Catastrophic Musculoskeletal Injury Research Articles

Using accelerometers to identify a high risk of catastrophic musculoskeletal injury in three racing Thoroughbreds.

To describe the process whereby the screening of racing Thoroughbreds with accelerometer-based inertial measurement unit (IMU) sensors followed by clinical evaluation and advanced imaging identified potentially catastrophic musculoskeletal injuries in 3 horses. 3 Thoroughbred racehorses. All cases demonstrated an abnormal stride pattern either during racing (cases 1 and 2) or while breezing (case 3) and were identified as being at very high risk of catastrophic musculoskeletal injury by an algorithm derived from IMU sensor files from > 20,000 horses' race starts. Veterinary examination and 18F-sodium fluoride (18F-NaF) positron emission tomography were performed within 10 days of the respective race or breeze in each of the cases. The intensity and location of the 18F-NaF uptake in the condyles of the third metacarpal bone in cases 1 and 2 identified them as at potential increased risk of condylar fracture. The pattern and intensity of the 18F-NaF uptake in case 3 indicated that the third carpal bone was likely responsible for the horse's lameness, with an impending slab fracture subsequently identified on radiographs. Following periods of convalescence, cases 1 and 2 returned to racing and were identified by the sensor system as no longer being at high risk of catastrophic musculoskeletal injury. Case 3 returned to training but has yet to return to racing. When worn by Thoroughbreds while racing or breezing, these IMU sensors can identify horses at high risk of catastrophic musculoskeletal injury, allowing for veterinary intervention and the potential avoidance of such injuries.

The association between Thoroughbred racehorse training practices and musculoskeletal injuries in Victoria, Australia.

Catastrophic musculoskeletal injuries (CMI) in horses are associated with both too little and too much high-speed exercise. In order to advise trainers on training and management strategies that minimize the risk of musculoskeletal injury (MSI), a better understanding of how training practices affect MSI in racehorses is needed. Data from prospective studies relating training data and MSI are complicated by the gradual development of pathology and the effect of this on the ability of horses to train consistently prior to the identification of an injury. To circumvent this, 66 Australian Thoroughbred trainers were surveyed on their intended training practices, including rest, pre-training, and race-fit practices. Associations between intended training practices and catastrophic and non-catastrophic race day MSI outcomes in two-year-old and mature (≥three-year-old) horses were assessed using multivariable negative binomial regression models. The incidence of two-year-old race day MSI was lower for trainers who preferred shorter times (weeks) to trial, less time in fast work pre-trial (p = 0.003), shorter, more frequent rest periods (p < 0.01) and higher amounts of fast work at 15.5-16.7 m/s once race-fit (p = 0.001). The incidence of mature horse race day MSI was lower for trainers who preferred longer rest periods (p = 0.026) and a high-volume pre-trial training strategy comprising a high volume of slower speed gallop training and longer times to trial compared to fast and light training programs (p = 0.004) for their mature horses, in addition to higher amounts of fast work at 15.5-16.7 m/s for their race-fit two-year-olds (p = 0.012). Race day CMI incidence was lower for trainers who preferred lower volumes of fast gallop work for their race-fit mature horses (p < 0.05). These results suggest that two-year-old training practices could affect MSI risk later in a horse's career, and that age and stage in training (pre-trial, race-fit) are important considerations when developing training practices to minimize the risk of MSI.

The Reporting of Racehorse Fatalities in New Zealand Thoroughbred Flat Racing in the 2011/12-2021/22 Seasons.

