Implante autólogo de células-tronco mesenquimais do tecido adiposo no tratamento de tendinites experimentais em equinos: avaliação clínica, ultrassonográfica, histopatológia e imunoistoquímica

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Estudo do nanocristal Qtraker 655 como marcador de células tronco mesenquimais pré e pós implante em tendinites experimentais em equinos

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Implante de células-tronco mesenquimais autólogas, associadas ao plasma rico em plaquetas em tendinites experimentais de equinos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Implantes de matrizes de colágeno isoladas ou associadas às células estromais mesenquimais multipotentes autólogas na reparação tendínea em ovinos

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Avaliação ultrassonográfica quantitativa e qualitativa do canal do carpo em equinos

Pós-graduação em Medicina Veterinária - FMVZ

Avaliação da migração das células progenitoras após terapia da tendinite equina

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Evaluation of mesenchymal stem cell migration after equine tendonitis therapy

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Uso de células-tronco para o tratamento de tendinite em eqüinos

Brazil has the fourth largest horse herd in the world, this is due the recognition and appreciation that the different equestrian games are having within the country. Injuries of the tendon, especially in the digital flexor tendon, are the main cause of athletic life reduction among horses. The treatment of tendinitis in horses seeks full recovery of the damage tissue reestablishing the function previously lost, however conventional treatments have proven to be ineffective when considered the quality of the scar tissue and the rate of recurrence. Due to this, the use of adult stem cells to the treatment of musculoskeletal injuries of horses has been studied for some time. This method of treatment consists of aspiration of bone marrow or removal of subcutaneous fat tissue and implantation of these cells in the injured tissue. After obtaining the bone marrow the implantation can be performed with total bone marrow, with the mononuclear fraction of MSC or with cells cultured in vitro. From the fat tissue is used the stromal vascular fraction obtained by collagenase digestion, followed or not by cell culture. According to some studies, cell therapy with material obtained from bone marrow or adipose tissue has shown to be viable, given that these materials are abundant in repair components such as mesenchymal stem cells (MSC), growth factors and other components of the collagen matrix. Several studies using both types of cells have shown great potential and promising clinical results. However, knowledge of the biology and characterization of these cells remain largely unknown, and therefore is needed great care and caution when using stem cells for the treatment of musculoskeletal disorders in horses

Utilização da ultrassonografia transcuneal como auxílio no diagnóstico da síndrome do navicular em eqüinos

The equine locomotors system alterations are very frequent and corresponds a large portion of cases in equine medicine. The most equine veterinarian’s challenge is to do a precise diagnosis of lameness cause to perform a specific and proper treatment as early as possible. The navicular syndrome is considered responsible for one third of lameness causes and, although much studied, its etiology is still not fully understood. The most varied methods of diagnosis, such as x-ray, magnetic resonance, bursography, scintigraphy, computed tomography and ultrasound, have been used to assess podotrochlear apparatus situation in order to diagnose this syndrome. Among them transcuneal ultrasound can be used to observe some important structures such as the flexor surface of distal sesamoid bone, distal deep digital flexor tendon, distal sesamoid ligament entheses odd and the distal phalanx. The aim of this present paper is provide a brief review on the use and the technique of ultrasonography on third phalanx transcuneal region evaluation and its interpretation on navicular syndrome diagnosis in horses

Use of power doppler for the assessment of vascularization in equine tendinitis treated with mesenchymal stem cells

Tendinous lesions are very common in athlete horses. The process of tendon healing is slow and the quality of the new tissue is often inferior to the original, leading in many cases to recurrence of the lesion. One of the main reasons for the limited healing capacity of tendons is its poor vascularization. At present, cell therapy is used in equine practice for the treatment of several disorders including tendinitis, desmitis and joint disease. However, there is little information regarding the mechanisms of action of these cells during tissue repair. It is known that Mesenchymal Stem Cells (MSCs) release several growth factors at the site of implantation, some of which promote angiogenesis. Comparison of blood flow using power Doppler ultrasonography was performed after the induction superficial digital flexor tendon tendinitis and implantation of adipose tissue-derived MSCs in order to analyze the effect of cell therapy on tendon neovascularization. For quantification of blood vessel histopathological examinations were conducted. Increased blood flow and number of vessels was observed in treated tendons up to 30 days after cell implantation, suggesting promotion of angiogenesis by the cell therapy.

