V-PET - · PDF fileOsteoartritis 3. Woundhealing Platelet-rich plasma gel promotes differentiation and regeneration during ... V-PET presentatie.pptx.pdf Created Date:

V-PET Veterinary Platelet Enhancement Therapy

August 2015

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Katilyne Ghijselings, DVM ORTHOPAEDICS.BE

INTRODUCTION

Whole blood contains 3 types of blood cells 1.  White blood cells 2.  Red blood cells 3.  Platelets

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PLATELET RICH PLASMA

= a volume of autologous plasma with a platelet

concentration two-fold or more above baseline

(>1.000.000 pl/µl) Platelet-Rich Plasma (PRP): What Is PRP and What Is Not PRP?

Reprinted from IMPLANT DENTISTRY Vol. 10 No. 4 2001

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! Platelet rich plasma (PRP) is a new treatment used for some common orthopedic conditions, including sports injuries. PRP is a concentration of platelet cells taken from the blood. These platelets have growth factors that may help in the healing process of chronic injuries. Growth Factors are chemicals that signal the body to initiate a healing response. By injecting PRP into areas of an injury, the hope is to stimulate and optimize your body’s ability to heal the chronic conditions.

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A. PLATELETS

= Thrombocytes •  Produced in the bone marrow •  Responsible for coagulation •  Containing different Growth Factors

•  Platelet-Derived growth factors •  Transforming growth factor beta •  Fibroblast growth factor •  Insuline-Like growth factor •  Vascular endothelial growth factor

" Healing capacity

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B. GROWTH FACTORS

=cytokine proteins: •  Regulating other cells function •  Playing a role on modulation of the inflammatory

response •  Promoting angiogenesis •  Attraction of fibroblasts, and local stem cells to the

site of injury and induction of autocrine GF production •  Mishra A, Tummala P, King A, Lee B, Kraus M, Tse V, et

al. Buffered platelet-rich plasma enhances mesenchymal stem cell proliferation and chondrogenic differentiation. Tissue Eng Part C Methods 2009;15:431–5.

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!  No correlation between number of platelets and GF concentrations

!  GF concentrations highly variable between individuals

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INDICATIONS

#  Widely used in human en veterinary medicine

#  A lot of studies available but very difficult to standardise

#  Many different commercial kits available

#  Only one filtration based system on the market : V-PET

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INDICATIONS # ANALGESIC?

!  Potentionally primary analgesic effect !  Some human studies state decreased post-

op pain-levels !  Stimulation of thrombin receptors

(ie,PAR-1) shown to increase pain threshold in laboratory animals through opioid pathways

!  May attain secondary analgesia through improved hemostasis

!  No clear evidence

# REGENERATIVE? •  In vitro indications, not proven in vivo

•  Attracting Stemcells

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A. EQUINE 1.  Tendon and ligament repair

INDICATIONS

Ultrasound Guided injections

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# Intralesional injection of platelet-rich plasma followed by controlled exercise for treatment of midbody suspensory ligament desmitis in Standardbred racehorses Martin Waselau, dr med vet, ms; W. Wesley Sutter, dvm, ms, dacvs; Ronald L. Genovese, vmd; Alicia L. Bertone, dvm, phd, dacvs

# Effects of Platelet-Rich Plasma on the Quality of Repair of Mechanically Induced Core Lesions in Equine Superficial Digital Flexor Tendons:A Placebo-Controlled Experimental Study Gerco Bosch,1 Hans T. M. van Schie,1,2 Mark W. de Groot,3 Jennifer A. Cadby,1,2 Chris H. A. van de Lest,1,4 Ab Barneveld,1 P. Rene´ van Weeren1

#  Evaluation of a filter-prepared platelet concentrate for the treatment of suspensory branch injuries in horses.

Castelijns G, Crawford A, Schaffer J, Ortolano GA, Beauregard T, Smith RK. Vet Comp Orthop Traumatol. 2011;24(5):363-9. doi: 10.3415/VCOT-11-01-0001. Epub 2011 Sep 2. http://www.ncbi.nlm.nih.gov/pubmed/21887455

INDICATIONS

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A. EQUINE

1.  Tendon and ligament repair

2. Osteoartritis

#  Intra-Articular Use of a Platelet-Rich Product in Normal Horses: Clinical Signs and Cytologic Responses Jamie A. Textor, DVM PhD Diplomate ACVS, and Fern Tablin, VMD PhD

#  Autologous platelet concentrate as a treatment for horses with refractory fetlock osteoarthritis. Pichereau F, Décory M, Ramos GC. J Equine Vet Sci 2014;34:489–93

There is scientific interest in the effects of the growth factors especially on osteoarthritis and cartilage repair because of their ability to recruit chondrogenic cells, stimulate proliferation and enhance synthesis of cartilage matrix (Kon et al. 2010; Spakova et al. 2012).

