Vet Comp Orthop Traumatol 2011; 24(05): 363-369
DOI: 10.3415/VCOT-11-01-0001
Original Research
Schattauer GmbH

Evaluation of a filter-prepared platelet concentrate for the treatment of suspensory branch injuries in horses.

G. Castelijns
1   Equihealth Vetrinarios SL., Real Club de Polo de Barcelona, Carrer General Batet, s/n., Barcelona, Spain
,
A. Crawford
2   Department of Veterinary Clinical Sciences, The Royal Veterinary College, University of London, Hatfield, Hertfordshire, UK
,
J. Schaffer
3   Pall Corporation, Port Washington, New York, USA
,
G. A. Ortolano
3   Pall Corporation, Port Washington, New York, USA
,
T. Beauregard
4   Summerhill Farm, Naunton, Cheltenham, Gloucestershire, UK
,
R. K. W. Smith
2   Department of Veterinary Clinical Sciences, The Royal Veterinary College, University of London, Hatfield, Hertfordshire, UK
› Author Affiliations
Financial support: The study was supported, in part, by VetCell Ltd. and the Pall Corporation.
Further Information

Publication History

Received: 03 January 2011

Accepted: 09 May 2011

Publication Date:
17 December 2017 (online)

Summary

Objectives: Platelet preparations have become a treatment for soft tissue injuries in horses. This study evaluated a novel filter-based system to concentrate platelets and assesses its value in the treatment of suspensory ligament branch desmitis.

Methods: Filtered platelet concentrate was prepared from 55 ml of venous blood obtained from 21 normal horses. Platelets and white blood cells in whole blood and filtered platelet concentrate were measured, as was platelet activating factor (PAF)–induced platelet-derived growth factor-BB (PDGF-BB) release. Eleven horses with 18 focal acute suspensory ligament branch injuries were treated intra-lesionally with autologous filtered platelet concentrate and evaluated clinically and ultrasonographically for one to three years.

Results: The increase in concentration of platelets in the filtered concentrate in comparison with whole blood (6.9 ± 1.9-fold) was significantly greater than the increase in white blood cells (3.8 ± 0.8-fold) (p <0.0001). There was no effect of sex or breed on platelet concentration. Platelets were responsive to PAF with >100-fold higher levels of PDGF release over basal levels. All hypoechoic lesions re-evaluated within three months had resolved. Five of the 11 horses returned to their previous level of work, one was exercising at a lower level, three were retired, one died for unrelated reasons, and one was still convalescing.

Clinical significance: Filtered platelet concentrate was easily and reliably prepared and injected into suspensory ligament branch injuries without short-term complications. This treatment was associated with rapid resolution of ultrasonographic lesions and lameness. Filtered platelet concentrate represents a convenient alternative for the treatment of suspensory ligament branch injuries.

