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Joint Injections

Intra-Articular Hyaluronic Acid Compared to Traditional Conservative Treatment in Dogs with Osteoarthritis Associated with Hip Dysplasia

Summary:

“The purpose of this study was to compare the efficacy of the intra-articular (IA) hyaluronic acid injection to traditional conservativetreatment (TCT) in dogs with osteoarthritis (OA) induced by hip dysplasia.”

Conclusion:

“Both treatments reduced the clinical signs associated with hip OA. However, more significant results were achieved with intra-articular hyaluronic acid injection.”

Author & Journal:Carapeba, Gabriel O. L., et al, Hindawi Evidence-Based Complementary and Alternative Medicine Journal, 2016
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Examination of synovial fluid and serum following intravenous injections of hyaluronan for the treatment of osteoarthritis in dogs.

Summary:

A randomized, blinded, prospective clinical trial was performed to determine the effects of intravenous (i.v.) administration of hyaluronan sodium (HA) on serum glycosaminoglycans (GAG) concentrations, synovial fluid (SF) hyaluronan concentrations and viscosity in dogs treated for unilateral rupture of the cranial cruciate ligament.

Conclusion:

Data were analyzed using a Wilcoxon sign rank test (p < 0.05). Mean +/- SD viscosity (cP) was significantly higher (p = 0.011) in SF obtained from the intact stifle (450 +/- 604.1) than injured (54.8 +/- 60.8) prior to surgery. Mean +/- SD HA concentrations (ug/ml) were significantly higher (p = 0.02) in synovial fluid obtained from the injured stifles (281.4 +/- 145.9) than intact stifles (141.6 +/- 132.5). No significant difference was noted within or between treatment groups in SF viscosity, HA concentrations, or serum GAG concentrations at any time following surgery. Stifles with cranial cruciate ligament insufficiency had significant alterations in SF viscosity and HA concentrations.

Author & Journal:Canapp SO, et al, Vet Comp Orthop Traumatol 2005;18:19-174
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Mechanisms of action and potential uses of hyaluronan in dogs with osteoarthritis

Summary:

Consideration of the use of intra-articular hyaluronic acid (IAHA) for treatment of OA in dogs.

Conclusion:

“The mechanisms by which IAHA may lead to improvement in clinical signs and homeostasis in joints affected by OA may include restoration of vis- coelasticity and lubrication, antinociceptive and anti- inflammatory effects, enhancement of anabolic processes, and inhibition of catabolic processes. Because the activity of catabolic and anabolic factors in osteoarthritis is controlled by a complex network of binding proteins, cell receptors, and signaling path- ways, it is likely that these multiple effects interact with each other to result in improvement of joint health. However, in vitro findings and in vivo evidence in other species may not be directly relevant to use of this treatment in dogs. Although currently available data indicate potential benefits of using IAHA for treat- ment of OA in dogs, the authors do not recommend its clinical use until further evidence for clinical efficacy and safety in dogs with OA is provided in the literature.”

Author & Journal:Kuroki, Keiichi, et al, Journal of the American Veterinary Medical Association, 2002
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Effect of intraarticular hyaluronan injection on synovial fluid hyaluronan in the early stage of canine post-traumatic osteoarthritis.

Summary:

To determine how the quantity and molecular weight of synovial fluid hyaluronan (HA) within the synovial fluid (SF) of osteoarthritis (OA) joints is affected by intraarticular injection of HA.

Conclusion:

Intraarticular injection of HA did not alter the volume of SF or molecular weight of HA in SF of OA canine knees, nor did it restore the HA concentration to that of normal canine SF.

Author & Journal:Smith GN, et al, J Rheumatol 2001;28:1341-1346
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Diagnostic value of intra-articular anaesthetic in primary osteoarthritis of the hip.

Summary:

“We investigated 42 patients who were being considered for primary total hip arthroplasty (THA), but in whom it was uncertain whether the hip was the source of their pain.”

Conclusion:

“Of 33 patients who gained pain relief from their injection, 32 subsequently had successful THA. The remaining patient has not had surgery.”

Author & Journal:Crawford, R.W., et al, The Journal of Bone and Joint Surgery, 1998
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Effect of corticosteroids on articular cartilage: have animal studies said everything?

