Tackling Osteoarthritis

Joint disease is a major cause of lost competition days and ultimately can reduce the working lifetime of a competition horse.

Repetitive wear and tear coupled with the poor regenerative capacity of cartilage means that osteoarthritis is a degenerative condition. This is because joints are naturally in a continuous cycle of wear and repair, and when wear happens faster than repair, osteoarthritis develops.

Once the cycle of osteoarthritis has begun the joint fluid fills with inflammatory cells and compounds, resulting in break down of the joint cartilage, which then further stimulates more inflammation, and so the cycle continues. In chronic cases the result is a continually painful, physically altered joint with reduced movement, which is often performance limiting for the horse.

Commonly osteoarthritis develops due to excessive loading from exercise, concussion or general wear and tear, which means that we can try and protect the joint from osteoarthritis by concentrating on reducing the effect of these factors.

If osteoarthritis does take hold of the joint then there are various treatments which can be considered. These range from simple anti-inflammatory medication given in feed to targeted medications injected into the joint. However, traditional treatments such as steroid injections tend to focus on reduction of lameness and inflammation alone and do not have a reparative effect on the joint.

Over the last 20 years, vets and scientists have worked to identify treatments that can address both the symptoms of osteoarthritis and the disease process itself. The goal is to ‘turn back the clock’ on joint disease and give owners more active time with their horses and ponies.

One of the most significant advances made in osteoarthritic treatments are stem cell medications. A lot of research has been focused on the use of stem cells in horses to try and achieve these goals. Stem cells have many properties, some of which we are yet to discover, including the release of natural anti-inflammatory substances and their ability to ‘instruct’ the horse’s own cells to increase production of new healthy tissues at the site of an injury.

In the past, stem cells have shown promise for use in equine joint disease but their production has involved lengthy, expensive and invasive procedures to harvest them from the patient’s own bone marrow, with variable results. A breakthrough came in 2019 when Arti-Cell® Forte became licensed as modern techniques meant that these medicines could be produced to a consistent standard and subjected to clinical trials to demonstrate safety and efficacy.

Arti-Cell® Forte is now available to vets to treat appropriate cases, where the lameness associated with osteoarthritis needs to be resolved but the longevity of treatment is also important. Investing in the health of a joint could give owners and horses more active time to enjoy together.

Arti-Cell® Forte suspension for injection for horses contains chondrogenic induced equine allogeneic peripheral blood-derived mesenchymal stem cells. UK: POM-V IE: POM. Advice should be sought from the prescriber. Further information available in the SPC or from Boehringer Ingelheim Animal Health UK Ltd., RG12 8YS, UK. Tel: 01344 746957. Email:vetenquiries@boehringer-ingelheim.com. Arti-Cell® Forte and Equitop® GLME are registered trademarks of Boehringer Ingelheim Vetmedica GmbH, used under licence. ©2022 Boehringer Ingelheim Animal Health UK Ltd. All rights reserved. Date of preparation: June 2022. UI-EQU-0063-2022. Use Medicines Responsibly.

McIlwraith, C.W., Frisbie, D.D. and Kawcak, C.E. (2012) The horse as a model of naturally occurring osteoarthritis. Bone and Joint Research, 1(11), pp. 297-309

Christopher J. Centeno, MD and Sarah M. Pastoriza, DO. (2020) Past, current and future interventional orthobiologics techniques and how they relate to regenerative rehabilitation: A clinical commentary. Int J Sports Phys Ther Apr: 15(2): 301-325

Ruiz, M., Maumus, M., Jorgensen, C. and Noël, D., (2019). Mesenchymal Stem Cell-Based Therapy of Osteoarthritis: Current Clinical Developments and Future Therapeutic Strategies. In A Roadmap to Non-Hematopoietic Stem Cell-based Therapeutics (pp. 87-109). Academic Press.