Polo Players Edition

JAN 2019

Polo Players' Edition is the official publication of the U.S. Polo Association. Dedicated to the sport of polo, it features player profiles, game strategy, horse care, playing tips, polo club news and tournament results.

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16 POLO P L A Y E R S E D I T I O N E Q U I N E A T H L E T E BY STEPHANIE COLBURN, DVM TIED WITH A BOW P oor healing capacity of tendons and ligaments is a huge problem in sport horses, with bowed tendons being on the forefront of injuries sustained by lower-goal polo ponies. Regenerative medicine techniques to repair equine tendons have been on the cutting edge of veterinary medicine, but cost can play a huge factor in deciding how to proceed with treatment for these injuries. I can remember, within the last 10 years, how there were many different regenerative medicine therapies, all quite pricey, and none with enough scientific evidence to guarantee the results that would justify treatment versus simply just kicking your horse out to pasture for a few months to heal. Are regenerative medicine techniques worth the hefty price? Yes, if affordable. Utilizing regenerative medicine techniques in combination with rest and a rehabilitation program is the best way to successfully treat tendon injuries. There are many reasons why polo ponies sustain tendon injuries. The sport itself asks a lot from our equine athletes. We ask them to gallop at top speeds, require quick stops and turns, and we expect them to win hard ride offs. Many injuries can be related to the level of use and conditioning afforded to our mounts or lack of conditioning in some cases. We may be weekend warriors, but that is not the best recipe for success in our mounts. Playing surface can be another major factor. Playing or riding surfaces that are too hard or footing that is too deep, wet or muddy, can all be factors for injury. One also cannot forget the importance of routine hoof care and basic conformation and the role they can play in tendon injuries. Tendons are elastic structures; their composition is similar to the many cords that make up a rope. Their elasticity allows them to stretch like a bungy cord. When tendons tear without treatment, they scar. The fibrous scar tissue material that fills in tendon tears is functionally deficient compared to normal tendon and does not allow the tendon to stretch. This stiffer tissue can reduce performance and increase the chance of tendon reinjury. Due to poor blood supply, tendon injuries take a longer amount of time to heal than bone. In general, it takes about three months for a bone to heal, but tendons can take many months, some even up to one year to heal. Regenerative medicine-based cell therapy has improved the quality and speed of tendon and ligament healing. Although, many practitioners still see success with tendon splitting, where the fluid pocket within the injured tendon is "split" or drained to increase blood flow and healing to the area. The aim of regenerative medicine is to promote healing of tissue in a way that preserves the functionality of that tissue, maintaining the strength and elasticity of the original tissue and decreasing the likelihood of scar formation. There are many regenerative medicine techniques used to improve tendon injuries in the horse: Platelet Rich Plasma (PRP, a concentrated amount of platelets in a small volume of blood plasma with many endogenous growth factors), stem cells (bone marrow or adipose tissue derived), Interleukin receptor antagonist protein (IRAP), and Pro-stride. Stem cells and PRP are used more with soft tissue injuries, with stem cells typically being the most expensive therapy for owners. IRAP, an anti- inflammatory therapy designed to block interlukin-1—a major inflammatory substance released during injury—is mainly used as a joint therapy. Pro-stride incorporates IRAP and is another anti- inflammatory joint treatment for arthritis and joint inflammation. Many medical resources now proclaim the benefits of utilizing regenerative medicine techniques. In 2017, The Regenerative medicines can preserve tissue functionality Approximate Tendon Healing Times Superficial Digital Flexor Tendon (SDFT): 8-12 months Deep Digital Flexor Tendon (DDFT): 12 months Check Ligament: 3-4 months Suspensory (forelimb): 4 months Suspensory (hindlimb): 8-12 months Stem cells are injected using ultrasound guidance to help generate tissue in tendon injuries. Stem cell therapy is typically more expensive than other therapies but offers promising results.

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