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Discussion on Stem cell help for tendon repair
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Member:
Frances
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Posted on Saturday, Oct 8, 2005 - 11:05 am:
DrO: I've come across a very interesting new (new to me anyway) treatment for tendon/ligament injuries. It involves removing bone marrow from the horse's sternum under simple sedation, sending the marrow to a lab where clever things are done to it to give it the propensity to become tendon/ligament material, and then injecting it into the injured tendon/ligament.
If you put "stem cell + equine tendon" into google, there are loads of entries on it.
I'd be interested to hear your opinion?
Many thanks,
Lynn
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Member:
Frances
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Posted on Saturday, Oct 8, 2005 - 11:17 am:
Oh, and there's a Californian co. called Vet-Stem which obtains the stem cells from a sample of the horse's fat, rather than bone marrow. Easier to harvest and richer in stem cells, apparently.
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Member:
Rubysmom
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Posted on Saturday, Oct 8, 2005 - 10:33 pm:
Actually, LL, Vet Stem takes fat from the top of the buttocks, and it yields more usable stem cells than using marrow.
I live about 5 minutes from where Vet-Stem is based, and my vet is working with them on a research project.
I did alot of reading when my horse strained his suspensory, fortunately, it was a mild injury and the Vet-Stem was not necessary, (thank goodness, it's a great therapy, but VERY expensive).
I was joking with my vet that my horse has PLENTY of fat donor areas on his body. LOL!
You still need to take the time for the horse to heal, it's not something that will heal them "quicker" so to speak, but it helps the injured area to heal in a more uniform way, making the tendon or ligament not as prone to reinjury upon healing.
It's pretty facsinating stuff!
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Member:
9193
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Posted on Sunday, Oct 9, 2005 - 1:54 pm:
Hi Lynn,
One of our good barn buddies has a 15 year old TB/Quarterhorse that sustained a back leg tendon injury (I need to double check if it was SDF or DDF). Long story short, it was recommended he undergo surgery on his tendon with the bone marrow injection from his chest to his tendon after months of rest and ultrasounds were showing the tendon not healing hardly at all..
This was done at Alamo Pintado in San Luis Obispo, California. I can get the name of the vets that did the surgery later..
This place does a lot of tendon surgeries, which is why our friends took their horse there. Woody is doing well, the surgery was done in January 05 and he is now up to 5 minutes trotting in 45 minute outing.. Angela is right in that it is not a short-cut to healing quicker, but the tendon was not healing in the conventional way and this was an option they chose to take which seems to be working for them..
Let me know if you would like more info.
Smiles,
Debra
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Member:
9193
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Posted on Sunday, Oct 9, 2005 - 2:06 pm:
Hello,
The proper name of the facility is Alamo Pintado Equine Medical Center. Using yahoo and adding "tendon surgery" gives you some links to discussions related to bone marrow surgery for tendon/ligament repair.
Debra
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Member:
Frances
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Posted on Monday, Oct 10, 2005 - 9:12 am:
Thanks, Angela and Debra.
My vet came out today, so I asked him if he was familiar with the procedure, and he said he was planning to start doing it in a few months here in Greece, although the lab work would be done abroad - perhaps in Switzerland. He favours the "bone-marrow-from-the-sternum" approach.
He said, though, that not enough trials have been carried out yet to be sure there were no unwanted side-effects, and gave an interesting example: there is a possibility that the manipulated material might instead form bone within the tendon (the last thing you want). I suppose that would only occur if the labwork had gone awry somewhere along the line?
I'm not really considering this for my mare, as from what I've read it's best carried out in the first weeks after the initial trauma, so far too late for us. I just think it's a fascinating idea, and I'll definitely check out the link you gave, Debra.
Thanks again
Lynn
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Member:
Lilou
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Posted on Monday, Oct 10, 2005 - 11:57 am:
Lynn, I hope the procedure will be successful. It sounds very interesting! Good luck! Who is your vet (if you don't mind me asking)? I'm also in Greece and it interests me. Best wishes!
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Member:
Frances
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Posted on Thursday, Oct 13, 2005 - 7:55 am:
Hi Helen. Sorry I haven't replied until now but we lost our internet connection for 3 days (how annoying is that).
Yes, doesn't the procedure sound interesting! Still, as I said, I'm not planning to have it done for my mare, as her lesion seems to have healed (phtu phtu) albeit in a less than perfect way.
I suppose to be really correct I should ask my vet first if he minds my mentioning his name on the internet. Is that ok with you?
All the best,
Lynn
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Member:
Lilou
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Posted on Friday, Oct 14, 2005 - 1:43 pm:
Lynn, thanks for your reply! I'm glad your mare is doing better (phtu phtu is right!!!). You are right, it is very nerve racking when there is no internet connection, and you are also right about mentioning the vet's name... it's ok. It's just that the greek riding world is very small and I' m sure I know him. Which club are you a member of?
Best wishes,
Helen
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Moderator:
DrO
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Posted on Tuesday, Oct 18, 2005 - 9:02 am:
Hello All,
I apologize for the time it has taken to put this together but we have been extra busy recently and this subject has taken a fair amount of research. The bottom line is that while the procedure in some form remains very promising the success of this therapy, particularly directly implanted stem cells, is not at all clear and certainly depend highly on how the procedure is done.
As much as this procedure is talked about and advertised in equine medicine you would think it a well established procedure but even in human medicine this remains experimental and they are not at the point of using this procedure regularly because of the current inability to create repairs with sufficient strength and flexibility and the potential of complications like calcification. This review published in the last 3 months sums up the review I made of 120 published articles:
Tissue Eng. 2005 Jul-Aug;11(7-8):1198-211.
Review: mesenchymal stem cells: cell-based reconstructive therapy in orthopedics.
Caplan AI.
Skeletal Research Center, Department of Biology, Case Western Reserve University, Cleveland, OH 44106, USA. ddb9@case.edu
Adult stem cells provide replacement and repair descendants for normal turnover or injured tissues. These cells have been isolated and expanded in culture, and their use for therapeutic strategies requires technologies not yet perfected. In the 1970s, the embryonic chick limb bud mesenchymal cell culture system provided data on the differentiation of cartilage, bone, and muscle. In the 1980s, we used this limb bud cell system as an assay for the purification of inductive factors in bone. In the 1990s, we used the expertise gained with embryonic mesenchymal progenitor cells in culture to develop the technology for isolating, expanding, and preserving the stem cell capacity of adult bone marrow-derived mesenchymal stem cells (MSCs). The 1990s brought us into the new field of tissue engineering, where we used MSCs with site-specific delivery vehicles to repair cartilage, bone, tendon, marrow stroma, muscle, and other connective tissues. In the beginning of the 21st century, we have made substantial advances: the most important is the development of a cell-coating technology, called painting, that allows us to introduce informational proteins to the outer surface of cells. These paints can serve as targeting addresses to specifically dock MSCs or other reparative cells to unique tissue addresses. The scientific and clinical challenge remains: to perfect cell-based tissue-engineering protocols to utilize the body's own rejuvenation capabilities by managing surgical implantations of scaffolds, bioactive factors, and reparative cells to regenerate damaged or diseased skeletal tissues.
I believe the procedure should be looked upon as experimental with the realization that there is a good chance this may not help and may increase the chance of calcification of the tendon.
DrO
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Member:
Frances
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Posted on Wednesday, Oct 19, 2005 - 8:51 am:
Thank you DrO for the analysis. There seem to be a lot of issues still to be resolved in the procedure.
Let us know how your friend's horse gets on, Debra!
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