Distribution of radiodense contrast medium after perineural injection of the palmar and palmar metacarpal nerves (low 4-point nerve block): an in vivo and ex vivo study in horses

REASONS FOR PERFORMING STUDY: Evidence-based information is limited on distribution of local anaesthetic solution following perineural analgesia of the palmar (Pa) and palmar metacarpal (PaM) nerves in the distal aspect of the metacarpal (Mc) region ('low 4-point nerve block'). OBJECTIVES: To demonstrate the potential distribution of local anaesthetic solution after a low 4-point nerve block using a radiographic contrast model. METHODS: A radiodense contrast medium was injected subcutaneously over the medial or the lateral Pa nerve at the junction of the proximal three-quarters and distal quarter of the Mc region (Pa injection) and over the ipsilateral PaM nerve immediately distal to the distal aspect of the second or fourth Mc bones (PaM injection) in both forelimbs of 10 mature horses free from lameness. Radiographs were obtained 0, 10 and 20 min after injection and analysed subjectively and objectively. Methylene blue and a radiodense contrast medium were injected in 20 cadaver limbs using the same techniques. Radiographs were obtained and the limbs dissected. RESULTS: After 31/40 (77.5%) Pa injections, the pattern of the contrast medium suggested distribution in the neurovascular bundle. There was significant proximal diffusion with time, but the main contrast medium patch never progressed proximal to the mid-Mc region. The radiological appearance of 2 limbs suggested that contrast medium was present in the digital flexor tendon sheath (DFTS). After PaM injections, the contrast medium was distributed diffusely around the injection site in the majority of the limbs. In cadaver limbs, after Pa injections, the contrast medium and the dye were distributed in the neurovascular bundle in 8/20 (40%) limbs and in the DFTS in 6/20 (30%) of limbs. After PaM injections, the contrast and dye were distributed diffusely around the injection site in 9/20 (45%) limbs and showed diffuse and tubular distribution in 11/20 (55%) limbs. CONCLUSIONS AND POTENTIAL RELEVANCE: Proximal diffusion of local anaesthetic solution after a low 4-point nerve block is unlikely to be responsible for decreasing lameness caused by pain in the proximal Mc region. The DFTS may be penetrated inadvertently when performing a low 4-point nerve block.

[Disorders of the origin of the suspensory ligament in the horse: a diagnostic challenge]

Lameness in horses due to pain originating from the proximal metacarpal/metatarsal region remains a diagnostic challenge. In cases of obvious lameness the pain can be localised to this region by diagnostic anaesthesia. Because a variety of disorders can cause lameness in this region different imaging modalities including radiography, ultrasonography and scintigraphy should be used to arrive at an accurate diagnosis. Even though a precise anatomic-pathologic diagnosis can still be an enigma, because not only bone and joints, but also soft tissue structures including the proximal suspensory ligament, its origin at the proximal metacarpus/ metatarsus, its fascia, the superficial fascia, as well as the intermetacarpal/metatarsal ligaments, the accessory ligament of the deep digital flexor tendon and both digital flexor tendons may be involved. Magnet resonance tomography (MRT) shows a high diagnostic sensitivity in imaging soft tissue structures and bone. In horses MRT is still at the beginning. The MRT appearance of the proximal metacarpal/metatarsal region has not yet been evaluated in detail and there are only few anatomic studies of the origin of the suspensory ligament in horses. The first experiences showed, that more gross and histologic examinations are necessary to fully interpret MRT-images and to differentiate pathologic alterations from clinically not relevant variations.

