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.
Polo Times Dec/Jan 17 - Lipogems Equine International Outreach
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.
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