 
  • References

  • 1 Dyson SJ, Arthur RM, Palmer SE. et al Suspensory ligament desmitis. Vet Clin North Am Equine Pract 1995; 11: 177-215.
  • 2 Lindstrom L, Smith RKW. Ultrasonic evaluation of suspensory ligament desmitis – an audit of 57 cases. Proceedings of the 35th British Equine Veterinary Association Annual Conference. 1996. September UK.;
  • 3 Smith RKW. Pathophysiology of tendon injury. In Ross MW, Dyson S. editors. Diagnosis and Management of Lameness in the Horse. St. Louis: W.B.; Saunders Co.; 2003. p 616-628.
  • 4 Kasashima Y, Takahashi T, Smith RK. et al Prevalence of superficial digital flexor tendonitis and suspensory desmitis in Japanese Thoroughbred flat racehorses in 1999. Equine Vet J 2004; 36: 346-350.
  • 5 Keg PR, Schamhardt HC, van Weeren PR. et al The effect of the high palmar nerve block and the ulnar nerve block on lameness provoked by a collagenase-induced tendonitis of the lateral branch of the suspensory ligament. Vet Q 1996; 18 (Suppl. 02) Suppl S103-S105.
  • 6 Cornelissen BP, Rijkenhuizen AB, Barneveld A. The diagnostic nerve block of the sesamoidean nerve: desensitized structures and possible clinical applications. Vet Q 1996; 18 (Suppl. 02) Suppl S97-S102.
  • 7 Reef VB. Equine diagnostic ultrasound. Philadelphia: W.B.; Saunders Co; 1998: 99-107.
  • 8 Minshall GJ, Wright IM. Arthroscopic diagnosis and treatment of intra-articular insertional injuries of the suspensory ligament branches in 18 horses. Equine Vet J 2006; 38: 10-14.
  • 9 van den Belt AJ, Dik KJ, Barneveld A. Ultra-sonographic evaluation and long-term follow-up of flexor tendonitis/desmitis in the metacarpal/meta-tarsal region in Dutch warmblood horses and stan-dardbred racehorses. Vet Q 1994; 16 (Suppl. 02) Suppl S76-S80.
  • 10 Dyson S. Proximal suspensory desmitis: clinical, ultrasonographic and radiographic features. Equine Vet J 1991; 23: 25-31.
  • 11 Dyson S. Proximal suspensory desmitis in the hind-limb: 42 cases. Br Vet J 1994; 150: 279-291.
  • 12 Dyson SJ, Genovese RL. The Suspensory Apparatus. In Ross MW, Dyson SJ. editors. Lameness in the Horse. St. Louis: Saunders; 2003. p. 654-672.
  • 13 Gibson KT, Steel CM. Conditions of the suspensory ligament causing lameness in horses. Equine Vet Educ 2002; 14: 39-50.
  • 14 Avella CS, Smith RKW. Ch. 86. Diagnosis and management of tendon and ligament disorders. In Auer JA, Stick JA. editors. Equine Surgery. 3rd Edition.. St. Louis; Saunders; 2006. pg 1086-1111.
  • 15 Arguelles D, Carmona JU, Climent F. et al Auto-logous platelet concentrates as a treatment for musculoskeletal lesions in five horses. Vet Rec 2008; 162: 208-211.
  • 16 Waselau M, Sutter WW, Genovese RL. et al Intralesional injection of platelet-rich plasma followed by controlled exercise for treatment of midbody suspensory ligament desmitis in Standardbred race-horses. J Am Vet Med Assoc 2008; 232: 1515-1520.
  • 17 Anitua E, Sanchez M, Orive G. et al Shedding light in the controversial terminology for platelet rich products. J Biomed Mater Res A 2009; 90: 1262-1263.
  • 18 de Mos M, van der Windt AE, Jahr H. et al Can platelet-rich plasma enhance tendon repair? A cell culture study. Am J Sports Med 2008; 36: 1171-1178.
  • 19 Schnabel LV, Mohammed HO, Miller BJ. et al Platelet rich plasma (PRP) enhances anabolic gene expression patterns in flexor digitorum superficialis tendons. J Orthop Res 2007; 25: 230-240.
  • 20 Schnabel LV, Sonea HO, Jacobson MS. et al Effects of platelet rich plasma and acellular bone marrow on gene expression patterns and DNA content of equine suspensory ligament explant cultures. Equine Vet J 2008; 40: 260-265.
  • 21 Smith JJ, Ross MW, Smith RK. Anabolic effects of acellular bone marrow, platelet rich plasma, and serum on equine suspensory ligament fibroblasts in vitro. Vet Comp Orthop Traumatol 2006; 19: 43-47.
  • 22 Sanchez M, Anitua E, Orive G. et al Platelet-rich therapies in the treatment of orthopaedic sport injuries. Sports Med 2009; 39: 345-354.
  • 23 de Vos RJ, van Veldhoven PL, Moen MH. et al Auto-logous growth factor injections in chronic tendinopathy: a systematic review. Br Med Bull 2010; 95: 63-77.
  • 24 Bosch G, van Schie HT, de Groot MW. et al Effects of platelet-rich plasma on the quality of repair of mechanically induced core lesions in equine superficial digital flexor tendons: A placebo-controlled experimental study. J Orthop Res 2010; 28: 211-217.
  • 25 Bosch G, Moleman M, Barneveld A. et al. The effect of platelet-rich plasma on the neovascularization of surgically created equine superficial digital flexor tendon lesions. Scand J Med Sci Sports 2010 March 10.
  • 26 Anitua E, Andia I, Ardanza B. et al Autologous platelets as a source of proteins for healing and tissue regeneration. Thromb Haemost 2004; 91: 4-15.
  • 27 Zimmermann R, Jakubietz R, Jakubietz M. et al Different preparation methods to obtain platelet components as a source of growth factors for local application. Transfusion 2001; 41: 1217-1224.
  • 28 Ross M. Movement. In Ross M, Dyson S. editors. Lameness in the Horse. 1st ed.. Philadelphia; Saunders; 2003. p 60-73.
  • 29 Riemersma DJ, van den Bogert AJ, Schamhardt HC. et al Kinetics and kinematics of the equine hind limb: in vivo tendon strain and joint kinematics. Am J Vet Res 1988; 49: 1353-1359.
  • 30 Riemersma DJ, van den Bogert AJ, Jansen MO. et al Tendon strain in the forelimbs as a function of gait and ground characteristics and in vitro limb loading in ponies. Equine Vet J 1996; 28: 133-138.
  • 31 Coombes BK, Bisset L, Vicenzino B. Efficacy and safety of corticosteroid injections and other injections for management of tendinopathy: a systematic review of randomised controlled trials. Lancet 2010; 376: 1751-1767.
  • 32 de Vos RJ, Weir A, van Schie HT. et al Platelet-rich plasma injection for chronic Achilles tendinopathy: a randomized controlled trial. JAMA 2010; 303: 144-149.
  • 33 Schepull T, Kvist J, Norrman H. et al Autologous Platelets Have No Effect on the Healing of Human Achilles Tendon Ruptures: A Randomized Single-Blind Study. Am J Sports Med 2011; 39: 38-47.