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Platelet Rich Plasma (PRP) is a platelet concentrate prepared from the patient's blood in a small amount of plasma. This preparation contains various cytokines, or so-called growth factors - PDGF, TGF, VEGF, EGF - and proteins responsible for cell adhesion - fibronectin, fibrin and vitronectin. Concentrated growth factors contained in the preparation have properties that stimulate tissue repair processes - they very strongly stimulate the regeneration of damaged tendons, muscles, ligaments, cartilage or bones. Thanks to these remarkable properties, PRP preparations are successfully used especially in joint therapy.

This method has found a very large application in orthopedics. It is used in the treatment of: arthritis, hard-to-heal fractures and resulting pseudoarthritis, OCD, hip and elbow dysplasia, and has also found application in the treatment of hard-to-heal wounds or ophthalmology.

PRP therapy is an alternative method of treating musculoskeletal disorders, which is also often used as an adjunctive therapy for the treatment of articular cartilage defects, after cruciate ligament reconstruction or in tendinopathies.

Preparation

Platelet cell concentrates containing growth factors are obtained by centrifugation of whole blood, using appropriate tubes and centrifuges. Easy and quick obtaining of platelet cell concentrate is possible even in outpatient conditions.

The extraction process is based on centrifugation at different speeds of whole blood collected with anticoagulant, which results in its separation into: red blood cells, platelet-rich plasma and platelet-poor plasma. The separation of the different fractions occurs automatically.

In our clinic, blood for preparation is collected from the jugular vein, due to the ease and speed of collecting a large volume of blood.

The amount of blood drawn depends on the size of the animal and the number of sites to be treated. Dogs undergoing treatment ranged in weight from 4 kg to 70 kg.

Blood was collected in an amount of 15 to 60 ml at a time from the animal, into a syringe containing sodium citrate, which prevents blood clotting. At the same time, blood should be collected into a tube for serum.

Steps of material preparation:

• Collection of blood from the jugular vein for sodium citrate in a ratio of 9:1 (blood: citrate)
• We separate blood with citrate into appropriate tubes and centrifuge.
• After centrifugation, we separate the plasma from the red blood cell elements.
• We centrifuge the collected plasma again, resulting in the precipitation of a suspension with growth factors and adherence proteins
• We drain the platelet-poor plasma.
• We take the precipitate into a syringe with the serum obtained from centrifugation of whole blood, in a ratio of 1:4
• We introduce the obtained material - platelet-rich plasma - into the affected area.

Injection of the preparation

The procedure is performed on a premedicated animal (anesthesia to be chosen by the doctor). In our clinic, a mixture of dexmedetomidine at a dose of 10 μg/kg with butorphanol at a dose of 0.4 mg/kg of body weight intramuscularly. To perform an injection of the PRP, the area of the joint to be treated should be shaved, disinfected and surgically prepared. After washing hands and maintaining full sterility, a puncture of the joint is performed.

In order to make sure that the injection has been performed correctly, the synovial fluid should be aspirated (in the case of a well-performed injection, the flow of transparent fluid into the syringe is visible). Only after 100% certainty can the PRP preparation be injected into the joint cavity.

Advantages

• PRP is a method with a large number of advantages. These have been compiled on the basis of patients in which this therapy has been applied:
• Minimally invasive procedure - application involves injecting the material directly into the affected area.
• Safety of the therapy - the material taken for PRP comes from the same organism, so no allergic reactions.
• Minimal risk of infection - the injection is performed under sterile conditions. To date, no patient has been reported to have an infection after a PRP injection.
• Short duration of therapy – it is recommended that 2-3 injections are administrered at an interval of 3-4 weeks (depending on the patient’s condition). Live transplanted cells are effective during this time
• Negligible soreness - the therapy is performed on the animal under premedication, and the pain after a properly performed injection is negligible.
• Efficacy incomparably higher (about 90%) compared to conventional injections and NSAID therapy.