1
|
Guo L, Tahir AM, Hore M, Collins A, Rideout A, Wang ZJ. A multi-task learning model for clinically interpretable sesamoiditis grading. Comput Biol Med 2024; 182:109179. [PMID: 39326263 DOI: 10.1016/j.compbiomed.2024.109179] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2024] [Revised: 08/26/2024] [Accepted: 09/18/2024] [Indexed: 09/28/2024]
Abstract
Sesamoiditis is a common equine disease with varying severity, leading to increased injury risks and performance degradation in horses. Accurate grading of sesamoiditis is crucial for effective treatment. Although deep learning-based approaches for grading sesamoiditis show promise, they remain underexplored and often lack clinical interpretability. To address this issue, we propose a novel, clinically interpretable multi-task learning model that integrates clinical knowledge with machine learning. The proposed model employs a dual-branch decoder to simultaneously perform sesamoiditis grading and vascular channel segmentation. Feature fusion is utilized to transfer knowledge between these tasks, enabling the identification of subtle radiographic variations. Additionally, our model generates a diagnostic report that, along with the vascular channel mask, serves as an explanation of the model's grading decisions, thereby increasing the transparency of the decision-making process. We validate our model on two datasets, demonstrating its superior performance compared to state-of-the-art models in terms of accuracy and generalization. This study provides a foundational framework for the interpretable grading of similar diseases.
Collapse
Affiliation(s)
- Li Guo
- Department of Electrical and Computer Engineering, University of British Columbia, Canada.
| | - Anas M Tahir
- Department of Electrical and Computer Engineering, University of British Columbia, Canada
| | - Michael Hore
- Hagyard Equine Medical Institute, Lexington, KY, United States
| | | | - Andrew Rideout
- Point to Point Research Development, British Columbia, Canada
| | - Z Jane Wang
- Department of Electrical and Computer Engineering, University of British Columbia, Canada
| |
Collapse
|
2
|
Carmona JU, Carmona-Ramírez LH, López C. Platelet-Rich Plasma and Related Orthobiologics for the Treatment of Equine Musculoskeletal Disorders-A Bibliometric Analysis from 2000 to 2024. Vet Sci 2024; 11:385. [PMID: 39195839 PMCID: PMC11359792 DOI: 10.3390/vetsci11080385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2024] [Revised: 08/20/2024] [Accepted: 08/20/2024] [Indexed: 08/29/2024] Open
Abstract
(1) Background: There is increasing interest in the use of platelet-rich plasma and related orthobiologics for the treatment of chronic musculoskeletal disorders in horses; however, there is no information on the bibliometric impact of the literature published in this area. (2) Methods: A bibliometric analysis was performed using the bibliometrix R package by analyzing the documents registered in the WOS and Scopus databases from 2000 to 2024. The included registers were evaluated according to the menu of results from the biblioshiny web app (overview, sources, authors, documents, words, trending topics, clustering, conceptual structure, and social structure). (3) Conclusions: The documents produced were mainly published in Frontiers in Veterinary Science, Journal of Equine Veterinary Science, BMC Veterinary Research, and the American Journal of Veterinary Research). The most productive institutions were Universidad de Caldas, Colorado State University, University of California-Davis, and University of Leipzig, and the most productive countries were the USA, Brazil, and Colombia. Horse, platelet-rich plasma, equine, osteoarthritis, and autologous conditioned serum were the most frequently used keywords. The trending topics in this area are platelet lysates and orthobiologics. The collaboration network of authors, institutions, and countries shows an isolated development of individual author networks with modest collaboration between institutions and countries.
