Intra-articular injection of allogeneic canine adipose-derived stem cell enriched secretome in dogs undergoing tibial plateau leveling osteotomy: a prospective double-blind and randomized pilot trial

Abstract This pilot study evaluated the short- and mid-term outcomes of intra-articular allogeneic canine adipose-derived stem cell (ADSC) enriched secretome in dogs undergoing tibial plateau levelling osteotomy (TPLO), focusing on postsurgical recovery and osteoarthritis (OA) progression. Twenty client-owned dogs were randomly assigned ( n = 10 per group) to a control group (CG), receiving placebo, or a treated group (ADSC-Se), receiving 250 µg of ADSC-derived enriched secretome intra-articularly at the end of TPLO. Lameness, stifle pain, accelerometry, and OA-related changes assessed by radiography and articular ultrasonography scores were evaluated for up to 150 days postoperatively. Median lameness (3 to 1) and stifle pain (2 to 0) scores decreased in ADSC-Se group at 15 days postoperatively, whereas similar improvements in CG occurred later (60 and 90 days postoperatively, respectively). No differences occurred in accelerometry outcomes. Radiographic assessment showed progressive median OA in the CG (1 to 2), whereas OA scores decreased in ADSC-Se group (1 to 0) from 15 days postoperatively and remained stable thereafter. Ultrasonography revealed reduced median joint effusion scores in ADSC-Se group (1 to 0) from 30 days postoperatively, with improvement in cartilage appearance from thin to normal, whereas CG showed no effusion improvement and cartilage deterioration. Radiographic bone healing scores at 30 days post-TPLO were higher in the ADSC-Se group, with mean differences of 1.9 (10-point scale) and 1 (5-point scale). Intra-articular ADSC-enriched secretome was associated with faster postoperative clinical improvement and reduced OA progression, suggesting its potential as a biologic adjunct to TPLO.