Race day fatalities as a consequence of catastrophic musculoskeletal injury and cardiac failure are both a welfare concern and provide a challenge for the social perceptions of equine welfare within the racing industry. To reduce race day fatalities, the risk factors under New Zealand racing conditions need to be identified. The aim of this study was to examine race and horse-level risk factors for fatalities in New Zealand Thoroughbred flat racing using retrospective race day data from the 2011/12-2021/22 racing seasons. Horse and race-level factors associated with a suspected cardiac failure and fatal fracture were identified by merging fatality data with the master race dataset for the corresponding seasons. Most fatalities were associated with fatal fracture (0.4 per 1000 starts, 95% CI 0.4-0.5). Horses which raced over distances > 1600 m were 1.7 times (95% CI 1.2-2.5) more likely to sustain a fatal fracture than horses racing ≤ 1600 m. Male horses and firmer track conditions were also associated with an increase in the risk of fatal fracture. Horses aged 5 years and older were 2.1 (95% CI 1.1-4.6) times more likely to suffer a suspected cardiac failure than younger horses. Changes in the industry reporting system improved the level of detail provided for fatalities, enabling the identification of specific risk factors.

Fifteen risk factors associated with sudden death in Thoroughbred racehorses in North America (2009-2021).

To identify risk factors associated with race-related sudden death in Thoroughbred racehorses in the US and Canada. 4,198,073 race starts made by 284,387 Thoroughbred horses at 144 racetracks in the US and Canada between 2009 and 2021. Study data were extracted from the Equine Injury Database, which contains detailed records of 92.2% of all official race starts made in the US and Canada during the study period. Forty-nine potential risk factors were analyzed using univariable and multivariable logistic regression. Cases were defined as race starts that resulted in fatality within 3 days of racing, in which at least 1 of 5 codes relating to sudden death was recorded. Fatalities due to catastrophic musculoskeletal injury were omitted from the study cohort. 536 race starts resulted in sudden death, an incidence rate of 0.13/1,000 starts. Fifteen risk factors were significantly associated with sudden death, including horse age and sex, season and purse of race, race distance, and horses' recent history of injury and lay-up. Horses racing while on furosemide medication were at 62% increased odds of sudden death. Associations found between previous injury and sudden death suggests preexisting pathology could contribute in some cases. The association between furosemide and sudden death prompts further study to understand which biological processes could contribute to this result.

Catastrophic Musculoskeletal Injuries in Thoroughbred Racehorses in Uruguay, 2011-2017

Catastrophic musculoskeletal injuries (CMI) pose a major welfare concern to horses and their riders, yet limited data are available describing their occurrence in South America. Using a retrospective cohort and case-control design, the objective of the study was to determine the incidence of CMI for Thoroughbreds in training and racing, and associated horse-level risk factors in Uruguay. Seventy-seven Thoroughbreds sustained a CMI, 37 of which were age- and sex-matched to 111 control horses in the same race. Training and racing data from 2011 to 2017 were collected. Incidence of race day CMI per 1,000 race starts and training CMI incidence per 100 horse months were calculated using Poisson regression. Univariable logistic regression was used to assess relationships between race history and occurrence of CMI by fracture location, and multivariable for all fracture locations. Overall race day incidence of CMI was 0.42 per 1,000 race starts (95% CI 0.29, 0.60). The incidence of CMI in training was 0.059 per 100 horse months. Twenty-nine percent (22/77) of horses that sustained a CMI had not raced prior. Most fractures were of the forelimbs (80.3%). There were 32 (41.6%) distal and 39 (50.6%) proximal limb fractures. The risk of CMI was greater for horses with fewer places (P = .001), and greater time between the previous race and the race in which CMI occurred (P = .020). The rate of race day CMI was low, despite Uruguay being a racing jurisdiction with policies and risk factors associated with greater CMI rates compared to other jurisdictions. Lightly raced horses with long periods since their previous race start should be monitored closely.

Inbreeding depression and the probability of racing in the Thoroughbred horse.

Small effective population sizes and active inbreeding can lead to inbreeding depression due to deleterious recessive mutations exposed in the homozygous state. The Thoroughbred racehorse has low levels of population genetic diversity, but the effects of genomic inbreeding in the population are unknown. Here, we quantified inbreeding based on runs of homozygosity (ROH) using 297 K SNP genotypes from 6128 horses born in Europe and Australia, of which 13.2% were unraced. We show that a 10% increase in inbreeding (FROH) is associated with a 7% lower probability of ever racing. Moreover, a ROH-based genome-wide association study identified a haplotype on ECA14 which, in its homozygous state, is linked to a 32.1% lower predicted probability of ever racing, independent of FROH. The haplotype overlaps a candidate gene, EFNA5, that is highly expressed in cartilage tissue, which when damaged is one of the most common causes of catastrophic musculoskeletal injury in racehorses. Genomics-informed breeding aiming to reduce inbreeding depression and avoid damaging haplotype carrier matings will improve population health and racehorse welfare.

