The Antimicrobial Effects of Intra-articular Autologous Platelet-Rich Plasma Injection on Decreasing the Infection Rate following TPLO Surgery

Introduction: Tibial plateau levelling osteotomy (TPLO) is commonly performed for cranial cruciate rupture in dogs. Previously published studies report a 7 to 12% infection rate with TPLO. Overall implant removal rate due to infection is reported to be 7.4% in a previous study.

Our hypothesis was that intra-articular injection of autologous platelet rich plasma (PRP) would lower the risk of TPLO infection rate due to anti-microbial effects of PRP.

Materials and Methods: This was a retrospective study on 62 dogs that underwent TPLO with concurrent autologous intra-articular PRP injection from January 2015 to August 2019. The rate of surgical site infection (SSI) and the need for implant removal at 6 months follow up were compared with the same rates in previously published studies on TPLO without PRP injection.

Results: The overall infection rate for dogs that underwent TPLO and intra-articular PRP injection in our study was approximately 2% and the rate of implant removal was approximately 1%. This is lower than what has been reported in the literature.

Discussion/Conclusion: Concurrent intra-articular administration of PRP at the time of TPLO could lower the chance of infection and subsequent need for implant removal. Anti-inflammatory properties of PRP could also slow the rate of osteoarthritis progression postsurgery. Since PRP is from autologous source, it can be harvested at the time of prepping the patient for TPLO surgery and administered upon closure of arthrotomy. PRP is relatively inexpensive and has no reported complication.

Study Limitations: Small population of patients.

Acknowledgment: There was no proprietary interest or funding provided for this project.