Analyze Diet
The Veterinary record2021; 188(2); e9; doi: 10.1002/vetr.9

Use of autologous products for the treatment of joint and soft tissue disease in horses: A systematic review.

Abstract: Soft tissue injuries and joint disease are the predominate causes of lameness in the equine athlete and these pathologies carry a guarded prognosis for a return to previous performance. Recently the use of autologous products has become more widespread as a treatment in equine sports medicine. However, the efficacy of these products is yet to be fully established. To evaluate the current published evidence base regarding the efficacy of autologous products in soft tissue injuries and joint disease. A systematic review of English articles using MEDLINE, EMBASE and Web of Science databases from 1980 to 2017. The search strategy identified 1594 papers for review. Fifty-eight papers were included in this review, 28 of which were randomised controlled trials. Significant benefit was reported under several parameters, most notably in the use of autologous chondrocytes in artificially induced cartilage defects on histology. One paper documented a significant clinical response under lameness examination. The current literature shows that the treatment of soft tissue injury and cartilage disease with autologous products is safe and that the use of some products can give significant benefit on some outcome measures. True clinical significance is yet to be demonstrated with any product.
Publication Date: 2021-01-19 PubMed ID: 34651853DOI: 10.1002/vetr.9Google Scholar: Lookup
The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
  • Journal Article
  • Systematic Review

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

The research discusses the application of autologous products as a treatment for joint and soft tissue disease in horses. Although the use of these products has become prevalent, their efficacy is still under review. The study includes a comprehensive review of previously published papers to determine the efficiency of these products in treating soft tissue injuries and joint disease.

Research Methodology

  • The research was done systematically by reviewing articles published in English using MEDLINE, EMBASE, and Web of Science databases from the year 1980 to 2017.
  • The search strategy resulted in the identification of 1594 papers for review.
  • Out of the total, 58 papers were included in the review, 28 of which were randomized controlled trials.

Key Findings

  • One of the key findings includes significant benefit found in the use of autologous chondrocytes in artificially induced cartilage defects on histology.
  • Another observation was that one paper documented a significant clinical response under a lameness examination.

Efficacy of Autologous Products

  • The current literature shows that the treatment of soft tissue injury and cartilage disease with autologous products is safe.
  • The use of some products can give significant benefits on some outcome measures. However, the extent of their clinical significance has not been determined conclusively for any product.

Conclusion

  • The systematic review suggests potential benefits of using autologous products in treating joint and soft tissue disease in equines.
  • Although the treatment has proven safe, more research is needed to establish the true clinical advantages of these products.

Cite This Article

APA
Tomlinson F, Terschuur J, Henson F. (2021). Use of autologous products for the treatment of joint and soft tissue disease in horses: A systematic review. Vet Rec, 188(2), e9. https://doi.org/10.1002/vetr.9

Publication

ISSN: 2042-7670
NlmUniqueID: 0031164
Country: England
Language: English
Volume: 188
Issue: 2
Pages: e9

Researcher Affiliations

Tomlinson, Francesca
  • Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
Terschuur, Janine
  • Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
Henson, Frances
  • Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.

MeSH Terms

  • Animals
  • Cartilage Diseases / veterinary
  • Horse Diseases / therapy
  • Horses
  • Joint Diseases / therapy
  • Joint Diseases / veterinary
  • Transplantation, Autologous / veterinary

