what is the current evidence for PRP, stem cells, and other orthobiologics in canine joint disease?

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PRP is the best-supported orthobiologic for canine joint disease, with clinical evidence demonstrating pain and lameness improvements across multiple joint conditions, while mesenchymal stem cell (MSC) therapy shows comparable promise but greater protocol heterogeneity, and autologous conditioned serum (ACS) represents an emerging alternative with distinct anti-inflammatory properties.1613 PRP produces clinically meaningful reductions in pain and functional scores in dogs with osteoarthritis (OA). In dogs with bilateral hip OA, two intra-articular PRP injections 14 days apart produced significant improvements in weight distribution, joint flexion/extension, and validated clinical scores from day 8 through day 180, with radiographic stabilization or improvement in the PRP group versus radiographic progression in saline controls.12 In dogs with hip OA randomized to PRP or placebo, the PRP group showed significantly improved scores and reduced lameness sustained through week 24.12 In dogs with chronic cranial cruciate ligament rupture and OA, a single PRP injection produced significant gait improvements on pressure walkway analysis over 3 months.12 In dogs with bilateral degenerative hip joint disease treated with two intra-articular injections 30 days apart, PRP reduced Canine Brief Pain Inventory (CBPI) scores by 43%, Visual Analogue Scale for locomotion (VAS-loc) by 43%, and descriptive numerical scale (DNS) scores by 33% at 60 days.8 PRP is simple to produce, relatively affordable, and deliverable on-site, making it one of few orthobiologic interventions with both anabolic potential and clinical study support in dogs.6 It is safe for intra-articular use; both autologous and allogeneic administration have been reported as safe in canine patients, and the FDA has granted pre-market approval for a leuko-reduced allogeneic pooled freeze-dried PRP product for use in dogs.16 Product composition is the central variable governing PRP efficacy, and no standardized protocol