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veterinary
farriery
2019
RCT

Comparison of efficacy and safety of single versus repeated intra-articular injection of allogeneic neonatal mesenchymal stem cells for treatment of osteoarthritis of the metacarpophalangeal/metatarsophalangeal joint in horses: A clinical pilot study.

Authors: Magri Carmelo, Schramme Michael, Febre Marine, Cauvin Eddy, Labadie Fabrice, Saulnier Nathalie, François Isé, Lechartier Antoine, Aebischer David, Moncelet Anne-Sophie, Maddens Stéphane

Journal: PloS one

Summary

# Editorial Summary This prospective pilot study compared single versus repeated intra-articular injections of allogeneic neonatal mesenchymal stem cells (derived from umbilical cord tissue) in 28 horses with metacarpophalangeal joint osteoarthritis, with one group receiving MSC at baseline and placebo at one month, and the other receiving MSC at both timepoints, alongside standardised 8-week rest and rehabilitation protocols. Both treatment groups demonstrated significant clinical improvement across lameness, joint palpation and flexion assessments at 2 and 6 months post-injection, with no statistically significant difference between single and repeated dosing at any evaluation point, whilst radiographic scoring for osteophytes, joint space narrowing and subchondral bone changes showed no progression between baseline and 6 months in either group. Adverse effects were minimal and mild, reported by owners in only 18% of horses, predominantly relating to local injection site reactions. For equine practitioners, these findings suggest that a single intra-articular MSC injection combined with structured rehabilitation may be sufficient to achieve functional improvement in forelimb fetlock osteoarthritis, potentially reducing treatment cost and handling burden without sacrificing clinical efficacy, though the modest sample size and lack of a true placebo control (given both groups received rehabilitation) warrant cautious interpretation of the results.

Read the full abstract on PubMed

Practical Takeaways

  • Single intra-articular MSC injection for MPJ/MTP OA produces equivalent clinical improvement to repeated injections when paired with 8 weeks rest and rehabilitation, reducing treatment costs and complexity
  • Clinical lameness improvement occurs despite minimal radiographic changes, suggesting functional benefit may be independent of structural healing on radiographs
  • MSC therapy appears safe with only minor adverse effects, though rest and rehabilitation remain essential components of the treatment protocol

Key Findings

  • Both single and repeated mesenchymal stem cell injections significantly improved clinical lameness scores over 6 months when combined with rest and rehabilitation
  • No significant difference in clinical outcomes between single MSC injection and repeated injections at 1-month interval
  • Radiographic OA scores, osteophyte scores, and subchondral bone changes showed no significant difference between baseline and 6 months in either group
  • Adverse effects were mild and detected in 18% of treated horses via owner survey

Conditions Studied

osteoarthritis of metacarpophalangeal jointosteoarthritis of metatarsophalangeal jointlameness

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