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Regenerative medicine in equine orthopaedics: what and when?

02 January 2020
12 mins read
Volume 4 · Issue 1
Figure 1. Equine mesenchymal stem cells in culture. These cells can be recovered from a variety of mesenchymal tissues, the most commonly used being bone marrow and fat, but blood, umbilical cord and teeth are other sources that have been developed for clinical use.
Figure 1. Equine mesenchymal stem cells in culture. These cells can be recovered from a variety of mesenchymal tissues, the most commonly used being bone marrow and fat, but blood, umbilical cord and teeth are other sources that have been developed for clinical use.

Abstract

The development of regenerative medicine has opened up many new therapeutic avenues in veterinary medicine. The focus of regenerative medicine in the horse lies primarily in the musculoskeletal system, where the consequences of injury make tendons, ligaments and joints particularly desirable targets for such interventions. This article focuses on what has been learned from the use of regenerative medicine in naturally-occurring tendon, ligament and joint disease in the horse.

Defining regenerative medicine is difficult because the name implies the ability of the treatment to regenerate damaged tissues and, while this remains the goal, there is little evidence that any of the currently available treatments actually achieve this. Therefore the term ‘biological therapy’ is probably more suitable than regenerative medicine. However, this does not mean that the treatments are ineffective and there is an accumulating robust body of evidence, certainly for mesenchymal stem cells (MSCs), that they are able to modulate inflammation via paracrine activity and thereby induce better quality healing than natural repair.

The consequences of injury within the musculoskeletal system (altered function because of fibrous healing) and the physical features of the disease (a ‘receptacle’ assisting ease of administration intralesionally) make tendon a particularly desirable target for the use of biological therapies. Other musculoskeletal diseases where regenerative medicine has attracted interest are in the treatment of joint disease, while work involving the use of veterinary clinical cases, mainly in small animal, have also investigated its use in spinal cord trauma and cardiac disease.

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