Biomechanics of the movable pretarsal adhesive organ in ants and bees

Hymenoptera attach to smooth surfaces with a flexible pad, the arolium, between the claws. Here we investigate its movement in Asian weaver ants (Oecophylla smaragdina) and honeybees (Apis mellifera).  When ants run upside down on a smooth surface, the arolium is unfolded and folded back with each step. Its extension is strictly coupled with the retraction of the claws. Experimental pull on the claw-flexor tendon revealed that the claw-flexor muscle not only retracts the claws, but also moves the arolium. The elicited arolium movement comprises (i) about a 90° rotation (extension) mediated by the interaction of the two rigid pretarsal sclerites arcus and manubrium and (ii) a lateral expansion and increase in volume. In severed legs of O. smaragdina ants, an increase in hemolymph pressure of 15 kPa was sufficient to inflate the arolium to its full size. Apart from being actively extended, an arolium in contact also can unfold passively when the leg is subject to a pull toward the body.  We propose a combined mechanical–hydraulic model for arolium movement: (i) the arolium is engaged by the action of the unguitractor, which mechanically extends the arolium; (ii) compression of the arolium gland reservoir pumps liquid into the arolium; (iii) arolia partly in contact with the surface are unfolded passively when the legs are pulled toward the body; and (iv) the arolium deflates and moves back to its default position by elastic recoil of the cuticle.

Descripción de resultados de la reconstrucción de placa plantar en inestabilidad de la segunda articulación metatarsofalángica

Objetivo: Describir los desenlaces funcionales, complicaciones postoperatorias, dolor y satisfacción de un grupo de pacientes con diagnóstico de inestabilidad de segunda articulación metatarsofalángica y lesión de la placa plantar, que fueron intervenidos quirúrgicamente para su reconstrucción en el Hospital Universitario de cuarto nivel Fundación Santa Fé de Bogotá, en el periodo comprendido entre Enero de 2010 hasta Diciembre de 2015. Métodos: Estudio descriptivo de corte transversal que evalúa desenlaces funcionales, dolor y satisfacción para un grupo consecutivo de pacientes con diagnóstico de inestabilidad de la segunda articulación metatarsofalángica que fueron intervenidos quirúrgicamente mediante reconstrucción de la placa plantar entre Enero de 2010 a Diciembre de 2015 en el Hospital Universitario Fundación Santa fe de Bogotá. Resultados: El procedimiento se realizó a 39 pacientes (40 MTF), encontrando mejoría en dolor, función y satisfacción. El dolor postoperatorio paso de severo a leve en el 80% de los pacientes, 67.5% de los pacientes presentaron prueba de aprehensión positiva, 85% alineamiento adecuado, el reporte de escala de AOFAS postoperatoria fue de 87, y los resultados fueron satisfactorios en un 94.5%. La principal complicación con la cirugía fue la extensión residual del dedo operado (22.5%). Conclusiones: La reconstrucción de la placa plantar en casos de inestabilidad metatarsofalángica ha demostrado tener resultados satisfactorios, en el presente estudio encontramos mejoría respecto a dolor, función y satisfacción posterior a la realización del procedimiento. Sin embargo puede presentar complicaciones como extensión residual del dedo o elevación, rigidez y recidiva.

Long-term follow-up of flexor digitorum longus transfer and calcaneal osteotomy for stage II posterior tibial tendon dysfunction

Flexor digitorum longus transfer and medial displacement alcaneal osteotomy is a wellrecognised form of treatment or stage II posterior tibial tendon dysfunction. Although excellent short- and medium-term results have been reported, the long-term outcome is unknown. We reviewed the clinical outcome of 31 patients with a symptomatic flexible flatfoot deformity who underwent this procedure between 1994 and 1996. There were 21 women and ten men with a mean age of 54.3 years (42 to 70). The mean follow-up was 15.2 years (11.4 to 16.5). All scores improved significantly (p < 0.001). The mean American Orthopedic Foot and Ankle Society (AOFAS) score improved from 48.4 pre-operatively to 90.3 (54 to 100) at the final follow-up. The mean pain component improved from 12.3 to 35.2 (20 to 40). The mean function score improved from 35.2 to 45.6 (30 to 50). The mean visual analogue score for pain improved from 7.3 to 1.3 (0 to 6). The mean Short Form-36 physical component score was 40.6 (SD 8.9), and this showed a significant correlation with the mean AOFAS score (r = 0.68, p = 0.005). A total of 27 patients (87%) were pain free and functioning well at the final follow-up. We believe that flexor digitorum longus transfer and calcaneal osteotomy provides long-term pain relief and satisfactory function in the treatment of stage II posterior tibial tendon dysfunction.