Stem cell therapy of tendon injuries – clinical outcome in 98 cases

Stammzellentherapie von Sehnenverletzungen – klinische Ergebnisse von 98 Fällen

Burk J, Brehm W

DOI: 10.21836/PEM20110207
Year: 2011
Volume: 27
Issue: 2
Pages: 153-161

Tendon injuries are among the most common orthopedic injuries in competition and race horses. It has already been reported that the intralesional injection of mesenchymal stem cells (MSCs) results in a better tendon healing and reduces re-injury rates compared to conventional therapies. The aim of this study was to evaluate success and safety of MSC-therapy in horses suffering from tendon and ligament injuries and to identify factors that influence the success of MSC-therapies. 98 horses had presented with tendon or ligament injuries, of which approximately two-thirds were suspensory ligament (SL) lesions and ne-third superficial digital flexor tendon (SDFT) lesions. All horses had been treated with an intralesional injection of autologous bone marrow MSCs and follow-up information was obtained by the responsible practitioner. MSC-therapy associated complications and the MSC-treatment success rate were assessed based on the data obtained for all 98 horses. Treatment success was defined as return to intended use and/ or return to full training without re-injury. Followup information over a period longer than 12 months could be btained for 58 horses. For these 58 horses, data was additionally analyzed with regard to the questions whether the disease stage at which the MSCs had been applied, the discipline in which horses used to perform, the age of the horses, or the injury localization (SL vs. SDFT) influence the treatment success rate. In 6 out of 98 cases treatmentassociated complications such as transient swellings had been observed; however, this had no effect on the clinical outcomes. The success rate after more than 12 months after treatment (n=58) was 84.5%. Patients with acute or chronic disease showed overall better results (82.2% and 91.7% respectively) than horses that had presented with recurrent disease (50.0%). Generally, six to twelve year old horses showed a higher success rate (88.9%) compared to older horses (75.0%). Competition horses reinjured less frequently (10.0%) than flat (27.3%) and trot race horses (66.6%). The success rate did not vary between horses with SL or SDFT injuries. However, the localization of the lesion within the SL seems to play a role concerning the treatment success. The results of this case study confirm the positive results reported in previous studies on regenerative tendon therapy with MSCs. Furthermore it shows that MSC-therapy is not only successful in the treatment of SDFT lesions but also leads to promising results in the treatment of SL injuries.