References

This article includes 84 references
  1. Pers Y-M, Ruiz M, Noël D, Jorgensen C. Mesenchymal stem cells for the management of inflammation in osteoarthritis: state of the art and perspectives.. Osteoarthritis Cartilage 2015;23:2027–35.
  2. Zaher W, Harkness L, Jafari A, Kassem M. An update of human mesenchymal stem cell biology and their clinical uses.. Arch Toxicol 2014;88:1069–82.
  3. Smith R, Korda M, Porter R, Kalia P, Wiseman M, Blunn G. Preliminary experience with the autologous implantation of bone marrow stromal cells for the treatment of equine tendinopathy.. Int J Exp Pathol 2005;86:A51–2.
  4. Fortier LA, Smith RKW. Regenerative medicine for tendinous and ligamentous injuries of sport horses.. Vet Clin North Am Equine Pract 2008;24:191–201.
  5. Goodrich LR, Nixon AJ. Medical treatment of osteoarthritis in the horse - a review.. Vet J 2006;171:51–69.
  6. Wei X, Yang X, Han Z-P, Qu F-F, Shao Li, Shi Yu-F. Mesenchymal stem cells: a new trend for cell therapy.. Acta Pharmacol Sin 2013;34:747–54.
  7. Marfe G, Rotta G, De Martino L, Tafani M, Fiorito F, Di Stefano C. A new clinical approach: use of blood‐derived stem cells (BDSCs) for superficial digital flexor tendon injuries in horses.. Life Sci 2012;90:825–30.
  8. Strem BM, Hedrick MH. The growing importance of fat in regenerative medicine.. Trends Biotechnol 2005;23:64–6.
  9. Bue MD, Riccò S, Ramoni R, Conti V, Gnudi G, Grolli S. Equine adipose‐tissue derived mesenchymal stem cells and platelet concentrates: their association in vitro and in vivo.. Vet Res Commun 2008;32:51–5.
  10. Ullah I, Subbarao RB, Rho GJ. Human mesenchymal stem cells - current trends and future prospective.. Biosci Rep 2015;35:e00191.
  11. Maia L, Da Cruz Landim‐Alvarenga F, Taffarel M, De Moraes C, Machado G, Melo G. Feasibility and safety of intrathecal transplantation of autologous bone marrow mesenchymal stem cells in horses.. BMC Vet Res 2015;11:63.
  12. Textor JA, Willits NH, Tablin F. Synovial fluid growth factor and cytokine concentrations after intra‐articular injection of a platelet‐rich product in horses.. Vet J 2013;198:217–23.
  13. Koch TG, Berg LC, Betts DH. Concepts for the clinical use of stem cells in equine medicine.. Can Vet J 2008;49:1009–17.
  14. Halper J. Advances in the use of growth factors for treatment of disorders of soft tissues.. 2014:59–76.
  15. Ursini TL, Amelse LL, Elkhenany HA, Odoi A, Carter-Arnold JL, Adair HS. Restrospective analysis of local injection site adverse reactions associated with 230 allogenic administrations of bone marrow‐derived mesenchymal stem cells in 164 horses.. Equine Vet J 2019;51:198–205.
  16. Moraes APL, Moreira JJ, Brossi PM, Machado TS, Michelacci YM, Baccarin RY. Short- and long‐term effects of platelet‐rich plasma upon healthy equine joints: clinical and laboratory aspects.. Can Vet J 2015;56:831–8.
  17. Ardanaz N, Vázquez FJ, Romero A, Remacha AR, Barrachina L, Sanz A. Inflammatory response to the administration of mesenchymal stem cells in an equine experimental model: effect of autologous, and single and repeat doses in pooled allogeneic cells in healthy joints.. BMC Vet Res 2016;12:65.
  18. Liberati A. The PRISMA statement for reporting systematic reviews and meta‐analyses of studies that evaluate health care interventions: explanation and elaboration.. Ann Intern Med 2009;151:W65–94.
  19. Ryan R, Hill S, Prictor M, McKenzie J. Study Quality Guide.. May 2013.
  20. Geburek F, Roggel F, van Schie HTM, Beineke A, Estrada R, Weber K. Effect of single intralesional treatment of surgically induced equine superficial digital flexor tendon core lesions with adipose‐derived mesenchymal stromal cells: a controlled experimental trial.. Stem Cell Res Ther 2017;8:129.