Collapse
Affiliation(s)
- Jorge U. Carmona
- Grupo de Investigación Terapia Regenerativa, Departamento de Salud Animal, Universidad de Caldas, Manizales 170004, Colombia
| | - Luis H. Carmona-Ramírez
- Grupo de Investigación EFE, Facultad de Educación, Universidad Católica de Manizales, Manizales 170004, Colombia;
| | - Catalina López
- Grupo de Investigación Patología Clínica Veterinaria, Departamento de Salud Animal, Universidad de Caldas, Manizales 170004, Colombia;
| |
Collapse
|
3
|
Peat FJ, Kawcak CE, McIlwraith CW, Berk JT, Keenan DP, Selberg KT, Ojeda A. Ultrasonography of the suspensory ligament branches in yearling and 2-year-old Thoroughbred sales horses: Prevalence, progression of findings and associations with racing performance. Equine Vet J 2024. [PMID: 39007207 DOI: 10.1111/evj.14137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2024] [Accepted: 06/21/2024] [Indexed: 07/16/2024]
Abstract
BACKGROUND Equine suspensory ligament branch (branch) ultrasonography is becoming increasingly commonplace presale. No ultrasonographical branch reference data exists for Thoroughbred sales horses. OBJECTIVES To define the prevalence of ultrasonographical findings in the forelimb suspensory branches of yearling and 2-year-old sales Thoroughbreds and to analyse associations with racing performance. To track changes in branch findings between 1 and 2 years of age in horses that present for sale at both ages. STUDY DESIGN Prospective cohort study using an enrolled sample. METHODS Horses were enrolled from a 2016 yearling sale and five 2017 2-year-old sales with consignor permission. Ultrasonography was performed immediately prior to the sales. Ultrasonographical findings relating to branch size, fibrillar pattern, the presence of hyperechoic foci, periligamentar tissue thickness and the adjacent proximal sesamoid bone surface were examined. Associations with racing performance from 2 to 4 years of age were investigated using multivariate regression analyses. Clinical follow-up was sought to ascertain why horses that did not race never started. RESULTS A total of 593 sales yearlings and 367 2-year-olds had forelimb branch ultrasonography performed. Grade ≥2 fibrillar branch change was present in 8.9% of yearlings and 14.4% of 2-year-olds. A 0.25 cm increase in branch width was associated with a 49-day delayed start to racing careers (P < 0.001, 95% confidence interval (95% CI): 21-77 days). The presence of grade 2 hyperechoic foci was associated with significantly lower total earnings (P = 0.01, 95% CI: $2000-$16 022) and lower earnings per start (P = 0.003, 95% CI: $349-$1718) in United States Dollars. Grade 3 fibrillar branch change had clinically important reductions in the probability of racing, the calibre of racing performance and earnings. Grade 1 fibrillar pattern was associated with significantly higher earnings per start (P = 0.004, 95% CI: $2641-$5759). MAIN LIMITATIONS The findings are applicable to horses prepared for public auction and deemed fit to be entered for sale. The results may underestimate the proportion of severe lesions in horses not entered for sale. CONCLUSIONS Reference values specific to young Thoroughbreds have been established. Grade 1 fibrillar branch change should be regarded as an acceptable appearance in sales yearlings and 2-year-olds. Approximately one-third of grade 2 yearling branches progressed to a grade 3 lesion. Evidence of enlarged branch width and grade 2 hyperechoic foci at 2-year-old sales constitute a risk to racing performance.
Collapse
Affiliation(s)
- Frances J Peat
- Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, Colorado State University, Fort Collins, Colorado, USA
| | - Christopher E Kawcak
- Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, Colorado State University, Fort Collins, Colorado, USA
| | - C Wayne McIlwraith
- Orthopaedic Research Center, C. Wayne McIlwraith Translational Medicine Institute, Colorado State University, Fort Collins, Colorado, USA
| | | | | | - Kurt T Selberg
- Department of Environmental & Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Alejandro Ojeda
- Department of Statistics, Colorado State University, Fort Collins, Colorado, USA
| |
Collapse
|
4
|
Hansen SH, Bramlage LR, Moore GE. Racing performance of Thoroughbred racehorses with suspensory ligament branch desmitis treated with mesenchymal stem cells (2010-2019). Equine Vet J 2024; 56:503-513. [PMID: 37534804 DOI: 10.1111/evj.13980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2022] [Accepted: 07/18/2023] [Indexed: 08/04/2023]
Abstract
BACKGROUND Suspensory ligament branch desmitis (SLBD) is a common injury in Thoroughbred racehorses. Orthobiologic treatment of these injuries is a relatively new approach, and there is limited information available on post injury racing performance in racehorses treated with mesenchymal stem cells (MSCs). OBJECTIVES To assess racing performance post injury in Thoroughbred racehorses with SLBD treated with MSCs. STUDY DESIGN Retrospective case series. METHODS Medical records of racehorses with SLBD treated with MSCs from 2010 to 2019 were reviewed. All horses were treated with allogeneic stem cells injected locally at the time of diagnosis and subsequently received 3-4 treatments with autologous bone-marrow derived MSCs. Ultrasonographic and radiographic images were evaluated to determine the degree of suspensory branch injury and sesamoiditis of the associated proximal sesamoid bone. Race performance was assessed by career length, class of races, number of starts and earnings post injury. Race performance of horses that raced pre and post injury were compared. RESULTS Of 69 treated horses, 71% (49/69) [95% CI: 59%-81%] raced post injury. Horses that had raced pre injury were more likely to race post injury (90% [18/20]) than horses that did not race pre injury (63% [31/49]; p = 0.03). Females were less likely to race post injury than males (52% [11/21] vs. 79% [38/49], respectively; p = 0.02). In the 18 horses that raced pre and post injury, the number of races, earnings and earnings per start were not significantly different pre and post injury. The average career length of all horses that raced post injury was 29.5 months. MAIN LIMITATIONS Retrospective study design and lack of controls. CONCLUSIONS Treatment with MSCs resulted in a majority of Thoroughbred racehorses with SLBD racing post treatment. Racing pre injury and being male was positively associated with racing post injury.