Serum Phosphorylated Neurofilament Heavy Subunit Levels and its Association with the Risk for Catastrophic Injury in Thoroughbred Racehorses

Neurofilaments are structural proteins that are concentrated in the body and axons of neurons. Damage to the neurons or axons as a result of trauma or infectious diseases leads to the release of neurofilaments into blood and cerebrospinal fluid (CSF). This case-control study was carried out to compare serum levels of phosphorylated neurofilament heavy chain (pNF-H) between clinically healthy Thoroughbred (TB) horses and TB horses that suffered catastrophic musculoskeletal injuries (cMSI), and to investigate the correlation between putative risk factors and serum concentrations of pNF-H in injured horses. Blood samples were collected from clinically healthy horses and from horses that suffered cMSI. The concentration of pNF-H in serum samples was determined using the Phosphorylated Neurofilament H Sandwich enzyme-linked immunosorbent assay kit. A total of 343 horses were enrolled in the study (148 cases and 195 controls). The median serum concentration of pNF-H for controls was 0.0 ng/ml and for cases was 0.07 ng/ml. No significant difference was observed between the 2 groups in racing. The number of lifetime starts was correlated with serum pNF-H concentration in case horses. The serum concentration of pNF-H was higher in case horses that experienced cMSI while training than while racing. The number of lifetime starts is a proxy measure for several risk factors related to cumulative exercise load during the career of racehorses. Measurement of serum concentrations of pNF-H in TB racehorses does not support the hypothesis that subclinical neurologic injury or conditions are associated with catastrophic injury of TB racehorses.

Risk Factors for Exercise-Associated Sudden Cardiac Death in Thoroughbred Racehorses.

Simple SummaryUnderstanding the causes of racehorse deaths is an important step in addressing this welfare concern. Previous studies have identified that during Thoroughbred racing, catastrophic musculoskeletal injuries, which necessitate euthanasia, account for approximately 75% of fatalities, with sudden athletic death occurring in the remaining 25% of cases. In sudden athletic death cases a post-mortem examination is needed to determine the cause of death. Approximately half of these sudden athletic deaths are attributed to a fatal cardiac arrhythmia, which is termed sudden cardiac death. In order to investigate risk factors for sudden cardiac death, we reviewed the post-mortem reports from horses that died on metropolitan racetracks in Melbourne, Australia and grouped horses into sudden cardiac death and all other fatal injuries. We found that horses with sudden cardiac death were more likely to die during training than during racing, had fewer lifetime starts and were less likely to be entire (uncastrated) males. Exercise intensity appears not to be critically important in precipitating sudden cardiac death in horses. Sudden cardiac death occurred early in the careers of affected horses.Cardiac arrhythmias resulting in sudden cardiac death (SCD) are an important cause of racehorse fatalities. The objective of this study was to determine risk factors for SCD in Thoroughbreds by evaluating a sample with a policy of mandatory post-mortem following racing or training fatalities. Risk factors were compared between case horses with SCD (n = 57) and control horses with other fatal injury (OFI, n = 188) by univariable and multivariable logistic regression. Survival in years for horses with SCD was compared to OFI using the Kaplan–Meier method with log rank test. The following variables were most important in the multiple logistic model: Horses with SCD were more likely to die during training than during racing, SCD (42/57, 74%) vs. OFI (82/188, 44%; odds ratio [OR], 95% confidence interval [CI], 2.5, 1.2–5.4; p = 0.01), had fewer lifetime starts, median (interquartile range [IQR]), SCD (3.0 [0.0–9.0]) vs. OFI (9.0 [0.0–22.8]; OR, 95% CI, 0.96, 0.9–1.0; p = 0.02 and were less likely to be entire (uncastrated) males, SCD 9/57 (16%) vs. OFI (46/188, 25%; OR, 95% CI, 0.47, 0.1–0.9; p = 0.03). Survival in years (median (IQR)) for horses with SCD was 3.6 (3.1–4.4), which was shorter than OFI (4.5 [3.1–6.0], hazard ratio, 95%CI, 1.6,1.2–2.3; p < 0.001). SCD occurs more commonly in training than racing, which suggests exercise intensity is less important in precipitating this fatality. In this study, SCD occurred early in the careers of affected horses.

