Autologous implant of bone marrow mononuclear stem-cells as treatment for equine bicipital tendonitis: case report Implante autólogo de células mononucleares de médula ósea como tratamiento de tendinitis bicipital equina: reporte de caso clínico

Bicipital bursitis in the horse, the inflammation of the bicipital tendon and its surrounding bursa, has been reported to represent a low percentage of lameness cause. However, it is the main cause of lameness associated to the shoulder region and it has been under diagnosed. Due to high recurrence in different types of tendon injuries, treatments aiming to re-establish tendon functionality have been a focus of research. The aim of this study is to report the implant of a bone marrow mononuclear cell fraction as treatment for bicipital bursitis in a horse. A 7 year old crossbred draught gelding was presented with severe lameness of the left forelimb and pain in the shoulder region. Clinical and ultrasonographic evaluation revealed hemorrhagic synovial fluid, decrease of lameness after shoulder joint anesthesia and bicipital tendon fibers rupture and inflammation. The patient was successfully treated by triamcinolone injection adjacent to the tendon lesion followed by intralesional injection of bone marrow mononuclear cells seven days after the first treatment. Also, rest and controlled exercise were performed. Further clinical and ultrasound evaluations were executed at days 2, 15, 35, 75 and 120. After day 120 the horse started working and despite bicipital bursitis has been reported to exhibit high recurrence, neither clinical nor ultrasonographic signs of recurrence were reported for 15 months after lameness onset. These results suggest that use of regenerative medicine associated to rest and a controlled exercise protocol, accelerated tendon repair, reduced recovery period and allowed successful return to working activities without recurrence. La bursitis bicipital es la principal causa de cojera asociada al hombro equino, sin embargo representa un peque o porcentaje de las causas de claudicaciones en caballos. Debido a la alta recurrencia observada en casos de tendinitis, tratamientos en base a medicina regenerativa se han tornado en un importante foco de investigación. El objetivo de este estudio es reportar el implante de células madre mononucleares como tratamiento de bursitis bicipital en un caballo. Un caballo carretonero, castrado, de 7 a os de edad, fue presentado al Hospital Veterinario - UACh, exhibiendo claudicación del miembro anterior izquierdo y sensibilidad a la palpación de la región del hombro. Los exámenes clínico y ultrasonográfico revelaron fluido sinovial hemorrágico, disminución de la cojera posterior a anestesia intrasinovial del hombro e inflamación y ruptura de fibras del tendón bíceps braquial. El caballo fue exitosamente t