Collapse
Affiliation(s)
- Stefanie H Hansen
- Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| | | | - George E Moore
- Department of Veterinary Administration, College of Veterinary Medicine, Purdue University, West Lafayette, Indiana, USA
| |
Collapse
|
5
|
McCarrel TM. Equine Platelet-Rich Plasma. Vet Clin North Am Equine Pract 2023; 39:429-442. [PMID: 37550126 DOI: 10.1016/j.cveq.2023.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/09/2023] Open
Abstract
Platelet-rich plasma (PRP) is an orthobiologic therapy composed of platelets, leukocytes, red blood cells, and plasma proteins. PRP has been used for 20 years, but progress determining efficacy has been slow. The definitions and classification of PRP are reviewed, and the use of PRP for tendon, ligament, and joint disease is discussed with a focus on findings of basic science and clinical studies, platelet activation, concurrent administration of nonsteroidal anti-inflammatory drugs, and treatment complications. Finally, the advantages of platelet lysates and freeze-dried platelets are discussed. The promising results of a PRP lysate optimized for antibiofilm and antimicrobial properties are introduced.
Collapse
Affiliation(s)
- Taralyn M McCarrel
- Department of Large Animal Clinical Sciences, University of Florida College of Veterinary Medicine, 2015 Southwest 16th Avenue, Gainesville, FL 32608, USA.
| |
Collapse
|
6
|
Franini A, Entani MG, Colosio E, Melotti L, Patruno M. Case report: Flexor carpi ulnaris tendinopathy in a lure-coursing dog treated with three platelet-rich plasma and platelet lysate injections. Front Vet Sci 2023; 10:1003993. [PMID: 36742986 PMCID: PMC9893791 DOI: 10.3389/fvets.2023.1003993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 01/05/2023] [Indexed: 01/21/2023] Open
Abstract
In the present case report a 7-year-old male Whippet competing in lure-coursing presented with third-degree recurrent lameness of the right forelimb, pain on palpation of the caudal aspect of the carpus and swelling of the forearm proximally to the accessory carpal bone. Clinical, radiographic, and ultrasonographic evaluation diagnosed a flexor carpi ulnaris (FCU) chronic tendinopathy unresponsive to previously attempted conservative treatments such as oral non-steroidal anti-inflammatory drugs (NSAIDs) administration along with padded palmar splint application and rest. The dog was subjected to one injection of autologous platelet-rich plasma (PRP) obtained using a double centrifugation tube method, followed by two platelet lysate (PL) injections. Treatment was administered at three-week intervals. The healing process was assessed through clinical and ultrasonographic imaging (US) on the day of the first injection (T0), and at week three (T1), six (T2), twelve (T3), fifty-two (T4), and one-hundred-and-four (T5). Fiber alignment score (FAS) and echogenicity score (ES) were developed by modifying a previously published US assessment scale. At T1, ES, and FAS improvement was detected, and at T2, further improvements in ES and FAS were observed. Ultrasonographic results were clinically consistent with the improvement in lameness: lameness grade 3/4 was detected at T0 and grade 2/4 at T1. A lameness grade of 1/4 was detected at T2, and grade 0/4 was observed at T3, T4, and T5. Moreover, at T5, the dog returned to competition, and no history of re-injury was reported. Our results suggest that the treatment of FCU tendinopathy in lure-coursing dogs with a combination of consecutive injections of autologous PRP and PL could be feasible. Additionally, no adverse reactions were observed.
