Case Report: Repeated Intralesional Injections of Autologous Mesenchymal Stem Cells Combined With Platelet-Rich Plasma for Superficial Digital Flexor Tendon Healing in a Show Jumping Horse.
Authors: Melotti Luca, Carolo Anna, Elshazly Noha, Boesso Filippo, Da Dalt Laura, Gabai Gianfranco, Perazzi Anna, Iacopetti Ilaria, Patruno Marco
Journal: Frontiers in veterinary science
Summary
A 10-year-old show jumping gelding with chronic superficial digital flexor tendon disease that had failed to respond to six months of standard anti-inflammatory and conservative management received repeated intralesional injections of autologous adipose-derived mesenchymal stem cells combined with platelet-rich plasma, administered two weeks apart. Within two weeks of the first injection, blood biomarkers demonstrated a shift towards a pro-healing milieu, with elevated anti-inflammatory cytokines and growth factors alongside reduced oxidative stress markers, whilst clinical improvements in lameness, swelling and pain became evident by four weeks. Ultrasonographic imaging at one year revealed complete restoration of normal tendon fibre architecture and echogenicity, with the horse returning to competition at its previous level without recurrent or residual lameness. Though limited to a single case, these findings suggest that repeated combined stem cell and PRP therapy may offer benefit in chronic, recurrent tendon injuries that have proven refractory to conventional treatment, potentially through enhanced inflammatory resolution and tissue regeneration. The measurable improvements in both systemic healing markers and functional outcome warrant further investigation of this combined approach in prospective studies, particularly for horses with failed previous repairs or degenerative tendon disease.
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Practical Takeaways
- •Repeated intralesional stem cell and PRP injections may be a viable treatment option for chronic SDFT tendonitis that has failed to respond to conventional NSAIDs and rest protocols
- •Clinical improvement and return to competition can occur despite severe chronic injury, though this case represents a single animal and outcomes may vary
- •Consider referral for stem cell therapy evaluation in sport horses with recurrent tendon injuries unresponsive to standard management, as objective markers of healing (blood inflammatory mediators, ultrasound appearance) improved within 2 weeks
Key Findings
- •Two intralesional injections of autologous mesenchymal stem cells and platelet-rich plasma administered 1 month apart resulted in clinical lameness resolution within 4 weeks in a horse unresponsive to 6 months of NSAIDs and conservative management
- •Treatment induced a reduction in oxidative stress markers and increased anti-inflammatory cytokines and pro-mitotic growth factors within 2 weeks of first injection
- •Ultrasonographic examination at 1-year follow-up demonstrated compact fiber alignment and normal echogenic tendon appearance comparable to the contralateral sound limb
- •The horse returned to previous level of show jumping competition with no signs of lameness or swelling at 1-year follow-up