Springtime, there’s no more appropriate season to talk regenerative therapy. Regenerative therapy is, by definition, an attempt to re-create and revive. In this context, it’s a revival of joint function and integrity that we’re after. Osteoarthritis is the leading cause of lameness in the horse and attempts to stop it, fix it and manage it have been an integral part of veterinary (and human) medicine since healing became an art form (ie. forever). Springtime is also a season of preparation for you who are planning to ride, slide, jump, drive or otherwise compete your equine athletes during the summer months. It’s time to gear up from winter's lower intensity training to building a fitness base to meet the challenges of our active equine summer.
WHAT IS REGENERATIVE MEDICINE?
The goal of regenerative medicine is to aid the healing of damaged tissues in a way that mimics the original structure as closely as possible (organized healing) while improving and preserving tissue function (range of motion, elasticity, strength and resilience). Creating autologous (cells or tissues obtained from the patient) therapies is also currently in the forefront of the healing arts and it is the focus of three new-ish regenerative / anti-inflammatory therapies presented “in a nutshell” below.
; Platelet Rich Plasma
Platelets are some of the body’s “first responders” to injury. They help to coagulate blood, reduce inflammation and aid the healing process. Plasma with concentrated amounts of platelets (platelet rich) is obtained by centrifugation and filtering of whole blood to remove cell components (RBC,WBCs). PRP is then injected into or around the lesion such as a tendon injury.
; stands for; Interleukin-1 Receptor Antagonist Protein
Joint injection with IRAP is an anti-inflammatory therapy which capitalizes on the body’s natural response to block inflammation mediated by interleukin proteins. The antagonist protein, IRAP, competes for receptor sites, thereby blocking the activity of interleukins. IRAP is produced from the recipients blood. White blood cells collected via venipuncture are incubated with glass beads which amplify natural interleukin antagonist protein production. After centrifugation and filtering the concentrated IRAP is injected back into the patient. Usually the injection is made into an inflamed joint. This is an anti-inflammatory treatment rather than a regenerative therapy. It does not treat the underlying cause of the inflammation.
; concentrated autologous protein
Pro Stride is another iteration of autologous treatment products that has proven to be on par with, or better than corticosteroids for the treatment of joint inflammation. Not just anti-inflammatory, this is a truly regenerative approach to healing. Pro-Stride is an Autologous Protein Solution (APS) containing a high concentration of cells, platelets, growth factors, and anti-inflammatory proteins to treat inflammatory processes in joints. You might think of it as a combination of PRP and IRAP. It is also produced from the patient's own blood, centrifuged, filtered and concentrated prior to injection into affected joint(s). The process takes 20-30 minutes and can all be completed on site in one visit.
Rocky Bay Equine now offers Pro Stride therapy to clients for horses that might benefit from anti-inflammatory joint therapy.
Regenerative and autologous therapies are all the rage for a lot of good reasons. They may effectively replace current, proven treatments, like corticosteroid injection, that also create potentially significant side effects. These regenerative treatments are relatively easy to administer and appear to have a low incidence of adverse reactions or long term side effects. Being the “new kids on the block”, what we don’t know for sure yet is how well they work in comparison to more proven therapies. Optimal protocols for administration have yet to be developed. There are few organized research reports of efficacy and no comparison studies yet in the equine veterinary literature. It is an evolving area of medicine that will no doubt change as more horses are treated and more scientific studies are undertaken. The exciting part is the potential to deliver real, regenerative healing in early cases of osteoarthritis rather than settle for treatments that just slow inevitable joint deterioration.
With it's relative ease of administration and low incidence of side effects, we expect to see much more research, both scientific and anecdotal, come out about the efficacy of autologous protein treatments (ProStride). We are happy to be on the forefront in offering such an optimistic treatment modality for a disease process that is such a widespread "occupational hazard" for athletes of all disciplines. Contact Rocky Bay Equine to discuss management options for your equine athlete today. (253 858-4529)
For the science nerds among us, here is a video with more details about the Pro Stride formulation...
How Pro Stride Works