Collapse
Affiliation(s)
- Alessio Franini
- Sporty Dog Veterinary Clinic, Brescia, Italy,*Correspondence: Alessio Franini ✉
| | | | | | - Luca Melotti
- Department of Comparative Biomedicine and Food Science, University of Padua, Padua, Italy
| | - Marco Patruno
- Department of Comparative Biomedicine and Food Science, University of Padua, Padua, Italy,Marco Patruno ✉
| |
Collapse
|
7
|
Nakajima K. Arthroscopic Autologous Bone Grafting for Hallux Sesamoid Fracture Nonunion Results in a High Rate of Complete Resolution. Arthrosc Sports Med Rehabil 2022; 4:e1789-e1797. [PMID: 36312710 PMCID: PMC9596892 DOI: 10.1016/j.asmr.2022.07.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/25/2022] [Indexed: 11/17/2022] Open
Abstract
Purpose To review the outcomes of patients with hallux sesamoid fracture nonunion who underwent arthroscopic autologous bone grafting. Methods Medical records of patients who underwent surgery between July 2017 and April 2020 were reviewed. The inclusion criterion was 2 years or more of follow-up. The exclusion criterion was less than 2 years of follow-up. Outcomes were assessed using the visual analog scale (VAS) for pain and the Japanese Society for Surgery of the Foot (JSSF) score. Improvements after surgery were analyzed using the Wilcoxon signed-rank test. Results Eleven patients (3 women and 8 men) were enrolled. The mean age was 18.6 years (standard deviation [SD] ± 10.3 years), and the mean body mass index was 21.9 kg/m2 (SD ± 2.5 kg/m2). The mean follow-up duration was 3.2 years (SD ± 0.8 years). One patient had fracture nonunion in the fibular sesamoid and a hypoplastic tibial sesamoid. Another patient had fracture nonunion in the distal part of the congenital bipartite sesamoid. The other patients had fracture nonunion in the normal tibial sesamoids. The mean duration until bone union was 2.9 months (SD ± 0.8 months). The mean duration until returning to sports was 5.3 months (SD ± 3.6 months). The VAS score improved from 72.1 (SD ± 15.2) preoperatively to 12.0 (SD ± 26.7) postoperatively. The JSSF score improved from 58.7 (SD ± 15.8) preoperatively to 95.0 (SD ± 11.0) postoperatively (P < 0.01, respectively). All patients except the two previously described achieved a VAS score of 0 and a JSSF score of 100 postoperatively. The remaining 2 patients with congenitally distinct sesamoids and fractures had poor outcomes. No complications were observed. Conclusions Nine of the 11 patients reported complete resolution. The remaining two patients with congenitally distinct sesamoids and fractures had poor outcomes.
Collapse
Affiliation(s)
- Kenichiro Nakajima
- Address correspondence to Kenichiro Nakajima, M.D., Department of Orthopedic Surgery, Yashio Central General Hospital, 845 Minamikawasaki, Yashio-shi, Saitama 340-0814 Japan.
| |
Collapse
|
8
|
Le HM, Stracciolini A, Stein CJ, Quinn BJ, Jackson SS. Platelet rich plasma for hallux sesamoid injuries: a case series. PHYSICIAN SPORTSMED 2022; 50:181-184. [PMID: 34346850 DOI: 10.1080/00913847.2021.1964006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Hallux sesamoid injuries are well described and can be debilitating and chronically disabling. The role of orthobiologics such as platelet-rich plasma (PRP) in sesamoid injuries has not been reported. This study describes three cases of recalcitrant hallux sesamoid injuries in teenage athletes who returned to impact activities, pain free, following one treatment of PRP. METHODS This is a case-series study describing three teenage athletes presenting to a tertiary level pediatric sports medicine practice with chronic hallux sesamoid injuries. RESULTS The three patients (two female, one male) described in this case series were 13-, 16-, and 17-year-old athletes. Their primary sports were ballet, basketball, and Irish step dance, respectively. All three athletes received PRP: two received unilateral treatment (one tibial sesamoid, one fibular sesamoid) and one received treatment to bilateral tibial sesamoids. The average duration of symptoms prior to PRP was 52.5 weeks (14-128 weeks). The average time out of their primary sport was 48.7 weeks (20-78 weeks). Three of the 4 sesamoids treated with PRP were tibial sesamoids. Each site of injury was treated with one treatment of leukocyte-rich PRP. All three athletes were cleared to return to impact activities such as running and jumping at 6-9 weeks following PRP, specifically 9 weeks after the final PRP injection for the patient who underwent bilateral treatments. CONCLUSION In the three cases provided of sesamoid injuries treated with PRP, the time to return to impact activities was less than reported for athletes not treated with PRP. Acknowledging that other management factors likely contributed to return to impact activities, this case series sets the groundwork for future research investigating the role of PRP with needle fenestration in the treatment of sesamoid injuries.