Summary:

Intra-articular (IA) corticosteroids (CS) have been used in the treatment of osteoarthritis for many years, although their effects on articular cartilage are not fully understood. To identify whether previous animal studies have provided enough evidence about the effects of CS, we undertook a systematic review that identified 35 relevant in vivo animal experimental studies between 1965 and 2014 assessing the effects of CS on either normal cartilage, or in either induced osteoarthritis (OA) or synovitis.

Conclusion:

Animal studies have not yet provided definitive data, and further research is required into the role of CS in articular pathobiology.

Author & Journal:Vandeweerd, Jean-Michel, et al., Fundam Clin Pharmacol, 2015
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Partial Cranial Cruciate Ligament Tears Treated with Stem Cell and Platelet-Rich Plasma Combination Therapy in 36 Dogs: A Retrospective Study.

Summary:

To evaluate outcomes in 36 dogs with a partial cranial cruciate ligament (CCL) tear treated with autologous bone marrow aspirate concentrate (BMAC) or adipose-derived progenitor cells (ADPC) with platelet-rich plasma (PRP) combination.

Conclusion:

Stifle arthroscopy findings at 90 days posttreatment were available on 13 of the 36 dogs. In nine dogs, a fully intact CCL with marked neovascularization and a normal fiber pattern was found with all previous regions of disruption healed. One dog revealed significant improvement and received an additional injection. The remaining three dogs had a >50% CCL tear, and a TPLO was performed. Four additional dogs were known to have had a TPLO performed elsewhere. Baseline and day 90 posttreatment objective gait analyses were available on 11 of the 36 dogs. A significant difference was found between the treated limb total pressure index percent (TPI%) at day 0 and day 90 (p = 0.0124), and between the treated limb and contralateral limb TPI% at day 0 (p = 0.0003). No significant difference was found between the treated limb and contralateral limb TPI% at day 90 (p = 0.7466). Twelve questionnaires were returned, of which eight were performance/sporting dogs. Seven of the eight had returned to sport; the remaining dog had just begun a return to sport conditioning program 6 months posttreatment. All 12 respondents believed that their dog had an excellent or very good quality of life and rated their dog’s procedural outcome as excellent or good.

Author & Journal:Canapp SO, et al, Frontiers Vet Sci 2016 doi: 10.3389/fvets.2016.00112
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Multiple injections of leukoreduced platelet rich plasma reduce pain and functional impairment in a canine model of ACL and meniscal deficiency.

Summary:

Platelet rich plasma (PRP) is used to treat many musculoskeletal disorders. We used a canine model to determine the effects of multipleintra-articular injections of leukoreduced PRP (ACP) on anterior cruciate ligament healing, meniscal healing, and progression of osteoarthritis (OA).

Conclusion:

Five intra-articular injections of leukoreduced PRP had beneficial effects for ACL healing, improved range of motion, decreased pain, and improved limb function for up to 6 months in this model.

Author & Journal:Cook JL, et al, J Orthop Res 2016; 34(4):607-615
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Effects of intramuscular administration of glycosaminoglycan polysulfates on signs of incipient hip dysplasia in growing pups.

Summary:

We tested the hypothesis that treatment of growing, susceptible (to hip dysplasia) pups by IM administration of glycosaminoglycanpolysulfates would mitigate the signs of incipient hip dysplasia.

Conclusion:

Of 8 treated pups, none had subluxation radiographically, whereas 4 of 8 control dogs had femoral head subluxation. Mean Norberg angle on the radiographs was 109.7 degrees +/- 1.6 degrees for the treated group and was 101.5 degrees +/- 1.6 degrees for controls, representing a mean improvement in coxofemoral congruity of 8.2 degrees in the treated pups.

Author & Journal:Lust G, et al, Am J Vet Res 1992; 53:1836-1843
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A randomized controlled trial of the efficacy of autologous platelet therapy for the treatment of osteoarthritis in dogs.

Summary:

To determine efficacy of a single intra-articular injection of an autologous platelet concentrate for treatment of osteoarthritis in dogs.

Conclusion:

Results suggested that a single intra-articular injection of autologous platelets resulted in significant improvements at 12 weeks in dogs with osteoarthritis involving a single joint.

Author & Journal:Fahie MA, et al, J Am Vet Med Assoc 2013;243:1291-1297
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