Case Report: Treatment of five short bones articular fractures with allogeneic adipose-derived stem cells as unique therapy on race horses

BENEDETTI LUCIANA; FAGUNDEZ, CAROL BETIANA; FIGARI MARCELO

Conferencia; 2016 NAVRMA (North American Veterinary Regenerative Medicine Association) Conference; 2016

Objectives: To evaluate fracture consolidation using allogeneic adipose tissue-derived mesenchymal stem cells [ATSCs] as unique therapy applied and to evaluate the return to sport activity.Materials and methods: 1. Five race horses with articular fractures of third carpal, third tarsal, radio-carpal, intermediate carpal, and proximal sesamoid bone. 2.Intraarticular injection of allogeneic ATSCs. 3.No other therapies were applied. Only preventive wide spectrum systemic antibiotics were administrated for 7 days post-treatment.4. Every horse selected in this study presented lameness, pain and inflammation of the joint involved and did not show any radiological evidence of fracture consolidation after forty days from injury.5. The samples were obtained from subcutaneous adipose tissue from different donors. 6. After laboratory isolation and culture amplification of ATSCs (p4), a single intra-articular injection of 40 million cells, was performed on each horse. Recovery period: During the recovery period, horses were at stable rest. Clinical examination was performed every week. Radiographs were taken 45 days after cell injection.Results: Mild articular inflammation was observed after injection. No antiinflamatories drugs were administrated. A week later inflammation was totally resolved and remarkable improvement in lameness and pain score.Control x-rays took 45 days after injection showed the formation of callus in the fracture line in all cases.Cases 1, 3, 4 and 5 achieved complete callus formation and are gradually returned to normal racing training within six months.The fracture in Case 2 was more severe than the other cases. It required longer recovery time but clinical and radiological improvement was evident (currently is conducting gradual training to walk and trot). Conclusions: Intra-articular application of allogeneic adipose-derived mesenchymal stem cells on short bones fractures showed to be effective and safe in this five cases.Although in this report we evaluate the osseous regenerative capability of the ATSCs alone, we believe this should be highly beneficial when used as complementary therapy of conventional treatments such as arthroscopy, screw fixation or cast application