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Polo Times Dec/Jan 17 - Lipogems Equine International Outreach

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This feature focuses on how this cutting edge regenerative concept is reaching world wide with vets being trained in Argentina by Consultant Lipogems Equine Vet Murray Shotter by the kind permission of global polo professional star Pite Merlos.

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Polo Times Dec/Jan 17 - Lipogems Equine International Outreach

  1. 1. Knowledge www.polotimes.co.uk 63Polo Times, December 2016 / January 2017 It was all about spreading the word at Alfonso Pieres’ beautiful estancia Don Urbano in Pilar, Argentina on Tuesday 29 November where Lipogems Equine held their first Argentine training seminar under the watchful eye of Pite Merlos, who has had two of his polo ponies treated with Lipogems. Diego Araya kindly also offered up a top class pony for the demonstration. Some of the country’s top vets were invited to learn about the latest veterinary regenerative therapy including Marco Sperati, who is the vet for the Pieres brothers and Ellerstina, Raffo Facundo and British vet Steph Gent who has been featured in Polo Times veterinary features before. The event was hosted by Martin ffrench Blake, Chief Executive Officer of Lipogems Equine and one of the world’s leading Lipogems accredited veterinary surgeons Murray Shotter BVSc MRCVS, who with the help from Marcus Araya arranged the day. The aim of the game was to demonstrate this simple harvesting process of Lipoaspirate, show how easy it is to perform stable-side and discuss the benefits of this new technology for multiple varieties of treatments. As the word spreads about Lipogems and its myriad of benefits and advantages, vets around the world are keen to learn. Lipogems Equine has a worldwide training program in place with leading vets from top equestrian countries asking to be trained and accredited in the use of Lipogems. Dr. Tim Watson, the lead vet for Lipocast Biotech UK (the distributer of Lipogems), is available for vets training in the UK. Later this month, training is taking place in USA and Dubai, Ireland, France and Germany and Denmark. The Lipogems process is unusual in the fact that it has been brought over from human medicine into equine medicine and so far, has shown unprecedented results, helping ponies with otherwise career-ending injuries to return to the polo field to play again. Lipogems Equine International Outreach Regenerative tissue engineering expands to Argentina Katie Vickery reports from Argentina In a Nutshell The Lipogems process is an adipose tissue transfer where fat cells are taken from the horse’s tail head and then micro fragmented using the Lipogems canister to help activate the healing cells found in the tissue. The fragmented Lipoaspirate is then injected into the injury site. The healing cells, Mesenchymal Stem Cells (DMSCs), understand the nature of the injury and attach themselves to the damaged site and provide a cushion and a structural support that promotes the natural healing process. Lipogems speeds up the healing process that can naturally take months or in some cases recovery wouldn’t have happened at all, and condenses it into just weeks. The process can be performed in under an hour and can be performed stable-side. It is minimally invasive with little to no recovery time from the procedure required and no other drugs are used, which is why it is known as a therapy. The tissue generated from the process is like the normal tendon tissue rather than the fibrous scar tissue formed after natural inflammation and repair from the more basic stem cell therapies or Platelet Rich Plasma (PRP) treatments. The Science Behind the Process The principles behind the use of fat injected into injury sites is that there are small blood vessels within the fatty tissue. Attached to the outside of these blood vessels are cells called Pericytes. When these cells are introduced into an area of injury and inflammation the environment caused by the inflammation induces the Pericytes to detach and change into Mesenchymal Stem Cells (MSCs). These Mesenchymal Stem Cells help the injury by producing pro-healing cells and they actually transform further to replace the damaged tissue. Pite Merlos examining the Lipogems device ahead of the treatment fig 1 fig 2 These scans show a tendon injury before treatment, fig 1., and six weeks later, note the dark hole at the top of the scan in fig 1. is no longer there in fig2.
