Prognostic value of power doppler ultrasonography for equine superficial digital flexor tendon injury in thoroughbred racehorses.

The potential value of hypervascularity detected with power Doppler ultrasonography (PDU) within equine superficial digital flexor tendon (SDFT) as a prognostic factor of SDFT injury is not clear. The purpose of this study was to test the hypothesis that hypervascularity within SDFT is one of the risk factors for subsequent severe SDFT injury and to evaluate the prognostic value. A prospective cohort study of 97 Thoroughbred racehorses without any clinical signs of SDFT injury was conducted. Six variables of age, body weight, sex, the cross-sectional area of SDFT, PDU signal within SDFT and experience of steeplechase were assessed for the possibility of risk factors of subsequent SDFT injury in follow-up period of 1 year. Multivariable logistic regression analyses were used for assessment of the odds ratios (ORs) and 95 % confidence intervals (CIs) of SDFT injury. Multivariable logistic regression analysis revealed that the PDU signal within SDFT was a risk factor for the development of SDFT injury in follow-up period (P = 0.017). The adjusted OR of SDFT injury was significantly higher in PDU positive group than in PDU negative group (OR 3.17, 95 % CIs 1.20-8.35). Although further studies are required, these results would be useful for early detection and/or prevention of development for clinical severe SDFT injury.

Effect of platelet-rich plasma in Achilles tendon allograft in rabbits.

BACKGROUND: Achilles tendon is composed of dense connective tissue and is one of the largest tendons in the body. In veterinary medicine, acute ruptures are associated with impact injury or sharp trauma. Healing of the ruptured tendon is challenging because of poor blood and nerve supply as well as the residual cell population. Platelet-rich plasma (PRP) contains numerous bioactive agents and growth factors and has been utilized to promote healing in bone, soft tissue, and tendons. OBJECTIVE: The purpose of this study was to evaluate the healing effect of PRP injected into the surrounding fascia of the Achilles tendon after allograft in rabbits. METHODS: Donor rabbits (n = 8) were anesthetized and 16 lateral gastrocnemius tendons were fully transected bilaterally. Transected tendons were decellularized and stored at -80°C prior to allograft. The allograft was placed on the partially transected medial gastrocnemius tendon in the left hindlimb of 16 rabbits. The allograft PRP group (n = 8) had 0.3 mL of PRP administered in the tendon and the allograft control group (n = 8) did not receive any treatment. After 8 weeks, rabbits were euthanatized and allograft tendons were transected for macroscopic, biomechanical, and histological assessment. RESULTS: The allograft PRP group exhibited superior macroscopic assessment scores, greater tensile strength, and a histologically enhanced healing process compared to those in the allograft control group. CONCLUSIONS: Our results suggest administration of PRP on an allograft tendon has a positive effect on the healing process in a ruptured Achilles tendon.

Stem cells and platelet-rich plasma for the treatment of naturally occurring equine tendon and ligament injuries: a systematic review and meta-analysis.

BACKGROUND: Platelet-rich plasma (PRP) and mesenchymal stromal or stem cells (MSCs) have been investigated as treatments for equine tendon and ligament injuries, but little consensus exists on the efficacy of these treatments. The study sought to evaluate the efficacy of PRP and MSC treatments by systematic review and meta-analysis. METHODS: A systematic review was performed using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines. Inclusion criteria required an original, peer-reviewed study where horses were administered MSCs or PRP (or both), and a comparator group was described. Studies were assessed for risk of bias and study quality. Random effects meta-analysis with inverse variance weighting was used to calculate pooled estimates of the ORs for the primary outcomes of return to performance and reinjury. RESULTS: The search criteria identified 764 unique studies, and 21 studies met the inclusion criteria for the systematic review. Seventeen studies were further assessed for the primary outcomes of return to performance and reinjury rate within a meta-analysis. Meta-analyses revealed no increase in the likelihood of a return to performance with any of the biologic treatments. However, MSCs and MSCs administered concurrently with PRP provide a reduced risk of reinjury. CLINICAL RELEVANCE: The current study identified a decrease in reinjury rate in horses administered MSCs or a combination of MSCs and PRP for tendinopathy and desmopathy. However, results should be interpreted with consideration of the heterogeneity of findings, poor study quality, and high risk of bias in the majority of studies.