Collapse
Affiliation(s)
- Hung M Le
- Division of Sports Medicine, Orthopedics Department, Boston Children's Hospital, Boston, MA, USA
| | - Andrea Stracciolini
- Division of Sports Medicine, Orthopedics Department, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Cynthia J Stein
- Division of Sports Medicine, Orthopedics Department, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Bridget J Quinn
- Division of Sports Medicine, Orthopedics Department, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| | - Sarah S Jackson
- Division of Sports Medicine, Orthopedics Department, Boston Children's Hospital, Boston, MA, USA.,Harvard Medical School, Boston, MA, USA
| |
Collapse
|
9
|
Camargo Garbin L, Lopez C, Carmona JU. A Critical Overview of the Use of Platelet-Rich Plasma in Equine Medicine Over the Last Decade. Front Vet Sci 2021; 8:641818. [PMID: 33869321 PMCID: PMC8044532 DOI: 10.3389/fvets.2021.641818] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 02/12/2021] [Indexed: 12/20/2022] Open
Abstract
In the 1990s, the role of platelets in inflammation and tissue healing was finally recognized. Since then, the clinical use of platelet-derived products (hemocomponents), such as, platelet-rich plasma (PRP), markedly increased. The promise of a more economical option of a disease-modifying treatment led to the intensive and continuous research of PRP products and to its widespread clinical use. A number of protocols and commercial kits have been developed with the intention of creating a more practical and reliable option for clinical use in equine patients. Still, the direct comparison between studies is particularly challenging due to the lack of standardization on the preparation methods and product composition. The incomplete reports on PRP cellular concentration and the poorly designed in vivo studies are additional matters that contest the clinical efficiency of this biomaterial. To overcome such challenges, several in vitro and in vivo studies have been proposed. Specifically, experiments have greatly focused in protocol optimization and its effect in different tissues. Additionally, in vivo studies have proposed different biological products envisioning the upgrade of the anti-inflammatory cytokines trusting to increase its anti-inflammatory effect. The individual variability and health status of the animal, type of tissue and condition treated, and protocol implemented are known to influence on the product's cell and cytokine composition. Such variability is a main clinical concern once it can potentially influence on PRP's therapeutic effects. Thus, lack of qualitative and quantitative evidence-based data supporting PRP's clinical use persists, despite of the numerous studies intended to accomplish this purpose. This narrative review aims to critically evaluate the main research published in the past decade and how it can potentially impact the clinical use of PRP.
Collapse
Affiliation(s)
- Livia Camargo Garbin
- Department of Veterinary Clinical Sciences, Faculty of Medical Sciences, School of Veterinary Medicine, The University of the West Indies at St. Augustine, St. Augustine, Trinidad and Tobago
| | - Catalina Lopez
- Grupo de Investigación Terapia Regenerativa, Departamento de Salud Animal, Universidad de Caldas, Manizales, Colombia
| | - Jorge U Carmona
- Grupo de Investigación Terapia Regenerativa, Departamento de Salud Animal, Universidad de Caldas, Manizales, Colombia
| |
Collapse
|
10
|
Montano C, Auletta L, Greco A, Costanza D, Coluccia P, Del Prete C, Meomartino L, Pasolini MP. The Use of Platelet-Rich Plasma for Treatment of Tenodesmic Lesions in Horses: A Systematic Review and Meta-Analysis of Clinical and Experimental Data. Animals (Basel) 2021; 11:793. [PMID: 33809227 PMCID: PMC7998797 DOI: 10.3390/ani11030793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 03/01/2021] [Accepted: 03/09/2021] [Indexed: 11/23/2022] Open
Abstract
The use of platelet-rich plasma (PRP) to enhance tenodesmic lesion healing has been questioned over the years. The aim of this study was to evaluate current literature to establish the effectiveness of PRP for treating tenodesmic lesions through a systematic review, in accordance with the PRISMA guidelines, and a meta-analysis. Studies comparing PRP with placebo or other treatments for horses with tenodesmic injuries or evaluated PRP effect on tendon and ligament explants were included. Outcomes were clinical, ultrasound, histologic, molecular evaluation, and adverse effects. Two authors independently extracted data and assessed each study's risk of bias. Treatment effects were evaluated using risk ratios for dichotomous data, together with 95% CI. Data were pooled using the random-effects model. The quality of the evidence for each outcome was assessed using GRADE criteria. Twenty-four trials met inclusion criteria for systematic review, while fifteen studies were included in the meta-analysis. Results showed no significant differences in the outcomes between PRP and control groups. Finally, there is no definitive evidence that PRP enhances tendons and ligaments healing. Therefore, there is a need for more controlled trials to draw a firmer conclusion about the efficacy of PRP as a treatment for tenodesmic lesions in the horse.
