Allogeneic chondrogenic-induced mesenchymal stem cells for the treatment of tarsometatarsal lameness in horses.
Authors: Coomer Richard P C, Terschuur Janine A, Pressanto M Chiara, Walker Ian
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Allogeneic Chondrogenic-Induced Mesenchymal Stem Cells for Tarsometatarsal Lameness Commercial intra-articular allogeneic-induced mesenchymal stem cells (CIMSCs) appear substantially more effective than corticosteroid injections for managing bilateral tarsometatarsal joint lameness, according to a retrospective analysis of 167 horses presented to a veterinary surgery centre. The study compared 67 horses treated with CIMSCs against 100 controls receiving corticosteroid injections, with matched cohorts for age (median 9 years), use, and radiographic pathology grade; lameness recurrence was tracked over a median follow-up period of 438 days (CIMSC group) and 546 days (controls). Whilst corticosteroid-treated horses experienced lameness recurrence in 86 of 100 cases with a median time to recurrence of just 90 days, only 25% of CIMSC-treated horses showed recurrence, and crucially, this occurred significantly later at 336 days—yielding a hazard ratio of 8.35 favouring the cellular therapy approach. For equine practitioners managing chronic tarsometatarsal lameness, these findings suggest that whilst intra-articular injection (whether CIMSC or steroid) can resolve acute symptoms, CIMSCs may provide substantially prolonged periods of soundness, potentially reducing repeat interventions and associated downtime over a horse's working life. The data warrant consideration of CIMSC therapy as a first-line intra-articular treatment option, though cost-effectiveness and accessibility remain important practical considerations for adoption into routine lameness management protocols.
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Practical Takeaways
- •Allogeneic mesenchymal stem cells provide substantially longer periods of soundness in horses with tarsal lameness compared to corticosteroid injection alone—expect recurrence at ~11 months vs 3 months
- •Initial lameness resolution occurs reliably in both treatment groups within 5-6 weeks, but CIMSC offers 3.7x longer time before recurrence returns
- •For working horses with tarsometatarsal lameness, CIMSC treatment may reduce need for repeated injections and extend usable athletic life significantly
Key Findings
- •Lameness recurred in 25% of CIMSC-treated horses vs 86% of corticosteroid-treated controls (p<0.0001)
- •Median time to lameness recurrence was 336 days in CIMSC group vs 90 days in controls (p<0.0001)
- •Cox proportional hazard ratio of 8.35 favoring CIMSC treatment (95% CI: 4.67-14.92, p<0.0001)
- •All treated horses (n=167) showed initial abolition of lameness at first re-examination (38 days post-treatment)