Current and Emerging Biologic Therapies for Equine Tendon and Ligament Injuries.
Authors: Shannon S. Connard, Lauren V. Schnabel
Journal: The Veterinary clinics of North America. Equine practice
Summary
# Editorial Summary: Biologic Therapies for Equine Tendon and Ligament Injuries Connard and Schnabel's comprehensive review examines how biologic regenerative therapies are reshaping the management of equine tendon and ligament injuries, moving beyond conventional treatments toward interventions that actively enhance tissue repair rather than simply providing support during healing. The authors evaluate five principal therapeutic approaches—scaffold-based systems, growth factor preparations, blood-derived biologics (such as platelet-rich plasma and bone marrow-derived stem cells), tissue-derived biologics, and gene therapy—assessing each for their underlying mechanisms, current evidence of efficacy, and practical limitations in clinical application. Across these modalities, biologics demonstrate the capacity to modulate inflammatory responses, stimulate angiogenesis, promote cellular proliferation, and guide organised collagen deposition in damaged tendons and ligaments, with emerging research suggesting superior functional outcomes compared to standard therapeutic approaches in carefully selected cases. The review highlights that clinical adoption remains variable due to inconsistencies in product standardisation, heterogeneity of study designs, cost considerations, and regulatory complexities, yet identifies promising directions in combination therapies and refined delivery systems. For equine professionals, this synthesis underscores the importance of understanding which biologic approaches have robust supporting evidence for specific injury presentations, the necessity of appropriate case selection and rehabilitation protocols alongside biological interventions, and the value of remaining informed as this therapeutic landscape evolves rapidly.
Read the full abstract on PubMed
Practical Takeaways
- •Biologic therapies (PRP, stem cells, scaffolds, growth factors) are advancing treatment options for tendon and ligament injuries beyond traditional rehabilitation protocols
- •Multiple biologic approaches exist with varying mechanisms; understanding which therapy suits specific injury types and stages of healing is critical for clinical decision-making
- •Gene therapy is emerging but remains largely experimental; focus your current practice on established biologics with documented clinical outcomes
Key Findings
- •Scaffold-based therapies, growth factors, blood-derived and tissue-derived biologics show promise for enhancing tissue repair and regeneration in equine tendons and ligaments
- •Gene therapy represents an emerging approach for improving healing outcomes in equine musculoskeletal injuries
- •Current biologic therapies present both efficacy advantages and clinical application challenges that require further evaluation