Collapse
Affiliation(s)
- Chiara Montano
- Veterinary Teaching Hospital, School of Veterinary Medicine, University of Córdoba, 14004 Córdoba, Spain;
| | - Luigi Auletta
- Institute of Biostructure and Bioimaging, National Research Council (IBB CNR), Via T. De Amicis 95, 80145 Napoli, Italy;
| | - Adelaide Greco
- Interdepartmental Centre of Veterinary Radiology, University of Napoli “Federico II”, Via Federico Delpino 1, 80137 Napoli, Italy; (A.G.); (P.C.); (L.M.)
| | - Dario Costanza
- Interdepartmental Centre of Veterinary Radiology, University of Napoli “Federico II”, Via Federico Delpino 1, 80137 Napoli, Italy; (A.G.); (P.C.); (L.M.)
| | - Pierpaolo Coluccia
- Interdepartmental Centre of Veterinary Radiology, University of Napoli “Federico II”, Via Federico Delpino 1, 80137 Napoli, Italy; (A.G.); (P.C.); (L.M.)
| | - Chiara Del Prete
- Department of Veterinary Medicine and Animal Production, University of Napoli “Federico II”, Via Federico Delpino 1, 80137 Napoli, Italy; (C.D.P.); (M.P.P.)
| | - Leonardo Meomartino
- Interdepartmental Centre of Veterinary Radiology, University of Napoli “Federico II”, Via Federico Delpino 1, 80137 Napoli, Italy; (A.G.); (P.C.); (L.M.)
| | - Maria Pia Pasolini
- Department of Veterinary Medicine and Animal Production, University of Napoli “Federico II”, Via Federico Delpino 1, 80137 Napoli, Italy; (C.D.P.); (M.P.P.)
| |
Collapse
|
11
|
Radtke AV, Goodale MB, Fortier LA. Platelet and Leukocyte Concentration in Equine Autologous Conditioned Plasma Are Inversely Distributed by Layer and Are Not Affected by Centrifugation Rate. Front Vet Sci 2020; 7:173. [PMID: 32478101 PMCID: PMC7235160 DOI: 10.3389/fvets.2020.00173] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2020] [Accepted: 03/13/2020] [Indexed: 01/08/2023] Open
Abstract
Background: Platelet rich plasma (PRP) is used extensively in equine regenerative medicine. Differences in preparation protocols give rise to significant variability in the cellular composition of PRP making it very difficult to establish a standard of care in the field. This study aimed to optimize the preparation protocol for leukocyte-reduced PRP (P-PRP). Methods: Blood (100 mL) was collected from horses (n = 5) and divided into 2 purple top EDTA tubes and 6 (15 mL) double syringesa with a final concentration of 10% acid citrate dextrose anticoagulant. Six double syringesa were collected from each horse; PRP samples were prepared in duplicate and centrifuged at 1,100 rpm (188 × g), 1,300 rpm (263 × g), or 1,500 rpm (350 × g). Duplicates were subjected to +/– braking at the end of centrifugation. The total volume of PRP generated was measured and divided into thirds. Each third (top, middle, and bottom) were drawn off separately using the inner (6 mL syringe) and placed in purple top EDTA tubes. Automated complete blood counts were performed on all peripheral whole blood and PRP samples. Results: The concentration of leukocytes was higher in the bottom layer of PRP compared to the top and middle layers (p < 0.0001). The concentration of platelets was slightly lower in the bottom layer of PRP than the middle layer (p = 0.02). Centrifugation braking increased the leukocyte concentration in the top (p = 0.03) and middle layers of PRP (p = 0.001). Centrifugation rate had no effect on the cellular composition of PRP (p = 0.1–0.6). Conclusions: Because layer of plasma affected both platelet and leukocyte concentrations in PRP, the most important modification for the current single spin, double syringe, plasma based PRP preparation protocols is to exclude the bottom 1/3 layer of PRP.
