Page 57 - Barrel Stallion Register 2017

Horses More At Risk For Injury
Some horses are more prone to soft tissue injuries—especially the western performance horses (cutting, reining, barrel racing) that have a lot of side-to-side strain on the joint as they pivot around a turn. “Certainly jumpers that hit fences with
the stifle are also at risk. Horses that try to jump over the divider in a trailer may also be injured,” says Frisbie.
“The horses with side-to-side maneuvers suffer more athletic-type injuries (strain and stress on the joint) rather than trau- matic injuries,” he says. Joint conformation and angle, such as post-legged horses (not enough angle in the stifle joint), can play a role since this puts more strain on the joint during strenuous movement.
participated in the study, their combined success was only 67%, so there were defi- nitely some variables.
“Something new in this area is some people putting a screw across the cyst, but at this point this technique is not supported by science and does not appear to have better outcomes than injecting the cysts. It is also more involved and costly than injection, and has the downside of leaving a screw in the horse,” explains Frisbie.
MENISCUS (SOFT TISSUE) DAMAGE
In the past few years, we’ve also learned more about meniscal damage. The meniscus
is a crescent-shaped cartilage-type structure dividing part of the stifle joint and providing support. “In my practice, I see a case nearly every day in which the horse is sore in the stifle and it’s been x-rayed and the x-rays don’t show anything significant. Assuming it is soft tissue injury, the horse gets treated—usually with HA and steroids in the joint. Within 6 weeks or less the horse is lame again,” says Frisbie.
Most of these horses have some degree of meniscal or soft-tissue damage. “In years past, with surgery alone, the success rate ranged from 60% (if it’s a grade 1 tear) down to about 6 or 7% success rate if it’s a grade 3 tear (the worst tear). By doing the surgery and adding stem cells free in the joint, we’ve been able
to change and enhance the success rate in a group of horses that we followed for a couple of years,” he says.
“About 12 years ago we started putting stem cells in joints, very tentatively at first.
About 6 months to a year later we realized it was working—and we increased our numbers. So then we followed 33 cases for 2 years or more,” says Frisbie.
He and several colleagues published a paper in a 2014 issue of Veterinary Surgery entitled “Clinical Outcome After Intra- Articular Administration of Bone Marrow Derived Mesenchymal Stem Cells in 33 Horses With Stifle Injury” in which they reported on this study. “This was the first long-term clinical case report of treating stifles with surgery and stem cells, and the first report of clinical cases treating joints with stem cells. When treating the grade 1 injuries with stem cells, we found that they did better than with just surgery alone. We had 100% success with the grade 1s, using this technique--adding stem cells. We had up to 65% success (horses going back to work) with the grade 3 tears. So, we obviously changed the odds quite a bit,” he says.
Frisbie became interested in stem cells in 2003 when someone in Ireland published a paper about use of stem cells in goats. “For that study, they took out the entire meniscus in 18 goats, then treated half of them with stem cells. Seven of those 9 treated goats regenerated 50 to 70% of their meniscus. That was amazing and enough to get me excited. When we are treating meniscal disease in horses, we aren’t taking the whole structure out. We merely remove the dam- aged tissue, so there would be a lot more left to work with. I realized we could possibly use stem cells to augment that surgery. So this
sparked the beginning of our study, and the paper we published,” he explains.
“A few years after the goat study, a
study in rabbits confirmed those finding. The rabbit study looked at the volume and the type of tissue that was formed when treating meniscus problems with stem cells versus no stem cells. Not only did this show an increase in the amount of tissue formed, but the quality of the tissue and its func- tionality (its ability to decrease arthritic progression) was significantly better with the stem cells.”
A new technique with good prognosis for most horses when dealing with cysts is to go around the periphery of the cyst with an injection to decrease the metabolism of the lining that produces chemicals that retard healing of the bone.
Treating joints by adding stem cells when doing stifle surgery for soft tissue damage resulted in the horse doing much better than with just surgery alone. Not only was there an increase in the amount of tissue formed, but the quality of the tissue and its functionality was better.
SPEEDHORSE 55
EQUINE HEALTH