  21. Geburek F, Gaus M, Van Schie HTM, Rohn K, Stadler PM. Effect of intralesional platelet‐rich plasma (PRP) treatment on clinical and ultrasonographic parameters in equine naturally occurring superficial digital flexor tendinopathies - a randomized prospective controlled clinical trial.. BMC Vet Res 2016;12:191.
  22. Balesdent Barreira AP, Garcia Alves AL, Saito ME, Amorim RL, Kohayagawa A, Menarim BC. Autologous implant of bone marrow mononuclear cells as treatment of induced equine tendinitis.. Int J Appl Res Vet Med 2008;6:46–54.
  23. De Mattos Carvalho A, Alves ALG, De Oliveira PGG, Cisneros Álvarez LE, Amorim RL, Hussni CA. Use of Adipose Tissue‐Derived Mesenchymal Stem Cells for Experimental Tendinitis Therapy in Equines.. J Equine Vet Sci 2011;31:26–34.
  24. Carvalho AdeM, Badial P, Álvarez LEC, Yamada ALM, Borges A, Deffune E. Equine tendonitis therapy using mesenchymal stem cells and platelet concentrates: a randomized controlled trial.. Stem Cell Res Ther 2013;4:85.
  25. Bosch G, van Schie HT, de Groot MW, Cadby JA, van de Lest CHA, Barneveld A. Effects of platelet‐rich plasma on the quality of repair of mechanically induced core lesions in equine superficial digital flexor tendons: a placebo‐controlled experimental study.. J Orthop Res 2010;28:211–7.
  26. Romero A, Barrachina L, Ranera B, Remacha AR, Moreno B, De Blas I. Comparison of autologous bone marrow and adipose tissue derived mesenchymal stem cells, and platelet rich plasma, for treating surgically induced lesions of the equine superficial digital flexor tendon.. Vet J 2017;224:76–84.
  27. Bosch G, Moleman M, Barneveld A, Van Weeren PR, Van Schie HTM. The effect of platelet‐rich plasma on the neovascularization of surgically created equine superficial digital flexor tendon lesions.. Scand J Med Sci Sports 2011;21:554–61.
  28. Maia L, De Souza MV, Ribeiro Júnior JI, De Oliveira AC, Alves GES, Dos Anjos Benjamin L. Platelet-rich plasma in the treatment of induced tendinopathy in horses: histologic evaluation.. J Equine Vet Sci 2009;29:618–26.
  29. Smith RKW, Werling NJ, Dakin SG, Alam R, Goodship AE, Dudhia J. Beneficial effects of autologous bone marrow‐derived mesenchymal stem cells in naturally occurring tendinopathy.. PLoS One 2013;8:e75697.
  30. Lacitignola L, Crovace A, Rossi G, Francioso E. Cell therapy for tendinitis, experimental and clinical report.. Vet Res Commun 2008;32(Suppl 1):33–8.
  31. Nixon AJ, Begum L, Mohammed HO, Huibregtse B, O'callaghan MM, Matthews GL. Autologous chondrocyte implantation drives early chondrogenesis and organized repair in extensive full‐ and partial‐thickness cartilage defects in an equine model.. J Orthop Res 2011;29:1121–30.
  32. Nixon AJ, Rickey E, Butler TJ, Scimeca MS, Moran N, Matthews GL. A chondrocyte infiltrated collagen type I/III membrane (MACIimplant) improves cartilage healing in the equine patellofemoral joint model.. Osteoarthritis Cartilage 2015;23:648–60.
  33. Goodrich LR, Chen AC, Werpy NM, Williams AA, Kisiday JD, Su AW. Addition of mesenchymal stem cells to autologous platelet‐enhanced fibrin scaffolds in chondral defects: does it enhance repair?. J Bone Joint Surg Am 2016;98:23–34.
  34. Fortier LA, Potter HG, Rickey EJ, Schnabel LV, Foo LiF, Chong LR. Concentrated bone marrow aspirate improves full‐thickness cartilage repair compared with microfracture in the equine model.. J Bone Joint Surg Am 2010;92:1927–37.
