Autologous Micro-fragmented Adipose Tissue Augmented by Platelet-Rich Plasma in Nonresponsive Distal Interphalangeal Joint Osteoarthritis in Horses: A Case Series of Eight Horses

Abstract

Case Report: This retrospective case series presents the outcomes after intra-articular injection of autologous micro-fragmented adipose tissue (AMFAT) augmented by platelet-rich plasma (PRP) in horses with history of unsuccessful previous treatments in the coffin joint. The study included sport horses with front feet distal interphalangeal joint osteoarthritis (DIP-OA), radiological and ultrasonographic examination of the foot, standing MRI examination, arthroscopy, and failure of at least two previous treatments. Patients with DIP-OA due to subchondral cyst lesions or fractures were excluded. Eight client-owned adult horses (13 coffin joints) fulfilled the inclusion criteria. Each horse was treated in the past with hyaluronic acid and cortisone, polyacrylamide hydrogel 2,5%, and additionally, either with autologous conditioned plasma or serum. The AMFAT injection occurred at least 4 months after the last treatment. The harvesting of adipose tissue was performed through mechanical liposuction from the tail head region. The lipoaspirate was transferred into a disposable, closed system (Lipogems) for washing through saline solution and disaggregating mechanically by steel marbles. The end-product was obtained through a size reduction filter. Fifty-five milliliters of blood were proceeded for PRP through double centrifugation. Seven horses became sound 6 weeks posttreatment and five patients remained sound 12 months follow-up. However, only four horses returned to their previous performance. No major complications were observed. Main limitations of this report are the absence of a control group with AMFAT solely and the low number of patients. In conclusion, the AMFAT augmented by PRP may be an alternative treatment option in case of advanced DIP-OA.