Collapse
Affiliation(s)
- Alexandra V Radtke
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Margaret B Goodale
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| | - Lisa A Fortier
- Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY, United States
| |
Collapse
|
12
|
Wylie CE, Newton JR. A systematic literature search to identify performance measure outcomes used in clinical studies of racehorses. Equine Vet J 2017; 50:304-311. [DOI: 10.1111/evj.12757] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2017] [Accepted: 08/22/2017] [Indexed: 11/30/2022]
Affiliation(s)
- C. E. Wylie
- Rossdales Equine Hospital; Exning, Newmarket Suffolk, UK
| | | |
Collapse
|
13
|
Watts AE, Millar NL, Platt J, Kitson SM, Akbar M, Rech R, Griffin J, Pool R, Hughes T, McInnes IB, Gilchrist DS. MicroRNA29a Treatment Improves Early Tendon Injury. Mol Ther 2017; 25:2415-2426. [PMID: 28822690 DOI: 10.1016/j.ymthe.2017.07.015] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 07/25/2017] [Accepted: 07/25/2017] [Indexed: 01/21/2023] Open
Abstract
Tendon injuries (tendinopathies) are common in human and equine athletes and characterized by dysregulated collagen matrix, resulting in tendon damage. We have previously demonstrated a functional role for microRNA29a (miR29a) as a post-transcriptional regulator of collagen 3 expression in murine and human tendon injury. Given the translational potential, we designed a randomized, blinded trial to evaluate the potential of a miR29a replacement therapy as a therapeutic option to treat tendinopathy in an equine model that closely mimics human disease. Tendon injury was induced in the superficial digital flexor tendon (SDFT) of 17 horses. Tendon lesions were treated 1 week later with an intralesional injection of miR29a or placebo. miR29a treatment reduced collagen 3 transcript levels at week 2, with no significant changes in collagen 1. The relative lesion cross-sectional area was significantly lower in miR29a tendons compared to control tendons. Histology scores were significantly better for miR29a-treated tendons compared to control tendons. These data support the mechanism of microRNA-mediated modulation of early pathophysiologic events that facilitate tissue remodeling in the tendon after injury and provides a strong proof of principle that a locally delivered miR29a therapy improves early tendon healing.
Collapse
Affiliation(s)
- Ashlee E Watts
- The Comparative Orthopedics and Regenerative Medicine Laboratory, Texas A&M University, College Station, TX 77843, USA
| | - Neal L Millar
- Institute of Infection, Immunity, and Inflammation, College of Medicine, Veterinary, and Life Sciences, University of Glasgow, Glasgow G12 8TA, UK.
| | - Josh Platt
- The Comparative Orthopedics and Regenerative Medicine Laboratory, Texas A&M University, College Station, TX 77843, USA
| | - Susan M Kitson
- Institute of Infection, Immunity, and Inflammation, College of Medicine, Veterinary, and Life Sciences, University of Glasgow, Glasgow G12 8TA, UK
| | - Moeed Akbar
- Institute of Infection, Immunity, and Inflammation, College of Medicine, Veterinary, and Life Sciences, University of Glasgow, Glasgow G12 8TA, UK
| | - Raquel Rech
- The Comparative Orthopedics and Regenerative Medicine Laboratory, Texas A&M University, College Station, TX 77843, USA
| | - Jay Griffin
- The Comparative Orthopedics and Regenerative Medicine Laboratory, Texas A&M University, College Station, TX 77843, USA
| | - Roy Pool
- The Comparative Orthopedics and Regenerative Medicine Laboratory, Texas A&M University, College Station, TX 77843, USA
| | - Tom Hughes
- Liphook Equine Hospital, Forest Mere, Liphook GU30 7JG, UK
| | - Iain B McInnes
- Institute of Infection, Immunity, and Inflammation, College of Medicine, Veterinary, and Life Sciences, University of Glasgow, Glasgow G12 8TA, UK
| | - Derek S Gilchrist
- Institute of Infection, Immunity, and Inflammation, College of Medicine, Veterinary, and Life Sciences, University of Glasgow, Glasgow G12 8TA, UK.