  35. Seo J-P, Tanabe T, Tsuzuki N, Haneda S, Yamada K, Furuoka H. Effects of bilayer gelatin/beta-tricalcium phosphate sponges loaded with mesenchymal stem cells, chondrocytes, bone morphogenetic protein‐2, and platelet rich plasma on osteochondral defects of the talus in horses.. Res Vet Sci 2013;95:1210–6.
  36. Seo J-P, Kambayashi Y, Itho M, Haneda S, Yamada K, Furuoka H. Effects of a synovial flap and gelatin/beta-tricalcium phosphate sponges loaded with mesenchymal stem cells, bone morphogenetic protein‐2, and platelet rich plasma on equine osteochondral defects.. Res Vet Sci 2015;101:140–3.
  37. Mcilwraith CW, Frisbie DD, Rodkey WG, Kisiday JD, Werpy NM, Kawcak CE. Evaluation of intra‐articular mesenchymal stem cells to augment healing of microfractured chondral defects.. Journal of Arthroscopic and Related Surgery 2011;27:1552–61.
  38. Tsuzuki N, Seo J, Yamada K, Haneda S, Furuoka H, Tabata Y. The effect of a gelatin beta‐tricalcium phosphate sponge loaded with mesenchymal stem cells (MSC), bone morphogenic protein‐2, and platelet‐rich plasma (PRP) on equine articular cartilage defect.. Can Vet J 2013;54:573–80.
  39. Tsuzuki N, Oshita N, Seo J-P, Yamada K, Haneda S, Furuoka H. Effect of platelet‐rich plasma‐incorporated gelatin hydrogel microspheres and subchondral drilling on equine cartilage defects.. J Equine Vet Sci 2014;34:820–4.
  40. Barnewitz D, Endres M, Krüger I, Becker A, Zimmermann J, Wilke I. Treatment of articular cartilage defects in horses with polymer‐based cartilage tissue engineering grafts.. Biomaterials 2006;27:2882–9.
  41. Bertone AL, Ishihara A, Zekas LJ, Wellman ML, Lewis KB, Schwarze RA. Evaluation of a single intra‐articular injection of autologous protein solution for treatment of osteoarthritis in horses.. Am J Vet Res 2014;75:141–51.
  42. Frisbie DD, Mccarthy HE, Archer CW, Barrett MF, Mcilwraith CW. Evaluation of articular cartilage progenitor cells for the repair of articular defects in an equine model.. J Bone Joint Surg Am 2015;97:484–93.
  43. Griffin DJ, Bonnevie ED, Lachowsky DJ, Hart JCA, Sparks HD, Moran N. Mechanical characterization of matrix‐induced autologous chondrocyte implantation (MACI) grafts in an equine model at 53 weeks.. J Biomech 2015;48:1944–9.
  44. Wike MM, Nydam DV, Nixon AJ. Enhanced early chondrogenesis in articular defects following arthroscopic mesenchymal stem cell implantation in an equine model.. J Orthop Res 2007;25:913–25.
  45. Pichereau F, Décory M, Cuevas Ramos G. Autologous platelet concentrate as a treatment for horses with refractory fetlock osteoarthritis.. J Equine Vet Sci 2014;34:489–93.
  46. Raheja LF, Galuppo LD, Bowers-Lepore J, Dowd JP, Tablin F, Yellowley CE. Treatment of bilateral medial femoral condyle articular cartilage fissures in a horse using bone marrow‐derived multipotent mesenchymal stromal cells.. J Equine Vet Sci 2011;31:147–54.
  47. Spaas JH, Oosterlinck M, Broeckx S, Dumoulin M, Saunders J, Van Soom A. Treatment of equine degenerative joint disease with autologous peripheral blood‐derived mesenchymal stem cells: a case report.. Vlaams Diergeneeskd Tijdschr 2012;81:11–5.
  48. Ferris DJ, Frisbie DD, Kisiday JD, Mcilwraith CW, Hague BA, Major MD. Clinical outcome after intra‐articular administration of bone marrow derived mesenchymal stem cells in 33 horses with stifle injury.. Vet Surg 2014;43:255–65.
  49. Cohen JM, Richardson DW, Mcknight AL, Ross MW, Boston RC. Long-term outcome in 44 horses with stifle lameness after arthroscopic exploration and debridement.. Vet Surg 2009;38:543–51.
  50. Ferguson SJ, Broeckx S, Zimmerman M. Regenerative therapies for equine degenerative joint disease: a preliminary study.. PLoS One 2014;9:e85917.
