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TheHorse.com THE HORSE September 2016
injuries to the meniscus, cartilage, and/or
ligaments.
"A single injection of cultured bone-
marrow-derived stem cells, including 15-
20 million stem cells, safely increased the
number of horses that were able to return
to work following surgery compared to
previous reports," says Goodrich.
In other words, stem cell therapy in
conjunction with surgery appears to be
more beneficial than surgery alone.
Additional Management
"After injury to such a substantial joint,
which frequently involves more than one
important structure, owners need to be
cognizant that persistent inflammation
of the joint can initiate a series of events
that culminate in osteoarthritis," says
Goodrich.
Osteoarthritis, the painful degradation
of articular cartilage, can develop in any
age horse following even mild trauma.
Evidence supports the preventive use of
oral joint health supplements containing
glucosamine and chondroitin sulfate
(with or without additional ingredients
such as methylsulfonylmethane, hyal-
uronic acid, and avocado-soybean unsa-
ponifiables). Once a stifle injury occurs,
veterinarians recommend a multimodal
treatment approach, meaning they use
several different methods to promote
healing. Based on the available research,
this includes:
■ Appropriate surgical correction of the
underlying traumatic injury;
■ Non-steroidal anti-inflammatory drugs;
■ Intra-articular medications (joint
injections), including corticosteroids,
hyaluronate sodium, and polysulfated
glycosaminoglycan;
■ Interleukin-1 receptor antagonist pro-
tein (IRAP, IRAPII);
■ Weight management;
■ Physical therapy;
■ Extracorporeal shock wave therapy;
and
■ Oral joint health and omega-3 fatty
acid supplements.
"Stem cell therapy may also be a useful
method of supporting horses with OA,"
says Goodrich. "Additional research will
reveal the types of cases that will benefit
the most from this therapy."
Take-Home Message
No injury is a good injury, especially
in competition horses. Stifle injuries are
among the most undesirable, because
the joint is very large, diagnostic and
treatment options are limited, affected
animals have difficulty returning to
performance, and many develop long-
term side effects, including osteoarthritis.
Researchers say continued advances in
diagnosis, surgical technique, and supple-
mentary approaches, such as stem cell
therapy, are likely to improve outcomes
following injury.
h
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Stifling THE PAIN
Stem cell therapy
may also be a useful
method of supporting
horses with OA."
DR. LAURIE GOODRICH