Tenogenically Induced Allogeneic Mesenchymal Stem Cells for the Treatment of Proximal Suspensory Ligament Desmitis in a Horse.
Authors: Vandenberghe Aurélie, Broeckx Sarah Y, Beerts Charlotte, Seys Bert, Zimmerman Marieke, Verweire Ineke, Suls Marc, Spaas Jan H
Journal: Frontiers in veterinary science
Summary
# Editorial Summary: Tenogenically Induced Allogeneic MSCs for Proximal Suspensory Ligament Desmitis Proximal suspensory ligament (PSL) injuries present a considerable clinical challenge in sport horses, particularly in dressage competitors, because the ligament's inherent poor healing capacity frequently results in chronic, treatment-resistant pathology that compromises return to performance. Vandenberghe and colleagues documented a case where a horse with Grade 2/5 lameness and a hypo-echoic lesion occupying 30% of the ligament's cross-sectional area—unresponsive to four months of conservative management—received intralesional injections of allogeneic mesenchymal stem cells that had been pre-differentiated along a tenogenic lineage, with a second treatment combined with platelet-rich plasma administered at 12 weeks. Within four weeks of the initial injection, lameness improved to Grade 1/5 with evidence of lesion filling on ultrasound, and by four weeks after the second injection, the horse demonstrated sound trotting with near-complete fibre alignment, ultimately returning to full competitive performance at 32 weeks and maintaining this level a year post-treatment. The tenogenic pre-differentiation protocol represents a potentially significant advancement over standard allogeneic MSC therapy, as this directed differentiation may enhance cellular commitment to ligamentous repair before injection, theoretically improving clinical outcomes. Whilst this single case cannot establish efficacy, it provides encouraging preliminary evidence that allogeneic tenogenically induced MSCs warrant further investigation as a regenerative option for performance horses with chronic PSL desmitis, particularly where conventional management has failed.
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Practical Takeaways
- •Allogeneic tenogenically-induced MSCs combined with PRP may offer a viable option for chronic suspensory ligament injuries that fail to respond to conservative management over several months
- •Repeated injections (2 doses spaced 12 weeks apart) and extended rehabilitation timeline (32 weeks to return to sport) should be expected when using this regenerative approach
- •Ultrasound monitoring shows promise for tracking tissue healing and guiding re-injection timing in recalcitrant suspensory ligament cases
Key Findings
- •Single horse with Grade 2/5 lameness refractory to 4 months conservative management showed improvement to Grade 1/5 lameness by 4 weeks post-treatment with allogeneic tenogenically-induced MSCs
- •Ultrasound imaging demonstrated lesion progression from 30% cross-sectional involvement to near-complete fiber alignment over 20 weeks
- •Horse returned to previous performance level at 32 weeks post-treatment and maintained soundness for at least 1 year