What is regenerative medicine?
Regenerative medicine is a branch of medicine, which deals with the “process of replacing, engineering or regenerating cells or tissues to restore or establish normal function”. This works by stimulating the body’s own repair mechanisms to functionally heal previously irreparable tissues. Whether a performance horse or family pony we want our animals to be pain free and not impaired by loss of function. Regenerative medicine helps restore this normal function. Working with the horse’s own repair mechanism, regenerative medicine amplifies or manipulates this process to encourage the body to produce the right type of cell or tissue without the use of drugs.
First trialled in the 1970s, regenerative medicine has been extensively researched and used by veterinary surgeons around the world to treat a multitude of conditions. Mainly chosen for the treatment of tendon, ligament and joint disease, regenerative therapies have enabled thousands of horses to return to their previous level of performance.
Regenerative medicine treatment options
Your veterinary surgeon may discuss various forms of therapy depending on the severity and length of time the horse has been suffering from the condition. In some cases the choice of treatment may change as the condition develops. It is important to understand that we need to work with the body’s own healing mechanism, which changes over time.
Regenerative medicine options include platelet rich plasma (PRP), bone marrow aspirate concentrate (BMAC), stem cells or autologous conditioned serum (ACS or IRAP). These four technologies have similarities but are very different in when and how they are used.
Using bone marrow or fat (adipose tissue) from the horse, the stem cells are isolated and cultured in the laboratory to increase their number. This process takes approximately two weeks giving rise to millions of cells, enough to treat two joints (1ml per joint). Implanted into the affected joint these cells then modulate the healing process.
National Hunt racehorses that have suffered tendon injuries have a return-to-performance rate of 74% after stem cell treatment compared to 48% anticipated for horses treated with non-biologicals (O’Meara 2010). Recent results have shown that stem cell treatment within one month of injury significantly improves the horse’s recovery.
This therapy involves bone marrow being harvested from the horse, a simple procedure carried out under standing sedation which causes only a little discomfort. A specialist machine is then used to recover the mononuclear cell population from the bone marrow. This is a varied population of cells, some of which are progenitor (stem) cells that can modulate and stimulate healing.
Mainly used in the treatment of tendons and joints, BMAC offers a patient side, same day administration of cells to help restore normal tissue function.
PRP starts with a simple blood collection from the horse from which the platelets are harvested. Within each platelet are growth factors that encourage new cells or tissue growth. Concentrating these factors allows the veterinary surgeon to inject the damaged tissue with a small volume to stimulate healing. PRP can also be activated to form an ‘active gel’ as an aid to wound healing. This gel can stimulate new tissue, blood supply and skin to form.
There are a number of published clinical studies showing the benefits of using PRP to treat orthopaedic conditions in horses, dogs and humans. For more details please click here.
Blood is taken from the horse and incubated for 24 hours to release a protein called IL1-Ra. When injected into a joint or inflamed area, this protein helps by blocking the harmful effects of inflammation (IL-1). IL1-Ra is produced normally within the joint to balance the levels of IL-1. In situations where the joint is inflamed or certain pathological changes have resulted in a decreased ability to produce IL1-Ra, ACS/IRAP can be used to help bring back a normal balance.