Multibody Computer Model of the Entire Equine Forelimb Simulates Forces Causing Catastrophic Fractures of the Carpus during a Traditional Race.

Simple SummaryPalios are traditional horseraces held in the main square of few Italian cities. Due to peculiar features of such circuits, adapted to the square architecture and thus characterized by tight curves and unconventional footing surface, horses involved are at particular risk of accidents. Prevention of catastrophic musculoskeletal injuries is a significant issue and matter of debate during these events. In particular, the negotiation of the curves in the city circuits is a significative concern. An experiment was set up to build a model of entire forelimb at the point of failure in the context of a turn comparable to that in a Palio circuit. The model was informed by live data and the output compared to post-mortem findings obtained from a horse that sustained a catastrophic fracture of the carpus during this competition. The objective of this study is to determine the magnitude and distribution of internal forces generated across the carpus under which the catastrophic injury has occurred and describe related post-mortem findings.A catastrophic fracture of the radial carpal bone experienced by a racehorse during a Palio race was analyzed. Computational modelling of the carpal joint at the point of failure informed by live data was generated using a multibody code for dynamics simulation. The circuit design in a turn, the speed of the animal and the surface characteristics were considered in the model. A macroscopic examination of the cartilage, micro-CT and histology were performed on the radio-carpal joint of the limb that sustained the fracture. The model predicted the points of contact forces generated at the level of the radio-carpal joint where the fracture occurred. Articular surfaces of the distal radius, together with the proximal articular surface of small carpal bones, exhibited diffuse wear lines, erosions of the articular cartilage and subchondral bone exposure. Even though the data in this study originated from a single fracture and further work will be required to validate this approach, this study highlights the potential correlation between elevated impact forces generated at the level of contact surfaces of the carpal joint during a turn and cartilage breakdown in the absence of pre-existing pathology. Computer modelling resulted in a useful tool to inversely calculate internal forces generated during specific conditions that cannot be reproduced in-vivo because of ethical concerns.

Risk Factors for Jockey Falls in Japanese Thoroughbred Flat Racing

Jockey safety is of paramount importance from welfare perspective and public perception. This retrospective case-control study aims to identify risk factors associated with jockey falls (JF) in flat races of Japan Racing Association (JRA). JF in 715,210 race starts by 74,328 horses at 10 racecourses from 2003 to 2017 were reviewed. Data were extracted from a database maintained by JRA and from official accident reports issued by race stewards. Seventeen possible risk factors were evaluated using multivariable logistic regression, to identify those significantly associated with JF. A total of 992 JF incidents were recorded, with an incidence rate of 1.39 falls per 1,000 starts (95% CI: 1.30-1.48). 6 risk factors were significantly associated with JF. Odds increased with horses that sustained catastrophic musculoskeletal injury (CMI) (OR: 203; CI: 169-241; P < 0.001). Increased odds were also associated with dirt track surfaces (OR: 1.99; CI: 1.74-2.29; P < 0.001), apprentice jockeys (OR: 1.43; CI: 1.21-1.68; P < 0.001), smaller track sizes (OR: 1.41; CI: 1.24-1.61; P < 0.001), larger fields (OR: 1.25; CI: 1.07-1.47; P=0.005), and longer race distances (OR per 200 m: 1.05; CI: 1.01-1.09; P=0.02). Since CMI was identified as a major contributing factor for JF, measures to minimize CMI may lead to improvement of jockey safety. The increased odds associated with apprentice jockeys may indicate the importance of jockey education and training. For jockey safety, proper staffing of medical professionals especially for races on dirt, smaller track, larger fields, and longer distances is recommended.

