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The goal of this study is to test the ability of a concentrated, activated, autologous blood solution to increase therapeutic mediators in joints and reduce lameness in horses with osteoarthritis.
Osteoarthritis is a degenerative disease affecting joints. The bones within a moving joint are cushioned by cartilage, a fibrous tissue, and bounded by a sac of fluid called the synovial sac that keeps the joint lubricated and freely moving. Cells in the cartilage produce both the substances that comprised cartilage as well as the fluid of the synovium. These cells fail to function in osteoarthritis and that causes the space between the points to narrow often to a point where bones rub against one another. The process causes progressively increasing pain and lameness.
Platelet and blood therapy is an emerging new technology being used as a biologic therapy. While the expression 'biologic therapy' conjures up thoughts of homeopathic medicine, platelet therapy is on the way to being proven to promote healing in other tissues such as tendons and joints. Studies show that the growth factors in platelets, plasma and white blood cells can facilitate tissue repair. Platelets from blood, while well known to be responsible for clotting, also contain a variety of growth factors that have been shown to promote wound healing. Some studies in humans have shown that platelet therapy may benefit patients with osteoarthritis but studies in horse and dog are lacking.
You will be asked to bring your animal to the medical facility once at the start of the enrollment. Your horse will be injected within 3 days of arrival. Exactly 2 weeks after injection your horse will be done with OSU evaluations and will be expected to be picked up. If you horse was in the control group, then if you elect to have the blood product injection, it will be performed at this point and your horse will remain here at the Veterinary Medical Center for an additional 3 days after injection at no charge to you. It will be expected you will pick your horse up 3 days after the final injection.
Day 1: Your animal will be physically examined. You must have with you, or have sent ahead of arrival, a signed consent form, a credit card to maintain on file, xrays that show your horse has osteoarthritis, or prior approval with Dr Bertone that your horse has osteoarthritis, and a filled out questionnaire that rates your horse's comfort for the week prior. Your horse will be bedded into a boxstall for the 2.5 to 3 weeks (3 days of acclimation, 2 weeks of study and if in the control group an additional 3 days after blood product injection) of the study. Once all paperwork is collected and your horse is in the stall, you can leave. If your horse is dropped off, the paperwork must arrive in our office, signed, prior to your horse being dropped off. Your horse will be acclimated to the treadmill and the force plate which require walking and/or trotting on a lead rope. For the forceplate the horse is jogged over the hidden plate for 5 valid measurements. For the Treadmill, the horse is walked and trotted on the treadmill for a warmup, walk, trot, walk and cool down 2 times per week. Your horse will be sedated for the injection. Approximately 60cc of blood will be drawn from a vein. The synovial fluid will be withdrawn from the affected joint to make room for the treatment to be administered. The synovial fluid samples will either be discarded, or may be saved for additional tests not planned for at this time. Then, your animal will be injected with either the control (saline) or the platelet therapy.
You will be asked to fill out the 3-month followup questionnaire. Finally, you will be asked to comply with the request to withdraw your animal from any pain medications 1 week prior to your appointments, if your animal needed them during this time. This is critical in order to determine the effectiveness of the therapy is not masked by pain killers. For enrollment your horse must not have had any joint injection for at least 2 months before coming to OSU.
Day 90: You will receive a phone call interview on how your horse is doing and be requested to fill out and mail in a questionnaire.
The costs for testing, sedations, board, treadmill and force plate, and treatment will be paid for by the sponsor of this pilot study. That includes the physical exams, x-rays if necessary, and all biochemical and blood tests as well as the technology used to harvest your horses blood therapy.
If an unexpected event occurs and you can not pick up your horse on the discharge day, you are allowed a 2 day grace period and then all board is charged to your credit card. You must provide a credit card at our reception prior to leaving your horse for the study.
Dr. Alicia Bertone
Alicia [dot] Bertone [at] cvm [dot] osu [dot] edu (Email)