  51. Getelman MH. Editorial Commentary: stem cell treatment for knee osteoarthritis: holy grail or tin cup?. Arthroscopy 2019;35:289–90.
  52. Fortier LA, Chapman HS, Pownder SL, Roller BL, Cross JA, Cook JL. BioCartilage improves cartilage repair compared with microfracture alone in an equine model of full‐thickness cartilage loss.. Am J Sports Med 2016;44:2366–74.
  53. Tsuzuki N, Seo Jp, Haneda S, Yamada K, Furuoka H, Tabata Y. Bioengineered osteochondral precursor for treatment of osteochondritis dissecans in a Thoroughbred filly.. Aust Vet J 2013;91:411–5.
  54. Russell JW, Russell TM, Vasey JR, Hall MS. Autologous bone marrow aspirate for treatment of superficial digital flexor tendonitis in 105 racehorses.. Vet Rec 2016;179:69.
  55. Prades M, Abellanet I. Intraarticular platelet rich plasma (PRP) therapy evaluated in 42 sport horses with osteoarthrosis (OA).. Proceedings of the 11th International Congress of the World Equine Veterinary Association Cartilage; 24–27 September 2009; Guaruja, SP, Brazil: 72.
  56. Witte S, Dedman C, Harriss F, Kelly G, Chang Y-M, Witte TH. Comparison of treatment outcomes for superficial digital flexor tendonitis in National Hunt racehorses.. Vet J 2016;216:157–63.
  57. Geburek F, Lietzau M, Beineke A, Rohn K, Stadler PM. Effect of a single injection of autologous conditioned serum (ACS) on tendon healing in equine naturally occurring tendinopathies.. Stem Cell Res Ther 2015;6:126.
  58. Scala M, Lenarduzzi S, Spagnolo F, Trapasso M, Ottonello C, Muraglia A. Regenerative medicine for the treatment of teno‐desmic injuries of the equine. A series of 150 horses treated with platelet‐derived growth factors.. In Vivo 2014;28:1119–23.
  59. Renzi S, Riccò S, Dotti S, Sesso L, Grolli S, Cornali M. Autologous bone marrow mesenchymal stromal cells for regeneration of injured equine ligaments and tendons: a clinical report.. Res Vet Sci 2013;95:272–7.
  60. Hall Ms, Vasey JR, Russell Jw, Russell T. Use of ultrasound‐guided autologous bone marrow transfer for treatment of suspensory ligament desmitis in 30 race horses (2003-2010).. Aust Vet J 2013;91:102–7.
  61. Bodor J, Pavelcova K, Klubal R. Use of mesenchymal stem cells for clinical tendinitis therapy in horses.. Regen Med 2013.
  62. Godwin EE, Young NJ, Dudhia J, Beamish IC, Smith RKW. Implantation of bone marrow‐derived mesenchymal stem cells demonstrates improved outcome in horses with overstrain injury of the superficial digital flexor tendon.. Equine Vet J 2012;44:25–32.
  63. Caniglia CJ, Schramme MC, Smith RK. The effect of intralesional injection of bone marrow derived mesenchymal stem cells and bone marrow supernatant on collagen fibril size in a surgical model of equine superficial digital flexor tendonitis.. Equine Vet J 2012;44:587–93.
  64. Torricelli P, Fini M, Filardo G, Tschon M, Pischedda M, Pacorini A. Regenerative medicine for the treatment of musculoskeletal overuse injuries in competition horses.. Int Orthop 2011;35:1569–76.
  65. Schnabel LV, Lynch ME, Van Der Meulen MCH, Yeager AE, Kornatowski MA, Nixon AJ. Mesenchymal stem cells and insulin‐like growth factor‐I gene‐enhanced mesenchymal stem cells improve structural aspects of healing in equine flexor digitorum superficialis tendons.. J Orthop Res 2009;27:1392–8.
  66. Frisbie DD, Kisiday JD, Kawcak CE, Werpy NM, Mcilwraith CW. Evaluation of adipose‐derived stromal vascular fraction or bone marrow‐derived mesenchymal stem cells for treatment of osteoarthritis.. J Orthop Res 2009;27:1675–80.
