Evaluation of Pentosan Polysulfate Sodium in the Postoperative Recovery from Cranial Cruciate Injury in Dogs: A Randomized, Placebo-Controlled Clinical Trial

• Published in: Veterinary surgery Vol. 36; no. 3; pp. 234 - 244
• Main Authors: BUDSBERG, STEVEN C, BERGH, MARY SARAH, REYNOLDS, LISA R, STREPPA, HEATHER K
• Format: Journal Article
• Language: English
• Published: Malden, USA Malden, USA : Blackwell Publishing Inc 01.04.2007; Blackwell Publishing Inc; Blackwell Publishing Ltd
• Subjects: animal injuries; Animals; Anterior Cruciate Ligament - diagnostic imaging; Anterior Cruciate Ligament - pathology; Anterior Cruciate Ligament - surgery; Anterior Cruciate Ligament Injuries; Anti-Inflammatory Agents, Non-Steroidal - administration & dosage; Anti-Inflammatory Agents, Non-Steroidal - therapeutic use; Arthritis; Arthroscopy - methods; Arthroscopy - veterinary; bone metabolism; Clinical outcomes; cranial cruciate ligament; disease course; dog diseases; Dog Diseases - blood; Dog Diseases - prevention & control; Dog Diseases - urine; Dogs; Dogs - injuries; Dogs - surgery; Double-Blind Method; drug evaluation; drug injection; Drug therapy; Female; Injections - veterinary; Injuries; lameness; Legs; Ligaments; Male; osteoarthritis; Osteoarthritis, Knee - prevention & control; Osteoarthritis, Knee - veterinary; pentosan polysulfate sodium; Pentosan Sulfuric Polyester - administration & dosage; Pentosan Sulfuric Polyester - therapeutic use; pentosans; physiological response; placebos; postoperative care; Postoperative Care - veterinary; Postoperative Complications - prevention & control; Postoperative Complications - veterinary; Prospective Studies; protective effect; Radiography; randomized clinical trials; stifle; surgery; Treatment Outcome; Veterinary services
• ISSN: 0161-3499; 1532-950X
• DOI: 10.1111/j.1532-950X.2007.00256.x

To evaluate the efficacy of pentosan polysulfate (PPS) for improving the recovery period and mitigate the progression of osteoarthritis (OA) of the canine stifle after extracapsular stabilization of cranial cruciate ligament (CCL) injuries. Randomized, blinded, placebo-controlled clinical trial. Dogs (n=40) with unilateral CCL instability. Each dog had an extracapsular stabilization of the stifle with or without partial meniscectomy. Dogs were divided into 4 groups based on preoperative radiographic assessment and whether a partial meniscectomy was performed. Dogs were randomly assigned to either (3 mg/kg) PPS or placebo treatment in each group, and then injected subcutaneously weekly for 4 weeks. Lameness, radiographic changes, biological marker concentration in blood and urine, and ground reaction forces (GRFs) were collected preoperatively, and at 6, 12, 24, and 48 weeks. Data were analyzed within and between groups using repeated measures ANOVA; P<.05 was considered significant. No adverse reactions to PPS were reported. Thirty-nine dogs completed a minimum of 24-weeks follow-up and 33 dogs completed 48 weeks. All dogs clinically improved after surgery without differences in lameness score, vertical GRFs, or radiographic progression. Grouped and evaluated only by initial radiographic score, PPS-treated dogs improved significantly faster in braking GRFs than placebo-treated dogs. In dogs with partial meniscectomies, urine deoxypyridinoline, and serum carboxy-propeptide of type II collagen were significantly increased at 6 weeks in placebo-treated dogs compared with PPS-treated dogs. PPS administered after stabilization of the cruciate deficient stifle may prove to be a useful adjunctive treatment option, although further studies are necessary to substantiate this claim.