This is a 12 yr Quarter Horse gelding. He sustained an injury in the pasture and came in the barn 3-legged lame. Radiographs showed no fractures and there was a significant swelling around the hind right fetlock. Ultrasound showed a very large core lesion to the deep digital flexor tendon with multiple peripheral tears coursing from above the fetlock to below. This kind of injury frequently results in the loss of any athletic use in the horse and is notoriously difficult to treat. Options for treatment range from a year of stall rest to PRP to stem cells. The owner, in this case, elected bone marrow derived stem cells for treatment of the injury. Over several months, this horse received 3 injections of stem cells. 2 of the injections were directly in the lesion above and below the fetlock, using an ultrasound guided needle. The 3rd treatment was a regional limb perfusion of the cells in the distal limb. Here are ultrasound images of the tendon at the beginning of treatment and then after 6 months. At the time of the follow up ultrasound, the horse is sound at a trot with minimal effusion of the tendon sheath.
After 6 months: the core lesion has greatly reduced and the peripheral tears are not evident. The picture on the left shows an off-axis image allowing us to see the tissue that is filling into the remaining hole. The healing tissue is represented by the brighter white. The picture on the right is a normal orientation image showing how much smaller the remaining damage is compared to before treatment.
This is the horse working at 18 months post-injury. He had a core lesion to the deep digital flexor tendon extending both above and below the fetlock of the left hind with multiple peripheral tears. A majority of horses with this type of injury will never reach athletic ability again using standard therapies. Even with stem cells, there is a significant number of them that do not return. This was a great success story and the horse will return to full competition this fall.