Knowhere charges home after a long, grueling jump race...notice how clean his right front leg looks, in spite of a serious bow in his past. Photo © Trevor Meeks/Horse & Hound/IPC+ Syndication.Thanks for the loan!Three years ago, Knowhere was, literally, nowhere. After two wins in novice hurdle company, his promising four-year-old race career ended when he injured the superficial flexor tendons of both front legs. The left fore showed low grade tendonitis while the right fore had a significant percentage of fiber rupture—what we call a “bow”.
Knowhere’s connections opted for stem cell therapy and a long layoff, in hopes of returning him to the top races on the National Hunt circuit. He was treated by Tim Beauregard MRCVS of Summerhill Farm in Gloucestershire, west of London.
Bone marrow samples were collected from Knowhere’s sternum. The marrow was then processed in a laboratory over a five week period to generate millions of stem cells. Knowhere was sedated, the tendon area was anesthetised and then the leg was surgically clipped and disinfected The stem cells which had been suspended in serum obtained from the original bone marrow sample, were then injected using ultrasound guidance, into the core of the damaged area of the tendon fibers.
For the first week after the implantation, Knowhere was kept in his stall to allow the cells to adapt to their new environment. Each day after this he was given walking exercise in order to stimulate the activity of the stem cells, encouraging them to differentiate into tendon cells and form into strong tendon fibers. The amount of exercise was incrementally increased, building up over a three-month period from five minutes each day to 45 minutes twice a day.
By the autumn of 2005 both of Knowhere’s tendons had healed very well and showed good fiber pattern on ultrasonography. He was re-introduced to the racetrack the following year and of the 15 or so races he has been in since then he has finished in the frame on eight occasions and has amassed some £175,000 (US$345,000) in winnings.
Vet Tim Beauregard concludes: “Knowhere’s successful return to the track has been exciting and immensely satisfying to follow and he showed particularly brilliant form in the Cotswold Chase. It remains to be seen whether he will be heading for the Ryanair Chase, the (Cheltenham) Gold Cup or the Grand National (three top jump races in the UK) but all involved will be hoping for the best.”
Note to American readers: the procedure used on Knowhere is different from the Vet-Stem system commonly used in the US, which extracts fat cells at the tail head and harvests stem cells from the fat. The procedure detailed in this post is a specific treatment program from the Vetcell company in the UK, developed at the Royal Veterinary College of London.
