Tyrrells have been using stem cells to treat a variety of tendon and ligament injuries over the last few years. Stem cells are ‘undifferentiated’, meaning that they have the ability to change themselves into the cell type that they come into contact with. Hence if implanted into a tendon they will turn into tendon cells, thereby regenerating new tendon rather than producing scar tissue.
Equine stem cells are harvested via a bone marrow biopsy from the horse’s sternum under standing sedation and local anaesthetic in the clinic. This sample is couriered to the VetCell laboratory in Scotland where the stem cell are extracted and cultured to rapidly increase their numbers. This process can take up to 3 weeks.
Once appropriate numbers of cells have been produced they are re couriered back to Tyrrells for implantation into your horse.
There is good evidence to show that appropriate injuries treated early with this new cellular technology have a lower injury recurrence rate compared to similar injuries with other treatment modalities.
IRAP (Interleuekin-1 receptor antagonist protein) is a treatment for osteoarthritis or acute synovitis, it is the latest substance for joint medication and is currently soaring in popularity as an alternative or adjunct to corticosteroids. Studies so far are very encouraging - it has less cartilage degrading effects than steroids and no association with laminitis as steroids do.
Currently we are using this in joints with radiographic signs of damage/osteoarthritis and in selected cases post arthroscopic surgery. It may be useful in cases where steroids are contra-indicated, such as laminitis prone ponies and would be safe in joints where fragmentation or chip fractures may be present where the use of steroids may be inadviseable. It is also worth trying in joints where steroids have limited or short term results. How does it work?
Interleukin-1 is one of the predominant inflammatory mediators in inflamed joints. By blocking its receptors we are trying to 'switch off' the inflammatory process, normalising the joint fluid environment and protecting the cartilage from further damage. IRAP is found in circulating blood. We collect this blood under sterile conditions and then with our processing system we isolate and concentrate the IRAP into a small volume for intra-articular injection in the affected joint(s). Because this is a physiological injection it is safe to medicate multiple joints at the same time. The effects of an IRAP injection are thought to last only a few days so to adequately break the cycle of inflammation within a joint it is necessary to repeatedly inject the joint to prolong the effect until the inflammation settles down. Currently most cases are receiving one injection weekly or fortnightly for three to four injections.