  67. Waselau M, Sutter WW, Genovese RL, Bertone AL. Intralesional injection of platelet‐rich plasma followed by controlled exercise for treatment of midbody suspensory ligament desmitis in Standardbred racehorses.. J Am Vet Med Assoc 2008;232:1515–20.
  68. Smith RKW. Mesenchymal stem cell therapy for equine tendinopathy.. Disabil Rehabil 2008;30:1752–8.
  69. Crovace A, Lacitignola L, De Siena R, Rossi G, Francioso E. Cell therapy for tendon repair in horses: an experimental study.. Vet Res Commun 2007;31(Suppl 1):281–3.
  70. Pacini S, Spinabella S, Trombi L, Fazzi R, Galimberti S, Dini F. Suspension of bone marrow‐derived undifferentiated mesenchymal stromal cells for repair of superficial digital flexor tendon in racehorses.. Tissue Eng 2007;13:2949–55.
  71. Romagnoli N, Rinnovati R, Ricciardi G, Lambertini C, Spinella G, Spadari A. Clinical evaluation of intralesional injection of platelet‐rich plasma for the treatment of proximal suspensory ligament desmitis in horses.. J Equine Vet Sci 2015;35:141–6.
  72. Tyrnenopoulou P, Diakakis N, Angelopoulou S, Pyrros A, Mparous E, Koliakos G. Clinical application of adipose‐derived stromal vascular fraction in 3 Thoroughbred horses with superficial digital flexor tendonitis: case report.. Journal of the Hellenic Veterinary Medical Society 2015;66:215–22.
  73. Guercio A, Di Marco P, Casella S, Russotto L, Puglisi F, Majolino C. Mesenchymal stem cells derived from subcutaneous fat and platelet‐rich plasma used in athletic horses with lameness of the superficial digital flexor yendon.. J Equine Vet Sci 2015;35:19–26.
  74. Estrada RJ, Van Weeren R, Van De Lest CHA, Boere J, Reyes M, Ionita J-C, Estrada M. Effects of autologous conditioned plasma (R) (ACP) on the healing of surgically induced core lesions in equine superficial digital flexor tendon.. Pferdeheilkunde 2014;30:633–42.
  75. Bazzano M, Piccione G, Giannetto C, Francesco T, Simona DP, Elisabetta G. Platelet rich plasma intralesional injection as bedside therapy for tendinitis in athletic horse.. Acta Sci Vet 2013;41:1145.
  76. Menarim BC, Fortini GA, Álvarez PS, Gómez J, Jarrín CD, Ramírez A. Autologous implant of bone marrow mononuclear stem‐cells as treatment for equine bicipital tendonitis: case report.. Archivos de Medicina Veterinaria 2012;44:291–5.
  77. Marycz K, Toker NY, Grzesiak J, Wrzeszcz K, Golonka P. The therapeutic effect of autogenic adipose derived stem cells combined with autogenic platelet rich plasam in tendon disorders in vitro and in vivo.. Research Journal of Animal and Veterinary Advances 2012;11:4324–31.
  78. Carmona JU, López C. Autologous platelet concentrates as a treatment for shoulder injury in a horse.. J Equine Vet Sci 2011;31:506–10.
  79. Burk J, Brehm W. Stem cell therapy of tendon injuries - clinical outcome in 98 cases.. Pferdeheilkunde 2011;27:153.
  80. Smith RKW. Stem cell therapy for tendon and ligament injuries in the horse - technique and outcome.. Pferdeheilkunde 2008;24:513–8.
  81. Mountford DR, Smith RKW, Patterson-Kane JC. Mesenchymal stem cell treatment of suspensory ligament branch desmitis: post mortem findings in a 10‐year-old Russian Warmblood gelding - a case report.. Pferdeheilkunde 2006;22:559–63.
  82. Dyson SJ. Medical management of superficial digital flexor tendonitis: a comparative study in 219 horses (1992-2000).. Equine Vet J 2004;36:415–9.
  83. Schnabel LV, Fortier LA, Wayne Mcilwraith C, Nobert KM. Therapeutic use of stem cells in horses: which type, how, and when?. Vet J 2013;197:570–7.
  84. Smith RKW. Harnessing the stem cell for the treatment of tendon injuries: heralding a new dawn?. Br J Sports Med 2005;39:582–4.

Citations

This article has been cited 0 times.