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Drug Interactions

Special considerations when using MSCs in joints, tendons and ligaments


  • MSCs primarily act by modulating the immune system

  • When planning a treatment, do not use any agents that might inhibit or interfere with the inflammatory response, including antibiotics. These are cytotoxic and Inhibit proliferation and function

  • Allow a 5-day washout period prior to MSC treatment

  • Use sterile technique to prepare the joint for injection

  • In the event of a flare-up, ice joint/ligament/tendon, monitor over 3-5 days.

  • When treating soft tissue, PRP is always recommended as an additive as it provides a biological scaffold and releases growth factors

  • When blocking – Marcaine is severely chondrotoxic

Use Naropin > Procaine > Lignocaine

Treatment can be done within 24hrs after block




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  2. Broeckx, S., Suls, M., Beerts, C., Vandenberghe, A., Seys, B., Wuertz-Kozak, K., et al. 2014. Allogenic mesenchymal stem cells as a treatment for equine degenerative joint disease: a pilot study. Curr Stem Cell Res Ther. 9(6):497-503

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  6. Fernández-Francos S, Eiro N, Costa LA, Escudero-Cernuda S, Fernández-Sánchez ML, Vizoso FJ. Mesenchymal Stem Cells as a Cornerstone in a Galaxy of Intercellular Signals: Basis for a New Era of Medicine. International Journal of Molecular Sciences. 2021; 22(7):3576.

  7. Freitag, J., Bates, D., Boyd, R., Shah, K., Barnard, A., Huguenin, L., et al. 2016. Mesenchymal stem cell therapy in the treatment of osteoarthritis: reparative pathways, safety and efficacy - a review. BMC Musculoskel Dis.17:230.

  8. Fu, Y., Karbaat, L., Wu, L., Leijten, J., Both, S.K., Karperien, M. 2017. Trophic effects of mesenchymal stem cells in tissue regeneration. Tissue Eng Part B Rev. Dec;23(6):515-528. doi: 10.1089/ten.TEB.2016.0365.

  9. Gugjoo, M. B., & Sharma, G. T. (2019). Equine mesenchymal stem cells: properties, sources, characterization, and potential therapeutic applications. Journal of equine veterinary science, 72, 16-27.

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  12. Leibacher, J. & Henschler, R. 2016. Biodistribution, migration and homing of systemically applied mesenchymal stem/stromal cells. Stem Cell Res. Ther. 7(7):doi 10.1186/s13287-015-0271-2

  13. MacDonald, E. S., & Barrett, J. G. (2020). The potential of mesenchymal stem cells to treat systemic inflammation in horses. Frontiers in Veterinary Science, 6, 507.

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