Mesenchymal Stem Cell therapy is a relatively new treatment, primarily used for tendon and ligament injuries.
There are currently two different sources of the stem cells:
- Autologous – this involves harvesting cells from the horse’s own bone marrow (usually from the sternum) or fat on day one, then culturing them over around 4 weeks to about 10 million cells and then re-injecting them into the injury under ultrasound guidance.
- Mixed stored - direct injection of about 10 million non autologous banked stem cells (i.e. stem cells not derived from the patient), which are ordered specifically for the horse
The stem cells are injected directly into the injured tissue where they have the potential to grow and differentiate into new tendon or ligament cells as well as being a source of growth factors which also help to stimulate healing.
Interleukin-1 receptor antagonist protein (IRAP) therapy has been used at REC for horses with joint disease for several years now. Interleukin-1 (IL-1) is one of the most destructive chemicals produced in joint inflammation and leads to ongoing cartilage damage. Its antagonist protein is produced naturally by the body and can block IL-1, but in an inflamed joint IL-1 is present in much higher concentrations than the antagonist can block. IRAP therapy involves taking a small amount of blood from the horse and incubating it to allow the horse’s white cells to produce increased amounts of IRAP. The sample is then spun down in a centrifuge to allow harvesting of the IRAP rich fluid portion which can then be injected directly into the affected joints to hopefully block IL-1, reduce inflammation and potentially allow cartilage regeneration. Each blood collection typically yields around 6 joint treatments and the extra doses are stored frozen for use later. See article below for more details.
Platelet Rich Plasma therapy (PRP) is a relatively new treatment which is most commonly used for tendon and ligament injuries. It involves taking a small amount of blood from the horse and processing it in the laboratory to harvest the portion containing the platelets. This portion contains high concentrations of various growth factors which are capable of stimulating enhanced healing responses in the damaged tissue. The PRP is injected directly into the injured tissue under ultrasound guidance. See article below for more details.
ESWT is a technique usually used for the treatment of bone and ligament injuries. Shock waves are very high energy sound waves, characterized by having a very rapid increase in energy (the “spike”) followed by a rapid drop. Shock waves can help in tissue regeneration by causing “microtrauma’ which stimulates increased rate of development of new blood vessels and therefore allows better delivery of the elements required for healing. It has also been shown to potentially increase bone turnover as well as having a short to medium term analgesic (pain-killing) effect. It has been effective in treating high suspensory desmitis, sesamoiditis, back and sacroiliac pain and navicular syndrome.