Treatment of Bilateral Medial Femoral Condyle Articular Cartilage Fissures in a Horse Using Bone Marrow-Derived Multipotent Mesenchymal Stromal Cells

Abstract

The objective of this study was to describe the use, and outcome, of multipotent mesenchymal stromal cells (MSCs) in the treatment of equine articular cartilage defects of the medial femoral condyle. A 4-year-old Thoroughbred gelding (n = 1) with bilateral stifle athroscopy was found to have bilateral articular cartilage fissure defects of the medial femoral condyles with concurrent cranial cruciate ligament injury. Bone marrow derived MSCs were isolated, expanded, and suspended in a partially autologous fibrin glue. The initial cell/fibrin glue mixture was delivered arthroscopically into the articular cartilage defects 90 days after the initial arthroscopic examination. Follow-up treatments included two additional injections of MSCs suspended in lactated Ringers solution, 5 and 13 months after the initial examination, directly into the joint. Post-treatment outcome was assessed by arthroscopic examination and by comparison of preinjury and post-treatment performance records. Arthroscopic evaluation 4 months after the initial MSC treatment revealed marked smoothing, reduction in the depth of cartilage defects and observation of moderate improvement in the cranial cruciate ligament. Approximately 15 months after the initial MSC treatment the horse returned to racing. Analysis of race records demonstrated that the post-treatment (including all three MSC treatments) average race earnings (earnings per start) were comparable with those predating the initial injury. The favorable clinical response in the face of an unknown, but likely, guarded prognosis suggest that MSC therapy is not deleterious and may augment healing of articular cartilage fissures of the medial femoral condyle. MSCs represent a viable and promising alternative therapy in the treatment of articular cartilage injuries in performance horses.