Treatment outcomes for equine osteoarthritis with mesenchymal stromal cells and hyaluronic acid.
Authors: Luque Rodrigo Munevar, Henderson Bri, McCorkell Terence Connor, Alizadeh Amir Hamed, Russell Keith A, Koch Thomas G, Koenig Judith
Journal: Equine veterinary journal
Summary
# Editorial Summary: MSC and Hyaluronic Acid for Equine Osteoarthritis Mesenchymal stromal cells (MSCs) have gained traction in equine practice for treating joint disease, yet evidence comparing their efficacy against established therapies remains limited. This prospective, single-blinded randomised controlled trial enrolled 27 client-owned horses with fetlock or carpus osteoarthritis, assigning them to receive either 10 million or 20 million equine umbilical cord-derived MSCs combined with hyaluronic acid (HA), or HA alone as control. All three groups demonstrated clinically meaningful lameness improvement over six weeks (median reductions of −1.5 to −2.0 grades), with no significant differences between treatments at three or six weeks post-injection, and crucially, no adverse reactions were recorded in any group. Whilst return-to-work rates trended higher in both MSC groups (78–89% versus 56% for HA alone at 18 weeks), this difference did not reach statistical significance, likely due to the study being underpowered—post hoc analysis suggests 30 horses per group would be required to detect meaningful clinical differences. For practitioners, this work confirms the safety profile of cord-derived MSCs and suggests that both cell-based and non-cellular approaches produce comparable short-term lameness outcomes, though larger studies are needed to establish whether MSC treatments genuinely confer longer-term functional advantages warranting their additional cost and complexity.
Read the full abstract on PubMed
Practical Takeaways
- •eCB-MSC therapy combined with hyaluronic acid appears safe for intra-articular use in horses with fetlock and carpus OA, with no clinically significant adverse reactions
- •Both MSC-treated and HA-only groups showed meaningful lameness improvements; MSC groups demonstrated numerically higher return-to-work rates suggesting potential additional benefit, though this requires larger studies to confirm
- •Current evidence does not yet provide compelling justification for MSC treatment over standard HA therapy alone based on lameness outcomes alone, pending larger trials with adequate statistical power
Key Findings
- •No significant adverse reactions occurred within 24-72 hours post-injection across all treatment groups
- •All groups showed significant lameness improvement over 6 weeks (p < 0.05), with no significant differences between eCB-MSC + HA and HA-only groups at 3 or 6 weeks
- •Median lameness improvement at 6 weeks was -1.5 grades for HA alone, -2.0 grades for both 10-million and 20-million MSC + HA groups
- •Return-to-work rates at 18 weeks were numerically higher in MSC + HA groups (8/9 and 7/9) versus HA-only (5/9), though not statistically significant; study was underpowered with 30 horses per group needed for significance detection