A veterinary practice in Scotland has pioneered a novel treatment strategy to successfully tackle elbow dysplasia (ED) in two Labradors.
Greenside Veterinary Practice, which has two surgeries in Melrose and Jedburgh, near the Scottish Borders, has developed a minimally-invasive treatment which targets joints using the body’s own ‘repair kit’ to prevent or reverse degenerative changes.
Leading the innovative regenerative medicine offering at the Linnaeus-owned practice is clinical director Andrew Armitage, who has treated hundreds of cats and dogs with stem cell therapy since trials began in 2014.
Andrew led the treatment of Labrador brothers Magic and Merlin. Magic first presented at his primary care vets at just nine months old due to intermittent thoracic limb lameness.
He underwent CT imaging and was diagnosed with bilateral ED with a fragmented medial coronoid process (FCP). The left elbow was treated with arthroscopy by removing the FCP and removing the damaged cartilage.
A similar procedure was recommended for the right elbow, however, Magic responded poorly to the arthroscopic intervention and his lameness persisted and worsened.
Andrew said: “Six months after the arthroscopy, Magic was brought to us to start regenerative medicine treatment in both elbows. At the same time, bilateral hip dysplasia was also diagnosed and repeat radiographs of the left elbow revealed extensive osteoarthritis (OA) had already formed in the joint.
“Magic underwent a small fat harvest procedure from the falciform ligament under general anaesthesia. The fat was shipped to a laboratory where it was processed to extract the adipose derived mesenchymal stem cells. These were culture expanded and returned to Greenside cryogenically frozen.
“Four weeks after the fat harvest, Magic was sedated and his elbows and hips were clipped and aseptically prepared. Blood was taken and spun in a special concentrating device in a centrifuge to separate and concentrate his platelets to form leukocyte poor platelet rich plasma (PRP).
“His stem cells were defrosted and combined with an equal volume of PRP and injected into both elbows and hips.
“Magic’s lameness improved over the following eight weeks and 12 weeks following implantation he was no longer lame and not receiving any analgesic medications. The range of motion in both elbows had also improved significantly.
“Magic did very well for 18 months after treatment before presenting with a mild left thoracic limb lameness again. A second treatment of autologous stem cells and PRP was given and Magic’s lameness resolved again without the requirement for pharmacological intervention.”
Magic’s brother Merlin became lame at 12 months. Considering the history of his brother, Merlin underwent the same diagnostic investigations in both elbows and hips.
Radiographs revealed bilateral hip dysplasia and suspected elbow dysplasia. CT scans confirmed the diagnosis of ED with FCP.
Andrew said: “Due to the owners’ experience with his brother, Merlin did not undergo arthroscopy and was presented immediately to start treatment with regenerative medicine (RM).
“He had fat harvested and autologous stem cells were cultured. He underwent stem cell therapy in combination with PRP into both elbows and hips, and his lameness resolved. He was managed without the need of analgesics for two years.”
Andrew said the cases of Magic and Merlin showed that regenerative medicine clearly helped prevent degenerative changes in the elbow joint.
He said: “When we compare these two cases with identical diagnoses, identical environmental factors and similar genetics due to being siblings, we can see that RM is a highly-effective treatment option to prevent the degenerative changes in the elbow joint following developmental abnormalities resulting in ED.
“These cases highlight something we have seen hundreds of times in our patients, namely that RM can effectively turn off the degenerative process within the joint, providing a sustained long-lasting treatment for OA.”
