Abstract
This retrospective study aimed to evaluate the clinical effect of bone marrow aspirate concentrate (BMAC) and leukocyte rich PRP (LR-PRP) compared to horses undergoing controlled exercise alone in horses with >3 months proximal suspensory desmopathy in hindlimbs (HPSD). Nighty-three horses were divided into three groups according to the treatment: a control (n = 22), LR-PRP (n = 46), and BMAC (n = 25) group. Lameness and ultrasound scores were recorded before treatment (T0) and at 6 months (T1) post-treatment. Records horses considered sound at evaluation and level of performance were additionally registered at 12 months (T2) and 18 months (T3) after treatment. The BMAC cytology profiles from 22 horses were also analysed and compared to clinical outcomes. The results at T1 showed that 9% (2/22) of the horses in the control group were sound compared to 59% (25/46) and 84% (21/25) in the LR-PRP and BMAC groups, respectively. Additionally, ultrasound scores at T1 in the BMAC and LR-PRP groups were improved in comparison with the control group (p = 0.02). At T2, 68% of the horses in the BMAC group and 39% of the horses in the LR-PRP group had returned to the previous performance level. At T3, a significantly higher percentage of horses in the LR-PRP (43%) and BMAC (72%) group were sound when compared to the control (4.6%) group (p = 0.02). Similarly, at T3, significantly more horses of the BMAC (16/25) and of the LR-PRP (15/46) group had returned to the previous or a higher performance level compared to the control (1/22) group (p = 0.01). No correlation was found between long-term clinical outcome and cytology profiles in the BMAC group. In conclusion, long-term outcomes of treatment with LR-PRP or BMAC are significantly better than conventional treatment of the hindlimb chronic PSD in horses. Additionally, BMAC yielded better lameness scores than LR-PRP at short- and long-term follow-up.
Highlights
Desmopathy of the hindlimb proximal suspensory ligament (HPSD) is a common cause of lameness in horses [1, 2]
There were no significant differences between the groups in terms of age, but the horses in the control group tended to be younger
The proximal suspensory ligament (PSL) of the left hindlimb was more commonly affected in the control (n = 14) and bone marrow aspirate concentrate (BMAC) (n =14) groups, while the right hindlimb was more commonly affected in the leukocyte rich platelet-rich plasma (PRP) (LR-PRP) group (n = 25)
Summary
Desmopathy of the hindlimb proximal suspensory ligament (HPSD) is a common cause of lameness in horses [1, 2]. Non-surgical conventional treatments of HPSD include local infiltration with corticosteroids and/or hyaluronan, extracorporeal shock wave therapy (ESWT), and systemic application of NSAIDs in combination with corrective shoeing [1, 3, 4]. Each of these have shown not satisfying long-term results in chronic cases (>3 months) [1,2,3,4,5,6]. There is an increasing need for a cost-effective and single-step cell-based treatment
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