Combined stem cell, plasma therapy gets showjumper back into competition – case report

Stem cell treatment and platelet-rich plasma were employed after six months of conventional therapy failed to heal the horse's tendon injury.
File image by Jean van der Meulen

A showjumper with chronic tendonitis was eventually able to return to his previous level of competition following treatment with stem cells and platelet-rich plasma, it has been reported.

The 10-year-old Sella Italiano gelding presented with severe lameness, swelling and pain at palpation of the mid-metacarpal region of the left forelimb.

The lameness was graded 2.5 out of 5 based on the American Association of Equine Practitioners (AAEP) scale.

Clinical and ultrasound examination led to a diagnosis of chronic tendonitis affecting the central region of the superficial digital flexor tendon.

Injuries to the superficial digital flexor tendon are a major problem among athletic and pleasure horses. Often, they reoccur and can force early retirement.

Luca Melotti and his colleagues, in a case report published in the Frontiers in Veterinary Science journal, said the lesion in this case was a reoccurrence, having developed from a previously healed injury.

The horse stopped competing and had proved unresponsive to gold-standard treatments such as non-steroidal anti-inflammatory drugs and conservative management after six months of therapy.

The horse was given two ultrasound-guided injections of mesenchymal stem cells derived from his own fat tissue, combined with platelet-rich plasma processed from the animal’s own blood.

The injections were given a month apart.

The healing process was assessed through clinical examination, ultrasound imaging and levels of oxidative stress products and inflammatory mediators in the blood plasma.

Two weeks after the first injection, a reduction in the concentration of oxidative-derived products was observed, together with an increase in anti-inflammatory cytokines and pro-mitotic growth factors.

These results were reflected clinically as the horse showed a reduction of lameness, as well as reduced swelling and pain after four weeks, the researchers said.

At the one-year follow-up, the horse showed no signs of lameness or swelling. An ultrasound examination showed compact fiber alignment in the tendon, which looked the same as the matching tendon in the other leg.

“Moreover, the horse went back to the previous level of competition,” the team reported.

The results, they said, suggest the positive effects of stem cell and plasma treatment for chronic tendonitis, with pleasing long-term effects in terms of the horse’s quality of life and athletic performance.

The case report team comprised Melotti, Anna Carolo, Noha Elshazly, Laura Da Dalt, Gianfranco Gabai, Anna Perazzi, Ilaria Iacopetti and Marco Patruno, all with the University of Padova; and veterinary practitioner Filippo Boesso, from Padua.

Melotti L, Carolo A, Elshazly N, Boesso F, Da Dalt L, Gabai G, Perazzi A, Iacopetti I and Patruno M (2022) Case Report: Repeated Intralesional Injections of Autologous Mesenchymal Stem Cells Combined With Platelet-Rich Plasma for Superficial Digital Flexor Tendon Healing in a Show Jumping Horse. Front. Vet. Sci. 9:843131. doi: 10.3389/fvets.2022.843131

The case report, published under a Creative Commons License, can be read here.

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