Stem cell therapy is used for the treatment of tendon, ligament and joint injuries and diseases.
A stem cell can become any type of cell (pluripotent) or it can become any cell with limitations (multipotent) and are derived from the horse’s own tissues. Fat, skin, blood and, most commonly, bone marrow can be taken from the horse and then stem cells are isolated and grown up in the laboratory.
Once grown up, the stem cells are implanted into the site of injury, where they then become the type of cell required to repair that specific injury. This type of therapy is known as autologous therapy.
Stem cell therapy can currently be used to treat tendon and ligament injuries, joint diseases and fractures.
If your horse has any of these problems, then stem cell therapy may be an option. Your vet will want to discuss all the options with you, including the benefits and risks associated with it, to find out which is the best one for your horse, depending on the injury or condition in question.
Tendon and ligament injuries
Stem cell therapy significantly improves the healing process by restoring the strength and elasticity of the injured tissue, rather than allowing inflexible scar tissue to develop.
The extent of soft tissue injury damage varies widely, in addition to the age of injury and the animal, therefore healing time varies considerably. However, tendon and ligament injuries usually respond to a single dose of stem cell therapy.
Due to the ongoing changes in degenerative disorders, stem cell therapy may not permanently stop the degenerative processes. However, it may provide long-term anti-inflammatory effects, decrease pain, stimulate regeneration of cartilage tissue that slows the degenerative processes, and initiate healing.
Due to the chronic nature of degenerative disorders, additional doses may be required depending on severity, which joint is affected and what the horse is used for.
Stem cell therapy can speed up the healing process of fractures by decreasing the fracture size, leading to a much quicker recovery.
With all these treatments, clinical improvement can be seen within just a few days to a few weeks following stem cell implantation.
Your vet will take a biopsy from your horse under local or general anaesthesia, usually of bone marrow, from either the breastbone or pelvis. This is then taken to a laboratory where the stem cells are prepared; this usually takes 3-4 weeks. The cells are then returned to your vet for implantation into the site of injury.
For ligaments and tendons, the procedure is fairly straightforward and implantation is generally performed under sedation using an ultrasound-guided injection. Implantation is usually done as day surgery so your horse can go home the same day.
A general anaesthetic may be required if the injury is complicated or the procedure involves a joint. Where a general anaesthetic is required, your horse will have to stay at the clinic for a couple of days to make sure he has an uncomplicated recovery.
Rehabilitation following implantation varies depending on the severity and location of the injury, as well as the discipline your horse competes in. Your vet will discuss a personalised rehabilitation plan with you.
Your horse will have to remain on box rest with a special clinical bandage over the implantation site for at last a week. Following this, standard stable bandages can be used while the horse is on box rest. Gentle walking exercise is usually started in weeks 2-4. Your vet will want to see your horse for a check-up about 4 weeks post-surgery, and all being well, a gradual increase in exercise can then be implemented over the coming months with regular check-ups.
Depending on how your horse responds, turnout can usually be considered around 6 months post-surgery, and a return to full work is usually seen within a year.
Prognosis depends on the extent of the original injury or condition, but complications are very rare.
When treating degenerative disorders, additional doses of stem cells may be required at varying intervals depending on severity, which joint is affected, and the ultimate use of the horse.
The most common reason for failure of stem cell therapy is excessive exercise during the rehabilitation period, therefore it is imperative that your horse is brought back into work according to your vet’s recommendations.