  2. 2. Knowledge www.polotimes.co.uk64 Polo Times, December 2016 / January 2017 The Process Murray Shotter demonstrates the Lipogems process is made up of three stages: Stage 1: Harvesting – The horse is sedated and restrained – The cells to be transposed are extracted from just under the skin near the tail head of the patient. They are collected through a cannula attached to a vacuum that when moved backwards and forwards like a violin bow, sucks the fat cells from beneath the skin into the attached syringe. This is repeated on both sides of the patient’s rump – Once an adequate amount has been collected (15-30ml of Lipoaspirate or fat cells) the Lipogems process is ready to be put into action The relatively intact structure of the fat helps form a scaffold for the healing process to form over, therefore promoting and speeding up the healing process. Because the Lipogems process can be performed stable-side the fatty tissue is kept relatively intact, this means there are a large number of Pericytes to help with the healing process as opposed to just aspirating the fat cells. Stage 2: Processing – The Lipogems device is filled with normal saline, making sure that all air bubbles are extracted – The 50ml syringe containing the extracted Lipoaspirate, minus any left- over aqueous tissue, is attached and slowly injected into the device – The syringe is removed and the Lipoaspirate washed for around 45 seconds. The inlet clip is closed and the device shaken in a vertical motion for 15 seconds. The shaking of the device helps to activate the Pericytes and also helps to remove any superfluous tissue – The solution is then washed again for 45 seconds – This cycle is repeated until there are no traces of blood or aqueous material and only a clean Lipoaspirate remains – The Lipogems are then extracted from the solution and concentrated Stage 3: Treatment – The injured site is surgically prepared for infiltration and the Lipoaspirate is injected observing aseptic precautions – The site is bandaged using a sterile dressing Once clipped the sites are cleaned The area for harvesting is clipped The cells to be transposed are extracted from just under the skin near the tail head The extracted Lipoaspirate is attached and slowly injected into the device The shaken cycle is repeated until there are no traces of blood or aqueous material and only a clean activated Lipoaspirate remains Post-Treatment The pony will need to be on a period of box rest depending on the injury, for example tendon injuries will need four to six weeks before a fitness schedule can commence, but unlike other treatments or the turn it out for the winter approach, the box rest time is very short. The lead vet on each case may chose to scan the affected area to monitor the progress of healing, usually 10 days to two weeks after treatment and at the end of the rest period to make sure that all is well before fitness can begin. After scanning Murray injects the treatment site Murray scans the site in preparation for injecting, making sure the cells get to the pinpoint of the injury site
  3. 3. Knowledge www.polotimes.co.uk 65Polo Times, December 2016 / January 2017 From Process to Progress Injuries and conditions that have now been treated by the Lipogems Equine veterinary team: • Tendon injuries with core lesions • Desmitis (Inflammation of a ligament) • Chronic desmitis (Chronic inflammation of a ligament) • Soft tissue injuries to the stifle joint • Synovitis (Inflammation of a synovial membrane) • Early osteoarthritis (Degenerative joint disease) • Deep lacerations • Septicemia • Huge anti-inflammatory properties Current Research & Development Performance Projects include • Cryogenic research project • Muscle recuperation Murray Shotter “It was great to do the training session in Argentina, we had a fantastic response from the vets and we managed to get three horses done. It is exciting to be able to show the Argentine vets that Lipogems is at the forefront of treating tendon injuries. It was a fun day and the hospitality was brilliant, many thanks to Diego Araya and Alfonso Pieres.” Pite Merlos “I have worked with Murray Shotter for more than 20 years. We make a good team I think because he is very conservative and I am always more anxious. We had a good mare with a tendon injury, about 40% damaged and he suggested this new ‘thing’ that he was working on which he believed in and thought could help. We decided to do it and after a 40 minute treatment and the process of taking the Lipogems we did the implant. The echo after six weeks was just amazing and surprising! This mare will start to work again in March, we will take her slowly and hopefully she will be back as good and healthy as before her injury.” Photographby©www.imagesofpolo.com Dr Tim Watson BVM&S, PhD, MRCVS Waterlane Equine Vets, tim.watson@mail.com Mob: 07557857793 Mr Bruce Middleton MA Vet MB MRCVS Blackdown Equine Clinic, bruce.vet@hotmail.com Mob: 07766993085 Mr Murray Shotter BVSc MRCVS Shotter and Byers Equine Surgery, murray.shotter@shooterandbyers.co.uk Tel: 01306627706 Mr Clive Hamblin B Vet Med MRCVS Collis Equine Services, chamblin@btconnect.com Mob: 07831385515 Lipogems is an advancement in Orthobiology and Regenerative Medicine. The Lipogems Equine veterinary team can treat: Tendon injuries with core lesions Desmitis (Inflammation of a ligament) Chronic desmitis (Chronic inflammation of a ligament) Soft tissue injuries to the stifle joint Synovitis (Inflammation of a synovial membrane) Early osteoarthritis (Degenerative joint disease) Deep lacerations Septicaemia For more information, contact and case studies visit: lipogemsequine.com @lipogemsequine L I P O G E M S E Q U I N E Website: lipogemsequine.com Email: martin_ffrench_blake@lipogemsequine.com @lipogemsequine

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