Effects of tenectomy of the medial head of the deep digital flexor on the hindlimbs of healthy horses / Efeitos da tenectomia da cabeça medial do tendão flexor digital profundo nos membros posterior de cavalos saudáveis

The tenectomy of the medial head of the deep digital flexor (TMHDDF) is a minimally studied surgery used in cases of dorsal subluxation of the proximal interphalangeal joint of the hindlimb in horses. The TMHDDF was evaluated in six healthy horses by the degree of lameness, perimeter of the surgical site, the angle of the distal articular joints, and the linear and angular measures of the hoof. Thus, TMHDDF of the right hindlimb was performed and the contralateral limb was used as a control. Both, right and left limbs were evaluated before surgery, as well as at 15, 30, and 60 days after surgery aiming to evaluate the effects of the surgical procedure in healthy limbs. Data were compared by analysis of variance regarding days and limbs. Values below the significant level (P< 0.05) were analyzed using the Tukey's test. TMHDDF caused a mild increase of the toe length and the height of lateral heel (0.2cm in both), as well as a decrease of the angle of the proximal interphalangeal joint (2°) when comparing the left hindlimb to the right hindlimb, 30 and 60 days after surgery. Overall, TMHDDF did not cause significant changes in the evaluated variables up to the 60 days of surgery.(AU)

A tenectomia da cabeça medial do flexor digital profundo (TCMFDP) é uma técnica cirúrgica pouco estudada, indicada para equinos com subluxação dorsal da articulação interfalângica proximal do membro pélvico. A TCMFDP foi avaliada em seis equinos hígidos no grau de claudicação; na perimetria da área operada; nos ângulos articulares distais; e nas medidas lineares e angulares de parâmetros dos cascos. Nesse sentido, foi realizada a TCMFDP do membro pélvico direito, permanecendo o esquerdo como controle. Ambos os membros foram avaliados nos momentos pré-operatório (0) e 15, 30 e 60 dias após a cirurgia, sendo objetivo avaliar os efeitos do procedimento cirúrgico em membros hígidos. Para comparação dos dados entre momentos e membros, foi realizada análise de variância. Os valores inferiores ao de significância (P<0,050) foram submetidos ao teste de Tukey. A TCMFDP provocou discreto aumento (0,2cm, em ambos) do comprimento de pinça e da altura do talão lateral e redução no ângulo da articulação interfalângica proximal (2°) na comparação com o membro pélvico esquerdo aos 30 e 60 dias após a cirurgia no contralateral. Em geral, a TCMFDP não causou alterações influentes nos aspectos avaliados até 60 dias do experimento.(AU)

Reparación de las lesiones crónicas del manguito rotador mediante diferentes compuestos / Repair of rotator cuff injuries using different composites

Objetivo. La reparación del manguito rotador se acompaña de una elevada tasa de rerrotura. Nuestro objetivo es determinar si el empleo de rhBMP-2 vehiculizada en un transportador híbrido mejora el proceso de reparación en lesiones crónicas del manguito. Material y métodos. Estudio experimental en 62 ratas. A las 4 semanas de la lesión se llevó a cabo una sutura transósea y la asignación aleatoria a uno de los 5 grupos de estudio: 1) grupo control: solo sutura; 2) grupo doble-control: se aplicó además un transportador de alginato-quitina; 3) grupo control-alginato: se añadió rhBMP-2 al alginato; 4) grupo control-quitina: se añadió rhBMP-2 a la quitina, y 5) grupo doble-muestra: se añadió rhBMP-2 a ambos componentes. A los 4 meses se evaluaron los resultados mediante estudios biomecánicos e histológicos. Resultados. En todos los casos se observó una brecha osteotendinosa macroscópicamente a las 4 semanas. La tasa de rerrotura fue del 7,5%, ocurriendo el 20% de ellas en el grupo control-alginato. En la evaluación histológica los mejores resultados se obtuvieron en el grupo doble muestra: 4,5 (3,3-5). La carga máxima soportada fue mayor en el grupo doble muestra 62,9N (59,8-69,4) presentando además una menor rigidez 12,7 (9,7-15,9). Conclusiones. El empleo de la rhBMP-2 vehiculizada en un transportador híbrido de alginato-quitina parece mejorar las características histológicas de la reparación e incrementar las propiedades biomecánicas del tendón en el contexto de una lesión crónica del manguito rotador (AU)

Aim. Rotator cuff repairs have shown a high level of re-ruptures. It is hypothesised that the use of rhBMP-2 in a carrier could improve the biomechanical and histological properties of the repair. Material and methods. Controlled experimental study conducted on 40 rats with section and repair of the supraspinatus tendon and randomisation to one of five groups: Group 1 (control) only suture; Group 2 (double control), suture and alginate-chitin carrier; Group 3 (alginate-control), the rhBMP-2 was added to the alginate; Group 4 (chitin-control) application of the rhBMP-2 to the chitin, and Group 5 (double sample): The two components of the carrier (alginate and chitin) have rhBMP-2. A biomechanical and histological analysis was performed at 4 weeks. Results. A gap was observed in all cases 4 weeks after supraspinatus detachment. The re-rupture rate was 7.5%, with 20% of them in the control-alginate Group. Histologically the best results were obtained in the double sample group: 4.5 (3.3-5.0). Double sample were also able to support higher loads to failure: 62.9N (59.8 to 69.4) with lower rigidity 12.7 (9.7 to 15.9). Conclusions. The use of alginate-chitin carrier with rhBMP-2 improves the biomechanical and histological properties of the repair site in a chronic rotator cuff tear (AU)

Componentes ricos em plaquetas na reparação de afecções tendo-ligamentosas e osteo-articulares em animais: [revisão] / Components rich in platelets used in wound healing tendon, ligaments and osteo-articular diseases of animals: [revision]

O plasma rico em plaquetas e o concentrado de plaquetas são fontes de diversos fatores de crescimento, com grande potencial terapêutico. Uma vez liberados dos grânulos alfa das plaquetas ativadas, esses fatores atuarão no sítio da lesão, estimulando a quimiotaxia, fibroplasia e angiogênese, melhorando assim a reparação tecidual. Embora esses componentes ricos em plaquetas sejam de fácil obtenção e de eficácia comprovada na medicina humana e odontologia, a utilização desses componentes na medicina veterinária é relativamente recente, necessitando ainda de estudos controlados. Neste artigo, os aspectos morfológicos das plaquetas, a ação dos fatores de crescimento e a utilização de componentes ricos em plaquetas na reparação tecidual de estruturas tendo-ligamentosas e osteo-articulares são revisados.

Platelet-rich plasma and platelet concentrates are involved in growing factors. Both have great therapeutic potential. When the alpha-granules are released by the active platelet, they act in the lesion site stimulating the chemotaxis, the fiberplasia and the angiogenesis. They improve the regeneration of the tissue. Although these rich platelet components are easy to obtain and efficiently to prove by medicine and dentistry, their use on vet medicine is recent. So, much more control studies need to be done. This article reviews morphological aspects of platelets, action of growing factors and use of components rich in platelet in wound healing tendons, ligaments and osteo-articular structures.

Tenoplastia experimental do calcâneo em cäes com peritônio bovino conservado em glicerina / Experimental calcaneal tenoplasty in dogs with bovine peritoneum conserved in glycerol

No presente estudo, avaliou-se a eficácia do emprego do peritônio bovino, conservado em glicerina a 98 por cento, no reparo de lesöes induzidas no tendäo calcâneo (TC) de cäes, quando um fragmento de aproximadamente 1cm do TC foi excisado e o espaço resultante preenchido por um fragmento de peritônio. Foram utilizados 21 cäes, pesando entre 10 e 15kg, divididos em 7 grupos de 3, sacrificados aos 02, 07, 15, 30, 60, 90 e 120 dias de pós-operatório. Analisaram-se os aspectos clínico-cirúrgicos referentes à recuperaçäo funcional motora, bem como, a integraçäo do peritônio com o tecido tendíneo mediante avaliaçäo macroscópica, por microscopia óptica e por microscopia eletrônica de varredura. Clinicamente, verificou-se que, por volta do 55§ dia de pós-operatório, os animais já apresentavam deambulaçäo normal e que o "neotendäo" apresentou resistência suficiente para suportar o estresse normalmente aplicado ao TC. Microscopicamente, o peritônio implantado esteve presente em todos os períodos de observaçäo. Proliferaçäo fibroblástica e neoformaçäo vascular foram observadas de forma incipiente no segundo dia; entretanto, no sétimo dia de pós-operatório, esta condiçäo foi exacerbada. Com a evoluçäo, as fibras de peritônio tendiam a se dissociar, entrando em estreita associaçäo com fibras conjuntivas, fibroblastos e colágeno. Aos 30, 60, 90, e 120 dias de pós-operatório, notava-se maior presença de colágeno que se tornava cada vez mais organizado. Conclui-se que o peritônio estimulou uma rápida deposiçäo de tecido conjuntivo com mínima reaçäo inflamatória, sendo incorporado ao tecido cicatricial e servindo como alicerce para o desenvolvimento de um novo tecido, restabelecendo assim a estrutura do tendäo.