The effect of leucocyte and platelet-rich fibrin (L-PRF) on healing of bone defects in dogs

Abstract

Objective: To evaluate and compare healing between L-PRF, cancellous bone graft(BG) and L-PRF and BG(BOTH) on the gap created during tibial tuberosity advancement procedure(TTA). Study Design: Prospective clinical study involving dogs treated with TTA (n=36). Hypothesis: The first hypothesis was that L-PRF could be used in dog long bones without causing clinically evident complications. The second hypothesis was that bone defects filled with BOTH would heal faster than those filled with BG alone. Material and Methods: Dogs underwent TTA at the University Veterinary Teaching Hospital Sydney via a technique using a tension-band plate. Ethics approval was obtained from the USYD AEC approval number 2013/5993. Consent was established prior to study inclusion however owners were blinded to treatment group (TG). TGs had osteotomy filled with L-PRF, BG or BOTH. A total of 36 stifles from 35 dogs met the inclusion criteria. Post-op radiographs from 2, 4 and 6weeks were graded using a 0-4 point scale. Computed tomography(CT) was also performed at 6weeks to assess bone healing. Logistic regression analysis was done to look at assessment parameters and the effect of TGs on osteotomy healing. Results: There was no effect of TG or time on rate of complications. There was no statistical significance between BG and BOTH groups except the proximal healing for the BOTH group was 2.49 times more likely to have a higher score than BG. BOTH scored significantly higher than L-PRF except for proximal healing (no difference). There was no effect of differing radiologists assessment on osteotomy fill, or TG on the mean Hounsfield Units at location ½ and ⅓ of the way distal to the cage. Conclusion: This study has demonstrated that L-PRF is a viable product for TTA resulting in successful bone healing. Healing at the proximal site using BG is the same as L-PRF based on radiographs. CT analysis suggests that the effect of L-PRF on bone healing is comparable to BG at 6 weeks post TTA.