horsesWhat are Platelets? By definition, PRP is a plasma sample frequently reinjure the tendon at the same There are three main types of cells in with platelet concentration above baseline site. PRP is believed to stimulate tendonblood circulation: red blood cells; white levels.1 Often, PRP produced using stall- injury repair. To date, several studies haveblood cells; and platelets. Technically, be- side systems can produce a plasma sample reported beneficial effects of PRP for thecause platelets do not have a nucleus (the with an even higher platelet level. treatment of superficial digital flexor ten-part of the cell that contains DNA), they PRP can be made using a number of don injuries (both acute and chronic cases)are referred to as “cell fragments.” Like commercially available systems. In gen- and suspensory ligament injuries.4 Theo-the red and white blood cells, platelets eral, all of the systems use the same basic retically, other types of tendon and liga-(also called thrombocytes) are produced components and principle. A blood sample ment injuries could also be treated. Some This Fact Sheet may be reprinted and distributed in this exact form for educational purposes only in print or electronically. It may not be used for commercialpurposes in print or electronically or republished on a Web site, forum, or blog. For more horse health information on this and other topics visit Published by The Horse: Your Guide To Equine Health Care, © Copyright 2011 Blood-Horse Publications. Contact
  2. 2. Fact Sheetstudies report only a single treatment is for wound healing in horses found that Information System, and to help repair the defect whereas treated wounds healed faster than wounds Each of these resources is available free toother researchers recommend multiple in- that were simply sutured (stitched) closed. horse owners. hjections over several weeks. The second study did not find any benefit PRP for Joints PRP also can be injected of PRP on wound healing using a specific, Key RefeRences 1. Fortier, L. Regenerative therapy for equine joint diseasedirectly into a joint (i.e., intra-articularly) surgically-created defect; however, those - where are we at? 49th British Equine Veterinary Associa-to treat osteoarthritis (OA). Several human authors did suggest that other wounds tion Congress proceedings, Sept. 8-11, 2010 Birmingham,clinical studies support using PRP to treat might benefit from PRP.6 United Kingdom. scientific/58.pdfarthritis, but no data on PRP in horses 2. Prades, M. Current Trends in Regenerative Medicinewith osteoarthritis has yet been published Future Directions for Soft Tissue Musculoskeletal Injury. In: Proceedings ofin a peer-reviewed journal.1 So far, only As exciting as the field of regenerative the Southern European Veterinary Conference & Congresopreliminary data has been presented at medicine is, experts advise keeping our Nacional proceedings 2007, Barcelona Spain. www.ivis. org/proceedings/sevc/2007/prades2/chapter.asp?LA=1various conferences. For example, one enthusiasm in check. All regenerative 3. Alvarez, ME, Giraldo, CE, Carmona, JU. Monitoringgroup of scientists from Spain presented therapies, including PRP, are in their in- bacterial contamination in equine platelet concentratestheir data at the 11th International Con- fancy, and the current body of knowledge obtained by the tube method in a clean laboratory envi- ronment under three different technical conditions. Equinegress of the World Equine Veterinary Asso- about these therapies remains rather lim- Vet J. 2010 Jan;42(1):63-7. in 2009.5 Researchers injected PRP ited. Variations in systems used to prepare pubmed/201219161-3 times into the joints of 30 horses with a high-quality biological sample, timelines 4. Oke, S. Investigating Platelet-Rich Plasma for Equine Tendon Injuries. occurring OA and compared on when, where, and how much to ad- 5. Abellanet, I, Prades, M. Intraarticular platelet richtheir post-treatment lameness and athletic minister, and post-treatment rehabilita- plasma (PRP) therapy: evaluation in 42 sport horses withfunction to that of 12 untreated (control) tion and prognoses remain to be clearly OA. 11th International WEVA Congress in 2009. www.ivis. org/proceedings/weva/2009/72.pdf?LA=1horses with OA. established. 6. Oke, S. Platelet-Rich Plasma: Healing Skin Wounds in PRP for Wounds PRP also has been hy- Research is being conducted aggres- Horses. to help improve wound healing. sively and progress in this field is rapid. Further reading and free horse healthIn horses, wound healing, after surgery or The most up-to-date information on these e-news: injury, for example, can be slow, and promising and important technologies Authored by Stacey Oke, DVM, MSc;in some cases “proud flesh” can develop. is available by searching websites such reviewed by: David Frisbie, DVM, PhD,One of the two published studies on PRP as PubMed, the International Veterinary Dipl. ACVS. Get the most out of Pure PRP ProTec™ PRP – Simple, consistent preparation meets effective healing • Blood-separating technology ensures pure PRP – separating gel physically separates plasma and platelets from red and white blood cells – takes the guess work out of PRP separation • 9 mL of blood and 6-minute centrifuge spin achieves consistent plasma and platelet separation every time • Technology results in fibrin matrix so platelets and growth factors remain protected until activation • Closed-system preparation yields 4-5 mL of PRP ready for sterile injection into tendon/ligaments, soft-tissue and wounds • Portable PRP processing available: with case, sterile kits, and low-cost centrifuge Leadership in Veterinary Regenerative Technology