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Many of the long-term consequences of injury or disease occur because the body’s structures cannot repair themselves.
This is because cells can’t adequately work out what to do or there has been a lack of a stem cell response. Therefore any repair of an injury may fail to replicate the normal structure.
Equine tendon injuries do heal slowly by producing scar tissue, which, while strong enough to allow some activity, is mechanically very different from a normal tendon.
This is why horses that have sustained a tendon injury often reinjure the same place in the future.
Stem cells have a unique ability to change their function and take on different guises; they can become specialised cells of cartilage, bone, tendon, fat, muscle or nerves.
By using stem cells, we can improve the quality of healing by providing cells that have the ability to recreate normal tendon tissue, rather than simply scar tissue.
Candidates for stem cell therapy are horses with overstrain injuries where an ultrasound scan reveals a clearly defined hole in the tendon.
The first step is to extract the stem cells from a sample of the horse’s bone marrow, which is taken either from the sternum (chest) or tuber coxae (near the point of the croup) under sedation and local anaesthesia.
The cells are then cultured, a process that takes an average of 18 days.
Not every sample will yield a useable culture – and we are not exactly sure at this point why this is – but fortunately the majority do.
The cultured cells are suspended in bone marrow supernatant (clear fluid) before being implanted several weeks later into the lesion in the tendon.
Stem cell surgery is by no means a quick fix. The horse then has to undergo a carefully controlled rehabilitation programme, which takes approximately one year.
It follows exactly the same lines as a programme for a horse not treated with this type of therapy.
For the full veterinary article on stem cell therapy see the current issue of H&H (1 December 2011)
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