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Harnessing the stem cell for the treatment of tendon injuries: heralding a new dawn?
  1. R K W Smith1,
  2. P M Webbon2
  1. 1Department of Veterinary Clinical Sciences, The Royal Veterinary College, University of London, Hatfield, Herts AL9 7TA, UK
  2. 2The Jockey Club, 151 Shaftesbury Avenue, London WC2H 8AL, UK
  1. Correspondence to:
 Professor Smith
 Department of Veterinary Clinical Sciences, The Royal Veterinary College, University of London, Hatfield, Herts AL9 7TA, UK; rksmithrvc.ac.uk

https://doi.org/10.1136/bjsm.2005.015834

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    Stem cell technology may be useful in the treatment of tendon and ligament injuries

    Strain induced tendon or ligament injuries are an all too common consequence of athletic endeavour in both horses1 and humans,2–4 resulting in high morbidity and often compromising a return to the same level of activity.

    In the horse, the most commonly injured structures are the weight bearing digital flexor tendons which lie on the palmar aspect of the metacarpus (fig 1). There are many similarities between the weight bearing tendons of the horse and the human athlete—for example, Achilles tendon—in function, matrix composition, and the nature of the injuries sustained. In contrast with positional tendons, such as the hand tendons, all weight bearing tendons function as springs, storing energy under weight bearing load for efficient locomotion.5 The horse has maximised this potential, resulting in efficiency of locomotion in excess of 100% at the gallop.6

    Figure 1

     Equine superficial digital flexor tendinopathy. (A) The clinical appearance of the injury in the acute stages. The tendon, which lies on the most superficial aspect (immediately deep to the skin) of the palmar surface of the limb, becomes swollen, hot, and painful. This results in a curved, rather than the normally straight, contour to the back of the limb, hence, the colloquial term for the injury “a bowed leg”. MCP, metacarpophalangeal. (B) A transverse ultrasonograph from the mid-metacarpal region of a case similar to that shown in (A). Note the central hypoechoic region within the superficial digital flexor tendon characteristic of this injury. (C) Pathological sections of a corresponding injury, showing the preferential area of injury in the centre of the extra-thecal (mid-metacarpal) region of the tendon. Interestingly the area of the tendon “impinged” on the back of the metacarpophalangeal joint where the tendon changes direction and …

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    Footnotes

    • Competing interests: RKWS is a director of VetCell Bioscience Ltd.