Regenerative Medicine Hastens Healing of Stifle Injuries

Regenerative Medicine Hastens Healing of Stifle InjuriesStifle radiograph showing an osteophyte (bone spur) that has formed on the medial tibial condyle.

Photo: Courtesy Dr. Ross Rich

The news post-lameness exam from the veterinarian isn’t good: Your sport horse has injured his stifle. Not only do these injuries tend to have long recovery times, they often don’t respond well to traditional treatment modalities.

Veterinarians are evaluating a new cutting-edge treatment, however, to solve the stifle problem: regenerative medicine. At the 2015 American Association of Equine Practitioners’ Convention, held Dec. 5-9 in Las Vegas, F. Ross Rich, DVM, PA-C, who owns Cave Creek Equine Surgical and Diagnostic Imaging Center, in Phoenix, Arizona, presented the results of his study on the topic.

This is the first study evaluating the effects of adipose-derive regenerative cells (ADRC) and interleuken-1 receptor antagonist protein (IRAP) on stifle joint injuries, he said.

The team examined the medical records of 98 horses (for a total of 189 stifles) diagnosed with stifle injuries or abnormalities, the most common of which was abnormal articular cartilage in 97% of horses. The horses received the following treatments:

  • Group 1—21 horses received intra-articular (in the joint) ADRC and IRAP injections;
  • Group 2—38 horses underwent stifle arthroscopy in addition to ADRC and IRAP injections; and
  • Group 3—39 horses only had stifle arthroscopy performed.

Following treatment, all horses followed a standardized six-month rehabilitation program, which included hand-walking, swimming, and more. Horses that returned to full work, and remained in normal competition for at least one year at their previous or higher level, without recurrence were considered successes, Rich said.

The researchers also characterized the horses’ articular cartilage lesions as mild, moderate, or severe.

The team found that:

  • Horses ranged in age from 1 to 17 years and included a variety of breeds and disciplines;
  • In Group 1, no horses had mild lesions, 20 had moderate lesions, and one had severe lesions;
  • One horse in Group 2 had mild lesions, 20 had moderate lesions, and 17 had severe lesions;
  • None of the Group 3 horses had mild lesions, 14 had moderate ones, and 25 had severe lesions;
  • 57% of horses had multiple abnormalities of their stifles;
  • Success rates were similar between the groups: 67%, 68%, and 59% for Groups 1, 2, and 3, respectively; and
  • Horses in Group 1 and Group 2 healed significantly faster than those in Group 3; “Many of the Group 3 horses were still in rehab and hand walking when the Group 1 and 2 horses had already been back to full work and competition for at least a year,” Rich said.
Treatment with regenerative therapy and arthroscopy (seen here) or regenerative therapy alone accelerated the horses’ healing time—eight-and-a-half months faster, on average, in this study—as compared with arthroscopy alone.

Photo: Courtesy Dr. Ross Rich

The team identified several factors that negatively impacted success and healing time, he added. A lack of compliance for rehabilitation, more severe lameness on presentation, more severe cartilage damage, and previous intra-articular corticosteroid treatment affected a horse’s chances for success, as did being a barrel racer. Factors that impacted healing time included abnormal radiographs and more severe abnormalities identified on MRI.

The team determined that treatment with regenerative therapy and arthroscopy or regenerative therapy alone accelerated the horses’ healing time—eight-and-a-half months faster, on average, in this study—as compared with arthroscopy alone.

The researchers also kept tabs on how their patients fared in the long run, a step that’s important in determining treatment efficacy, Rich said.

“When evaluating studies like this, it is important to evaluate the study findings using long-term follow-up, instead of short-term follow-up,” he explained. “Many horses with many types of orthopedic problems can become sound short-term following a specific treatment, but then become lame again very quickly because of the original injury. If the study only follows the horses for a short time period after returning to regular work and competition, incorrect assumptions may be made regarding the success rates of the treatment being evaluated. We used a very stringent long-term follow-up for every one of the horses in this study; some were followed for more than nine years following treatment, with no recurrent stifle problems.”

When it comes to selecting which option to use on your horse, Rich noted that regenerative therapy costs about the same as surgery. If you elect to use both surgery and regenerative therapy, the cost will approximately double. But it might worth it in the long run, he said.

“A big advantage to using both treatments is that the horse athlete can return to competition so much faster than they would otherwise and has the potential to remain in competition years longer than they otherwise would have, without requiring ongoing joint treatments such as corticosteroids,” he explained. “If we can get them back to work eight-and-a-half months faster than normal without jeopardizing their long-term athletic careers, that is a huge benefit to the owner, rider, trainer, and the animal. The cost of board, maintenance of the horse, and the loss of show or race winnings during those eight-and-a-half months of extra rehab time without regenerative therapy, is often far more than the cost of the regenerative therapy; and there is a much earlier return to their normal athletic endeavors.”

Rich noted that, while there aren’t necessarily any instances in which veterinarians should avoid using regenerative medicine, it might not help treat badly damaged joints.

“Once you have a joint that has severe osteoarthritis, and the joint is now ‘bone-on-bone’ (i.e., most of the joint cartilage has completely deteriorated), it is unlikely that regenerative therapy would be able to repair that much damage,” he explained. “Regenerative therapies can provide some sustained pain relief in joints like this though.”

Ultimately, Rich encouraged attendees to recommend ADRCs and IRAP to clients with horses dealing with stifle lamenesses. “I would discourage repeat intra-articular corticosteroid injections of the stifle,” he added, “since corticosteroids demonstrated a significant negative effect on long-term success rates and athletic longevity in this study.”

About the Author

Erica Larson, News Editor

Erica Larson, News Editor, holds a degree in journalism with an external specialty in equine science from Michigan State University in East Lansing. A Massachusetts native, she grew up in the saddle and has dabbled in a variety of disciplines including foxhunting, saddle seat, and mounted games. Currently, Erica competes in three-day eventing with her OTTB, Dorado, and enjoys photography in her spare time.

Santa Anita Daily Results and Activity

Results

Thursday, February 4
Race# Race Type Purse
Race 1 Maiden Special Weight $56,000 Overnight Overnight Overnight
Race 2 Maiden Claiming – $30,000 $23,000 Overnight Overnight Overnight
Race 3 Starter Allowance – $40,000 $30,000 Overnight Overnight Overnight
Race 4 Claiming – $12,500 $16,000 Overnight Overnight Overnight
Race 5 Claiming – $12,500 $16,000 Overnight Overnight Overnight
Race 6 Allowance Optional Claiming – $40,000 $58,000 Overnight Overnight Overnight
Race 7 Allowance Optional Claiming – $80,000 $58,000 Overnight Overnight Overnight
Race 8 Maiden Claiming – $20,000 $19,000 Overnight Overnight Overnight



Early Entries

Saturday, February 6 Overnight
Race# Race Type Purse
Race 1 Starter Optional Claiming – $40,000 $30,000
Race 2 Maiden Claiming – $30,000 $23,000
Race 3 Maiden Special Weight $56,000
Race 4 Robert B. Lewis S. $150,000
Race 5 Las Virgenes S. $300,000
Race 6 Allowance Optional Claiming – $40,000 $58,000
Race 7 San Antonio S. $500,000
Race 8 San Marcos S. $200,000
Race 9 Maiden Special Weight $56,000
Sunday, February 7 Overnight
Race# Race Type Purse
Race 1 Maiden Special Weight $56,000
Race 2 Claiming – $20,000 $26,000
Race 3 Maiden Special Weight $56,000
Race 4 Claiming – $50,000 $45,000
Race 5 Starter Handicap – $25,000 $40,000
Race 6 Palos Verdes S. $200,000
Race 7 Allowance Optional Claiming – $62,500 $60,000
Race 8 Maiden Claiming – $20,000 $19,000

Final Entries

Friday, February 5
Race# Race Type Purse
Race 1 Maiden Claiming – $30,000 $23,000
Race 2 Claiming – $16,000 $23,000
Race 3 Maiden Special Weight $56,000
Race 4 Allowance Optional Claiming – $62,500 $60,000
Race 5 Allowance Optional Claiming – $62,500 $60,000
Race 6 Claiming – $16,000 $20,000
Race 7 Allowance Optional Claiming – $80,000 $58,000
Race 8 Claiming – $10,000 $19,000

Portland Meadows Daily Results and Activity

Early Entries

Monday, February 8 Overnight
Race# Race Type Purse
Race 1 Maiden $3,800
Race 2 Claiming – $5,000 $5,000
Race 3 Portland Meadows Championship Bonus Challenge S. $20,400
Race 4 Sta-Sound Battle Of The Breeds H. $6,500
Race 5 Claiming – $2,000 $5,100
Race 6 Maiden Special Weight $6,400
Race 7 Claiming – $2,500 $5,400
Race 8 Claiming – $3,200 $5,000
Race 9 Claiming – $2,500 $5,100
Race 10 National Racing Club 6 Auction Sweepstakes 1 S. $3,000
Race 11 National Racing Club 6 Auction Sweepstakes 2 S. $3,000
Race 12 National Racing Club 6 Auction Sweepstakes 3 S. $3,000
Race 13 National Racing Club 6 Auction Sweepstakes 4 S. $3,000
Race 14 National Racing Club 6 Auction Sweepstakes 5 S. $3,000

RAILBIRD NOTES

RAILBIRD NOTES BY GLEN TODD

RAILBIRD NOTES BY GLEN TODD

HASTINGS OPENED FOR TRAINING YESTERDAY MORNING

Hastings Racecourse opened the track on Wednesday morning as horses and trainers start preparations for Opening Day on April 17th.

One of our newsletter photographers Patti Tubbs was out early and caught a few horses on the track..

Barn area appears busy as horses head to track on Wednesday morning at Hastings Racecourse the first day of spring  training - Patti Tubbs Photo

Barn area appears busy as horses head to track on Wednesday morning at Hastings Racecourse the first day of spring training – Patti Tubbs Photo

The horsemen’s associations have been very busy in the off-season and have re-allocated some of their funding to raise purses in some areas.  Listed below is the 2016 purse schedule.

Marathon Seriies   Purse BC Bred
       
Marathon #1   $16,000 $16,000
Marathon #2   $18,000 $18,000
Marathon #3   $20,000 $20,000
CATEGORY ALW Purse BC Bred
Alw/NW/$30000 C&G/Opt $50K ALW $27,000 $27,000
Alw/NW/$30000 F&M/Opt $50K ALW $27,000 $27,000
Claiming C& G/ Opt/$35,000 $35,000 $25,000 $25,000
Claiming F&M/Opt/$35,000 $35,000 $25,000 $25,000
Alw/NW2/BC3/opt $25000 ( 3 & up C&G) ALW $25,000 $25,000
Alw/NW2/BC3/opt $25000 ( 3 & up F&M) ALW $25,000 $25,000
ALW/nw/2/3 Opt $25000 (3 YR OLDS C&G) ALW $25,000 $25,000
ALW/nw/2/3 Opt $25,000   (3 YR OLDS Filies) ALW $25,000 $25,000
 
CATEGORY Claim $ Purse BC Bred
Claiming C& G $25,000 $18,000 $22,500
Claiming F&M $25,000 $18,000 $22,500
Claiming C&G $16,000 $14,000 $17,500
Claiming F&M $16,000 $14,000 $17,500
Claiming NW2/BC3 C&G $16,000 $12,000 $15,000
Claiming NW2/BC3 F&M $16,000 $12,000 $15,000
Claiming C&G $12,500 $13,000 $16,250
Claiming F&M $12,500 $13,000 $16,250
Championship Series C&G Alw/S $16,000 $16,000
Championship Series F&M Alw/S $16,000 $16,000
Claiming C&G $8,000 $12,000 $15,000
Claiming F&M $8,000 $12,000 $15,000
Claiming NW2/BC3 $8,000 $11,000 $13,750
Claiming NW2/BC3 $8,000 $11,000 $13,750
Claiming C&G $6,250 $11,000 $13,750
Claiming F&M $6,250 $11,000 $13,750
Claiming NW1-60days C&G $5,000 $10,000 $12,500
Claiming NW1-60days F&M $5,000 $10,000 $12,500
Claiming NW/2013/NW2/NW3NW/4 C &G $4,000 $11,000 $13,750
Claiming NW/2013/NW2/NW3/NW4 F&M $4,000 $11,000 $13,750
   
Maiden Races Only Claim $ Purse BC Bred
MDN – C&G MSW $25,000 $25,000
MDN- F&M MSW $25,000 $25,000
MDN – 2 yr C&G MSW $25,000 $25,000
MDN- 2 yr F&M MSW $25,000 $25,000
Mdn 2 yr olds 3/12 * MSW $18,000 $18,000
   
Maiden Races Only Claim $ Purse BC Bred
MDN   C&G $35,000 $18,000 $22,500
MDN   F&M $35,000 $18,000 $22,500
Mdn 2 yr olds 3/12 * $35,000 $15,000 $18,750
Mdn 2 yr olds 3/12 * $35,000 $13,000 $16,250
MDN   C & G $25,000 $16,000 $20,000
MDN   F&M $25,000 $16,000 $20,000
Mdn 2 yr olds 3/12 * $25,000 $12,500 $15,625
Mdn 2 yr olds 3/12 * $25,000 $12,500 $15,625
MDN   C & G $16,000 $13,000 $16,250
MDN   F&M $16,000 $13,000 $16,250
Mdn 2 yr olds 3/12 * $16,000 $11,000 $13,750
Mdn 2 yr olds 3/12 * $16,000 $11,000 $13,750
MDN C&G $12,500 $12,000 $15,000
MDN F&M $12,500 $12,000 $15,000
Mdn 2 yr olds 3/12 * $12,500 $10,000 $12,500
MDN C&G $8,000 $11,000 $13,750
MDN F&M $8,000 $11,000 $13,750
Mdn 2 yr olds 3/12 * $8,000 $11,000 $13,750
MDN C&G $4,000 $11,000 $11,000
MDN F&M $4,000 $11,000 $11,000
Exercise rider Robbie Henson out on the track on Wednesday morning - Patti Tubbs Photo

Exercise rider Robbie Henson out on the track on Wednesday morning aboard one of the horses from the Steve Henson Stable – Patti Tubbs Photo

MARKETING VIDEO

Earlier this week Mary Margaret Bentley from BCHRIMC, Richard Yates from the HBPA and Mike Heads from BCTOBA were out in the valley interviewing and filming owners and trainers as they are producing a Video to lure new owners to our great sport.

From what I witnessed it appeared they are producing a very first class production and it will be interesting to see the final production.

Speaking with Mike Heads on Wednesday morning, Mike said he was very impressed with the production company and Mary Margaret Bentley form the marketing end of the British Columbia Horse Racing Management Committee and she really know hers stuff when it comes to marketing and production. Heads also said it will be a very well done production.

HASTINGS TWO YEAR OLDS IN TRAINING AND HORSE OF RACING AGE SALE

The racing associations along with Hastings Racecourse are holding a Paddock Sale on March 26 at Hastings Racecourse.

Mike Heads has been appointed the sale manager and he is now accepting applications for the sale.  The sale has a website up and running and it can be found at www.hastingshorsesale.com.

For those interested in entering a horse in sale, you can apply online or by printing the application and forwarding it to sale office.

There is already 11 horses entered and they can been found on the website and according to Heads he has several owners and breeders in the process of entering more horses.

The associations are hoping for 25 to 30 horses to be entered.  There will be a preview day on Saturday, March 19th were horses can be seen under tack on the track and its hoped several of them will record workout times.

Hastings-Horse-Sale-2016-TV

QUOTE OF THE DAY

Good, better, best. Never let it rest. 'Til your good is better and your better is best. - St. Jerome

Santa Anita Daily Results and Activity

Early Entries

Friday, February 5 Overnight
Race# Race Type Purse
Race 1 Maiden Claiming – $30,000 $23,000
Race 2 Claiming – $16,000 $23,000
Race 3 Maiden Special Weight $56,000
Race 4 Allowance Optional Claiming – $62,500 $60,000
Race 5 Allowance Optional Claiming – $62,500 $60,000
Race 6 Claiming – $16,000 $20,000
Race 7 Allowance Optional Claiming – $80,000 $58,000
Race 8 Claiming – $10,000 $19,000
Saturday, February 6 Overnight
Race# Race Type Purse
Race 1 Starter Optional Claiming – $40,000 $30,000
Race 2 Maiden Claiming – $30,000 $23,000
Race 3 Maiden Special Weight $56,000
Race 4 Robert B. Lewis S. $150,000
Race 5 Las Virgenes S. $300,000
Race 6 Allowance Optional Claiming – $40,000 $58,000
Race 7 San Antonio S. $500,000
Race 8 San Marcos S. $200,000
Race 9 Maiden Special Weight $56,000

Final Entries

Thursday, February 4
Race# Race Type Purse
Race 1 Maiden Special Weight $56,000
Race 2 Maiden Claiming – $30,000 $23,000
Race 3 Starter Allowance – $40,000 $30,000
Race 4 Claiming – $12,500 $16,000
Race 5 Claiming – $12,500 $16,000
Race 6 Allowance Optional Claiming – $40,000 $58,000
Race 7 Allowance Optional Claiming – $80,000 $58,000
Race 8 Maiden Claiming – $20,000 $19,000

MARIO WATCH

Eclipse Award Winner and Kentucky Derby Winterbook favorite Nyquist with Mario Guiterrez aboard /Benoit Photo

Eclipse Award Winner and Kentucky Derby Winterbook favorite Nyquist with Mario Guiterrez aboard /Benoit Photo

Mario Gutierrez
Entries
February 4 – Santa Anita
Proud Captive Wgt-124 Race 5 Claiming $12,500
Semper Fortis Wgt-122 Race 7 Allowance Optional Claiming $80,000
February 5 – Santa Anita
Calm the Sea Wgt-123 Race 3 Maiden Special Weight
Highway Boss Wgt-120 Race 5 Allowance Optional Claiming $62,500
Aventador (FR) Wgt-124 Race 6 Claiming $16,000
February 6 – Santa Anita
Courageous Dave Wgt-121 Race 1 Starter Optional Claiming $40,000
C W Road Wgt-123 Race 3 Maiden Special Weight
Georgia Blue Wgt-123 Race 3 Maiden Special Weight
Land Over Sea Wgt-118 Race 5 Las Virgenes S.
Pernicious Wgt-120 Race 6 Allowance Optional Claiming $40,000
Donworth Wgt-119 Race 7 San Antonio S.
Gaga A (URU) Wgt-114 Race 8 San Marcos S.
Giant Expectations Wgt-123 Race 9 Maiden Special Weight

Turf Paradise Daily Results and Activity

Results

Wednesday, February 3
Race# Race Type Purse
Race 1 Maiden Optional Claiming – $30,000 $12,500 Overnight Overnight Overnight
Race 2 Claiming – $3,000 $7,000 Overnight Overnight Overnight
Race 3 Claiming – $6,250 $9,000 Overnight Overnight Overnight
Race 4 Claiming – $10,000 $8,500 Overnight Overnight Overnight
Race 5 Claiming – $3,000 $7,000 Overnight Overnight Overnight
Race 6 Claiming – $3,500 $7,100 Overnight Overnight Overnight
Race 7 Allowance Optional Claiming – $20,000 $17,500 Overnight Overnight Overnight
Race 8 Claiming – $3,000 $7,000 Overnight Overnight Overnight



Early Entries

Monday, February 8 Overnight
Race# Race Type Purse
Race 1 Claiming – $8,500 $8,500
Race 2 Claiming – $3,000 $7,000
Race 3 Allowance $14,000
Race 4 Maiden Claiming – $5,000 $6,300
Race 5 Claiming – $3,000 $7,000
Race 6 Claiming – $3,000 $7,000
Race 7 Claiming – $6,250 $9,000
Race 8 Claiming – $3,500 $7,000

Workouts


Stakes Nominations and Handicap Weights Posted Today

Race Date Stakes Name Nominations Handicap Weights
02/13/2016
Phoenix Gold Cup H.
Overnight
02/13/2016
Turf Paradise H.
Overnight
02/13/2016
Sun City H.
Overnight