Suspension of Bone Marrow–Derived Undifferentiated Mesenchymal Stromal Cells for Repair of Superficial Digital Flexor Tendon in Race Horses

Abstract

It has been proven that mesenchymal stromal cells (MSCs) can differentiate into tenocytes. Attempts to repair tendon lesions have been performed, mainly using scaffold carriers in experimental settings. In this article, we describe the clinical use of undifferentiated MSCs in racehorses. Significant clinical recovery was achieved in 9 of 11 horses evaluated using ultrasound analysis and their ability to return to racing. Our results show that the suspension of a small number of undifferentiated MSCs may be sufficient to repair damaged tendons without the use of scaffold support. Ultrasound scanning showed that fibers were correctly oriented. By using undifferentiated cells, no ectopic bone deposition occurred. A sufficient number of cells was recovered for therapeutic purposes in all but 1 case. We suggest that the use of autologous MSCs is a safe therapeutic method for treating incompletely (i.e., not full-thickness) damaged tendons.

CORR® ORS Richard A. Brand Award for Outstanding Orthopaedic Research: Engineering Flexor Tendon Repair With Lubricant, Cells, and Cytokines in a Canine Model

“…Adult mesenchymal stem cells most commonly are used clinically and experimentally. Although the adult mesenchymal stem cells can be derived from bone marrow, adipose, muscle, and other tissue, the most common use in tendon healing to date is the use of bone marrow stromal cells to treat equine flexor tendon injures [3,5,19,22,23].…”

The past, present and future in scaffold-based tendon treatments

“…Thus, delivery of cells is clearly more beneficial than any single or even dual biological molecule delivery strategy, which has little chance of commercialisation, given the complexity of the system. To this end, direct cell injections were pioneered, with positive results in equine patients [44,214], even with low number of cells [215][216][217]. However, direct cell injections have failed to deliver in a consistent manner in humans due to poor cell localisation [218][219][220][221], triggering an extensive investigation into the optimal cell carrier for tendon repair [1].…”

Expression of scleraxis and tenascin C in equine adipose and umbilical cord blood derived stem cells is dependent upon substrata and FGF supplementation

“…Adipose derived mononuclear cells were capable of improving tendon architecture but not biomechanical properties in a collagenase induced lesion of the SDFT (Nixon et al 2008). Transplantation of bone marrow derived stem cells into tendon lesions results in decreased lesion size and greater tendon density (Crovace et al 2007;Pacini et al 2007). …”