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2. Osteoartritis

3. Woundhealing

Platelet-rich plasma gel promotes differentiation and regeneration during equine wound healing Charleata A. Carter,a,* David G. Jolly,a Charles E. Worden Sr.,a Dennis G. Hendren,a and Cynthia J.M. Kaneb

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B. DOGS 1.  OSTEOARTRITIS Clinical outcome using canine platelet enhancement therapy (C-PET) Fahie MA1; Ortolano G2; Guercio V2; Schaffer JA2; Johnston G1; Au J3; Hettlich B3; Phillips T1; Allen M3; Bertone A3

A randomized controlled trial of the efficacy of autologous platelet therapy for the treatment of osteoarthritis in dogs. Fahie MA, Ortolano GA, Guercio V, Schaffer JA, Johnston G, Au J, Hettlich BA, Phillips T, Allen MJ, Bertone AL. J Am Vet Med Assoc. 2013 Nov 1;243(9):1291-7. doi: 10.2460/javma.243.9.1291.

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Pain-assessment canine osteoartritis

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B. DOGS

1.  OSTEOARTRITIS

2.  CRUCIATE LIGAMENT TEARS/ MENISCAL TEARS USE OF A COLLAGEN-PLATELET RICH PLASMA SCAFFOLD TO STIMULATE

HEALING OF A CENTRAL DEFECT IN THE CANINE ACL Murray, M. M.1, Spindler, K. P.2, Devin, C.2, Snyder, B. S.3, Muller, J.3, Takahashi, M.3, Ballard, P.1,2, Nanney, L. B.4, Zurakowski, D.1

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B. DOGS

1.  OSTEOARTRITIS

2.  CRUCIATE LIGAMENT TEARS

3.  TENDON AND LIGAMENT TEARS

Comparative study on animal model of acute Achilles tendon rupture with surgical treatment using platelet-rich plasma. Hernandez-Martinez JC, Vasquez CR, Ceja CB, et al: Acta Ortop Mex 26:170-173, 2012

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AVAILABLE SYSTEMS

A.  Centrifuge based : designed for human use

B.  Filtration based: Only veterinary

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A. CENTRIFUGE BASED •  2 types:

o  Buffy coated (double spin): High platelet and high leucocytes

- “SmartPrep2” –Harvest technologies - “GenesisSC” – Vet-stem - GPSII Biomet – Biomet Biologics - …

o  Plasma based (single spin): Low platelet and low leucocytes

-”ACP”- Arthrex system - … 20

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CENTRIFUGE BASED SYSTEMS

! Expensive centrifuge needed ! Difficult to prepair on stable-side ! Anticoagulant required ! Longer procedure time (30 minutes) !  Increased concentration platelets ! BUT, also increased concentration WBC’s &

RBC’s ! Often manufactured for Human use and not

adapted for veterinarian use

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B. FILTRATION BASED SYSTEM: V-PET

! Ready to use kit !  7-layer filter ! Filtration based on size and polarity of the

platelets ! Easy to prepair at stable-side ! Quick procedure (20 min) ! No centrifuge needed ! High platelet concentrate ! BUT also increased WBC’s and RBC’s

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V-PET In the past there were two different kits for dogs and horses: -E-PET -C-PET

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! MAY 2015 " E-PET and C-PET became V-PET !  Same principle !  Combined in one commercial kit !  Easier to explain to the customer

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DOCUMENTATION:

! http://www.tier-pet.de/erfahrungsberichte.html

CASE REPORTS:

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! E-pet !  https://youtu.be/VEDTT6ERRs4

! C-PET !  https://youtu.be/YKvau937WlU !  https://youtu.be/6nzwyxWI2Tg

YOU-TUBE MOVIES:

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MORE INFORMATION?

!  [email protected]

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Documents

V-PET - · PDF fileOsteoartritis 3. Woundhealing Platelet-rich plasma gel promotes differentiation and regeneration during ... V-PET presentatie.pptx.pdf Created Date: