Laboratory of Preclinical and Surgical Studies, Research Institute Codivilla-Putti, Rizzoli Orthopaedic Institute, Via di Barbiano 1/10, 40136, Bologna, Italy.
Int Orthop. 2011 Oct;35(10):1569-76. doi: 10.1007/s00264-011-1237-3. Epub 2011 Mar 11.
Tissue repair in musculoskeletal injuries is often a slow and sometimes incomplete process. Regenerative medicine based on the use of growth factors (GFs) and cell therapy is aimed at improving the quality and speed of tendon and ligament healing. The aim of this study was to evaluate the potential for the administration of a combination of autologous platelet-rich plasma (PRP) and freshly isolated bone marrow mononucleated cells (BMMNCs) in 13 competition horses affected by overuse musculoskeletal injuries (suspensory ligament desmopathy and superficial flexor tendinopathy) and refractory to other therapies.
After ultrasonographic localisation of the lesion, the autologous BMMNC suspension and PRP were injected directly into the core lesion. BMMNC and platelet count as well as growth factors in PRP were measured to determine factors influencing the clinical outcome.
Horses showed a marked improvement in their degree of lameness and 84.6% were able to return to competition. Among all the factors studied, the platelet concentration predicted the healing time: significantly faster recovery (p = 0.049) was observed in cases of PRP with more than 750 × 10(3)/μl platelets.
Competition horses are involved in highly demanding activities, thus being a similar model for the high mechanical overload typical of human athletes. The promising results obtained suggest that this combined biological approach may be useful even for the treatment of recalcitrant overuse musculoskeletal injuries in highly demanding patients if the appropriate dose of cells and GFs is applied.
肌肉骨骼损伤的组织修复通常是一个缓慢的过程，有时甚至是不完全的。基于生长因子（GFs）和细胞治疗的再生医学旨在提高肌腱和韧带愈合的质量和速度。本研究旨在评估在 13 匹因过度使用肌肉骨骼损伤（悬韧带病和浅表屈肌腱病）而受到影响且对其他治疗方法无反应的竞技马中，联合应用自体富血小板血浆（PRP）和新鲜分离的骨髓单核细胞（BMMNC）的潜力。
在超声定位病变后，将自体 BMMNC 混悬液和 PRP 直接注入核心病变部位。测量 BMMNC 和血小板计数以及 PRP 中的生长因子，以确定影响临床结果的因素。
马匹的跛行程度明显改善，84.6%的马匹能够重返比赛。在所有研究的因素中，血小板浓度预测了愈合时间：PRP 中的血小板超过 750×10(3)/μl 时，恢复明显更快（p=0.049）。
竞技马参与高要求的活动，因此与人类运动员典型的高机械过载相似。如果应用适当剂量的细胞和 GFs，这种联合的生物方法对于治疗高要求患者的顽固性过度使用肌肉骨骼损伤可能是有用的。