| |
Collapse
|
14
|
Brossi PM, Moreira JJ, Machado TSL, Baccarin RYA. Platelet-rich plasma in orthopedic therapy: a comparative systematic review of clinical and experimental data in equine and human musculoskeletal lesions. BMC Vet Res 2015; 11:98. [PMID: 25896610 PMCID: PMC4449579 DOI: 10.1186/s12917-015-0403-z] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 03/20/2015] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND This systematic review aimed to present and critically appraise the available information on the efficacy of platelet rich plasma (PRP) in equine and human orthopedic therapeutics and to verify the influence of study design and methodology on the assumption of PRP's efficacy. We searched Medline, PubMed, Embase, Bireme and Google Scholar without restrictions until July 2013. Randomized trials, human cohort clinical studies or case series with a control group on the use of PRP in tendons, ligaments or articular lesions were included. Equine clinical studies on the same topics were included independently of their design. Experimental studies relevant to the clarification of PRP's effects and mechanisms of action in tissues of interest, conducted in any animal species, were selected. RESULTS This review included 123 studies. PRP's beneficial effects were observed in 46.7% of the clinical studies, while the absence of positive effects was observed in 43.3%. Among experimental studies, 73% yielded positive results, and 7.9% yielded negative results. The most frequent flaws in the clinical trials' designs were the lack of a true placebo group, poor product characterization, insufficient blinding, small sampling, short follow-up periods, and adoption of poor outcome measures. The methods employed for PRP preparation and administration and the selected outcome measures varied greatly. Poor study design was a common feature of equine clinical trials. From studies in which PRP had beneficial effects, 67.8% had an overall high risk of bias. From the studies in which PRP failed to exhibit beneficial effects, 67.8% had an overall low risk of bias. CONCLUSIONS Most experimental studies revealed positive effects of PRP. Although the majority of equine clinical studies yielded positive results, the human clinical trials' results failed to corroborate these findings. In both species, beneficial results were more frequently observed in studies with a high risk of bias. The use of PRP in musculoskeletal lesions, although safe and promising, has still not shown strong evidence in clinical scenarios.
Collapse
Affiliation(s)
- Patrícia M Brossi
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil.
| | - Juliana J Moreira
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil.
| | - Thaís S L Machado
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil.
| | - Raquel Y A Baccarin
- Department of Internal Medicine, School of Veterinary Medicine and Animal Science, University of São Paulo, São Paulo, SP, Brazil.
| |
Collapse
|
15
|
Rich FR. Single-Center Study of 83 Horses with Suspensory Injuries Treated with Adipose-Derived Stem and Regenerative Cells. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/scd.2014.42005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
16
|
Smith R, McIlwraith W, Schweitzer R, Kadler K, Cook J, Caterson B, Dakin S, Heinegård D, Screen H, Stover S, Crevier-Denoix N, Clegg P, Collins M, Little C, Frisbie D, Kjaer M, van Weeren R, Werpy N, Denoix JM, Carr A, Goldberg A, Bramlage L, Smith M, Nixon A. Advances in the understanding of tendinopathies: A report on the Second Havemeyer Workshop on equine tendon disease. Equine Vet J 2013; 46:4-9. [DOI: 10.1111/evj.12128] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- R. Smith
- Department of Veterinary Clinical Sciences and Services; The Royal Veterinary College; UK
| | - W. McIlwraith
- Clinical Sciences; Orthopaedic Research Center; Colorado State University; USA
| | - R. Schweitzer
- SOM-Cell and Developmental Biology Department; Oregon Health and Science University; USA
| | - K. Kadler
- Faculty of Life Sciences; University of Manchester; UK
| | - J. Cook
- Department of Physiotherapy; School of Primary Health Care; Monash University; Victoria Australia
| | | | - S. Dakin
- Department of Veterinary Clinical Sciences and Services; The Royal Veterinary College; UK
| | | | - H. Screen
- The School of Engineering and Materials Science; Queen Mary, University of London; UK
| | | | - N. Crevier-Denoix
- Ecole Vétérinaire d'Alfort; UMR INRA-ENVA BPLC (Biomécanique du Cheval); France
| | | | - M. Collins
- Department of Human Biology; UCT/MRC Research Unit for Exercise Science and Sports Medicine (ESSM); South Africa
| | - C. Little
- Raymond Purves Bone and Joint Research Laboratories; Kolling Institute of Medical Research; E25 - Royal North Shore Hospital; University of Sydney; New South Wales Australia
| | - D. Frisbie
- Clinical Sciences; Colorado State University; USA
| | - M. Kjaer
- Department of Clinical Medicine; Section of Orthopaedics and Internal Medicine; Bispejerg Hospital; Denmark
| | - R. van Weeren
- Equine Sciences; Utrecht University; the Netherlands
| | - N. Werpy
- Veterinary Medicine and Surgery; University of Florida; USA
| | | | - A. Carr
- Nuffield Department of Orthopaedics; Rheumatology and Musculoskeletal Sciences; Nuffield Orthopaedic Centre; University of Oxford; UK
| | | | - L. Bramlage
- Rood and Riddle Equine Hospital; Kentucky USA
| | | | - A. Nixon
- Clinical Sciences; Cornell University; New York USA
| |
Collapse
|
17
|
Wright S. Highlights of recent clinically relevant papers. EQUINE VET EDUC 2013. [DOI: 10.1111/eve.12106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|