Abstract
BackgroundPolyacrylamide hydrogel (PAAG) was evaluated recently to treat osteoarthritis (OA) in horses with highly encouraging results; however no long term field-study was done to explore its clinical efficacy and lasting effect. The objective of this study was to evaluate the efficacy of PAAG in improving clinical signs of OA in horses. We hypothesized that lameness grade would significantly improve and the effect would last at least 2 years in osteoarthritic joints treated with PAAG. Forty three horses older than 2 years with OA in only one joint based on clinical evaluation, intra-articular anaesthesia and imaging (radiography) were included in this study. Horses were injected with 2 ml of PAAG into the affected joint and were followed up at 1, 3, 6, 12 and 24 months. Efficacy of PAAG was evaluated by blinded clinical assessment of lameness. Adverse reactions to joint injection were assessed. Data relating to case details, type of activity, joint and limb involved, lameness duration, lameness grading, previous joint treatment, joint effusion grading, radiographic grading, and owner assessment were recorded. Factors associated with the outcome measure “lameness grading” were analyzed using generalized linear mixed model for logistic regression.ResultsAt 1, 3, 6, 12 and 24 months follow-up, 59%, 69%, 79%, 81/% and 82.5% of horses were non-lame respectively. Reduction of joint effusion was observed over time. No side effect was observed in the treated joints. There was a significant decrease in lameness grade from baseline to 1, 3, 6, 12 and 24 months (P < 0.0001) and a significant positive association with joint effusion (P < 0.0001). Estimates for odds ratio (OR) showed that the effect of treatment increased over time (OR for lower lameness from month 1 to month 24 relative to baseline increased from 20 to 58).ConclusionsPAAG significantly alleviated lameness and joint effusion in osteoarthritic joints. PAAG is a safe and lasting (at least 24 months) OA treatment in horses. PAAG is a promising new treatment for OA in horses.
Highlights
Polyacrylamide hydrogel (PAAG) was evaluated recently to treat osteoarthritis (OA) in horses with highly encouraging results; no long term field-study was done to explore its clinical efficacy and lasting effect
A comparative prospective study has demonstrated that horses with OA treated with PAAG significantly improved their clinical signs when compared to horses with OA treated with triamcinolone acetonide combined with sodium hyaluronan (SH) [19]
Our hypothesis was that lameness scores would significantly improve and the effect will last at least 2 years in osteoarthritic joints after treatment with PAAG
Summary
Polyacrylamide hydrogel (PAAG) was evaluated recently to treat osteoarthritis (OA) in horses with highly encouraging results; no long term field-study was done to explore its clinical efficacy and lasting effect. We hypothesized that lameness grade would significantly improve and the effect would last at least 2 years in osteoarthritic joints treated with PAAG. A recent clinical study investigated the effect of PAAG on improving clinical signs of equine OA within the metacarpo(tarso)phalangeal joint or one of the carpal joints (antebrachiocarpal, middle carpal or carpometacarpal) [16]. A recent pilot study using an experimental OA model in goats has shown that PAAG was integrated into the synovial membranes of the injected joint, and significantly improved the lameness caused by OA, with 75% (3 out of 4) of the cases becoming non-lame at 4 months post treatment evaluation [18]. Another report has shown that PAAG effectively relieved lameness in horses with distal interphalangeal joint OA [20]
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