Systematic review and meta-analysis of positive long-term effects after intra-articular administration of orthobiologic therapeutics in horses with naturally occurring osteoarthritis.
Authors: Mayet Anna, Zablotski Yury, Roth Susanne Pauline, Brehm Walter, Troillet Antonia
Journal: Frontiers in veterinary science
Summary
# Editorial Summary Intra-articular orthobiologic therapies—including platelet-rich plasma, autologous serum, and mesenchymal stem cell derivatives—represent an increasingly popular approach to managing naturally occurring osteoarthritis in horses, yet evidence for their long-term clinical efficacy has remained fragmented across small, heterogeneous studies. Mayet and colleagues conducted a systematic review of 13 clinical trials using PRISMA guidelines, with meta-analysis of four randomised controlled trials examining lameness reduction as a primary outcome measure; they employed random-effects modelling to account for between-study variation and assessed risk of bias across all included publications. The analysis demonstrated that orthobiologic therapies produce statistically significant long-term improvements in lameness and appear safe when administered intra-articularly, supporting their use as a legitimate treatment option alongside conventional management. However, substantial methodological variation between trials—differing product compositions, joint locations, osteoarthritis staging systems, and outcome measurement timepoints—prevented the authors from drawing specific conclusions about which orthobiologic preparations, anatomical sites, or disease stages yield superior results. To advance the field, future trials must adopt standardised protocols for product characterisation, lameness assessment, and follow-up intervals, enabling direct comparison of efficacy across the range of regenerative therapeutics currently available to equine practitioners.
Read the full abstract on PubMed
Practical Takeaways
- •Intra-articular orthobiologic therapies are a safe and evidence-supported treatment option for managing naturally occurring OA and lameness in horses, but product selection should be based on individual case assessment pending more specific clinical guidance
- •When considering orthobiologics for your clients, recognize that current evidence does not yet distinguish which specific therapy (blood vs. MSC-derived), joint location, or OA stage responds best—future case documentation with standardized outcome measures will improve practice protocols
- •Advocate for detailed case records and outcome tracking in your practice; standardized data collection across the industry will accelerate development of clearer clinical guidelines for orthobiologic application
Key Findings
- •13 studies met inclusion criteria for systematic review; 4 RCTs included in meta-analysis evaluating orthobiologic therapies for naturally occurring OA in horses
- •Orthobiologic therapies (blood-derived and MSC-derived) demonstrated effective long-term lameness reduction and safety profile in horses with naturally occurring osteoarthritis
- •Significant heterogeneity between studies prevented specific recommendations for particular orthobiologic types, affected joints, OA stages, or intended use
- •Current evidence base limited by lack of standardized study designs, inconsistent definitions and compositions of orthobiologic products, and absence of direct comparisons between treatment types