Superficial digital flexor tendonitis is a very common injury in equine athletes. Many different treatments have been advocated over the years, each new modality remaining popular for only a short period of time.
Stem cell treatment has, for some time now, been offered as the ‘gold standard’ treatment for acute tendonitis. It was initially thought that the stem cells were incorporated into the repair to produce normal tendon tissue. More recent evidence suggests that they act as cellular conductors, co-ordinating the repair of the tendon. Traditional stem cell treatment uses bone marrow derived mesenchymal stem cells that are cultured in the lab to produce larger numbers of cells. These are then re-suspended in the bone marrow fluid before being injected back into the tendon. One drawback of the culture process is that it takes up to 4 weeks, meaning that treatment is delayed, and repair process has begun before the stem cells have been injected. There is also evidence that the cells become less potent as they are grown in the lab. Whilst we have had some excellent results using stem cells harvested in this way, there have been other cases where the results have been disappointing.
Bone marrow concentrate (BMAC) is a much simpler process of concentrating the cellular part of a larger bone marrow sample. The sample is collected from the horse’s sternum, then processed here at the hospital to produce the concentrate. This means it can be injected into the injury site straight away. This method gives early delivery of high quality stem cells, albeit in smaller numbers than with cultured stem cells. It now seems logical that a smaller number of higher quality cells early in the injury process is a more appropriate treatment.
Oakham Veterinary Hospital is able to offer Bone Marrow Concentrate as a treatment to our referral clients. It is usually performed during an outpatient appointment. All our vets are available to discuss the benefits of this treatment.