Leukocyte numbers and intestinal mucosal morphometrics in horses with no clinical intestinal disease.

Healthy horses and other animals have large numbers of resident leukocytes in the intestinal wall, but there is scant information regarding which and how many leukocytes are normally present in the equine intestinal wall. Our aim was to provide a reference range of leukocytes in the intestinal mucosal and submucosal propria of normal horses. We included in our study intestinal tissues from 22 Thoroughbred racehorses with no clinical intestinal disease, which had been euthanized because of catastrophic musculoskeletal injuries. Neutrophils, lymphocytes, eosinophils, macrophages, and plasma cells were counted in 5 random 17,600-µm2 areas of villus lamina propria of the duodenum, jejunum, and ileum, and deep lamina propria of the duodenum, jejunum, ileum, right ventral colon, left ventral colon, left dorsal colon, right dorsal colon, and small colon. Other features investigated in the same intestinal segments included villus height and width (small intestine), presence of ciliated protozoa, Paneth cells number, subcryptal leukocyte layers (number of leukocyte layers between the bottom of the crypts and the muscularis mucosae), and submucosal leukocytes. Lymphocytes were the most numerous cells in all segments analyzed, followed by plasma cells, eosinophils, macrophages, and neutrophils. Eosinophil numbers were significantly higher in both lamina propria and submucosa of the large intestine than in the small intestine. The duodenum had shorter and thinner villi than either jejunum or ileum. The data provided from our study will be useful for diagnosticians examining inflammatory processes in the intestinal tract of horses.

Exercise-Associated Sudden Death in Finnish Standardbred and Coldblooded Trotters - A Case Series With Pedigree Analysis

Exercise-associated sudden deaths (EASDs) are deaths occurring unexpectedly during or immediately after exercise. Sudden cardiac death (SCD) is one cause of EASD. Cardiac arrhythmias caused by genetic variants have been linked to SCD in humans. We hypothesize that genetic variants may be associated with SCD in animals, including horses. Genetic variants are transmitted to offspring and their frequency might increase within a family. Therefore, the frequency of such variants might increase with the inbreeding factor. Higher inbreeding could have a negative impact on racing performance. Pedigree data and career earnings from racehorses diagnosed with SCD between 2002 and 2017 were compared using non-parametric tests with 1) control horses that died due to catastrophic musculoskeletal injuries and 2) horses that raced during the same period without reported problems. Diagnosis of SCD was based on necropsy reports, including macroscopic and microscopic examinations. Death was registered in the study period for 61 horses. Eleven of these horses were excluded due to missing autopsy reports. In 25 cases, the diagnosis remained unknown and death was possibly caused by cardiac arrhythmia, in two cases cardiac disease was identified, in seven cases a rupture of a major vessel had occurred. In addition, 16 horses died or were euthanized due to severe musculoskeletal injuries. No significant differences in inbreeding coefficients or in career earnings were found between the groups or between horses with EASD compared with other horses racing during the same period. The study provides no evidence for increased inbreeding factor in Finnish racehorses with SCD.

32 Maturation of proximal sesamoid bones in Thoroughbred horses

Proximal sesamoid bone (PSB) injuries account for approximately 50% of fatal catastrophic musculoskeletal injuries in Thoroughbred racehorses. In addition, PSB fractures are not uncommon in Thoroughbred foals and yearlings as a result of energetic or intense free exercise. The ability to interpret some PSB pathology assessments, however, is more difficult given the limited information published on the normal development and maturation of these paired sesamoid bones. Further, information on the level of normal variation in PSB morphological and structural parameters within the Thoroughbred population as a function of age, body size, gender, and inter-animal differences generally are not well documented. This project aims to address these knowledge gaps through analyses of PSB anatomy from 18 Thoroughbreds obtained on postmortem examination representing an age range from birth to skeletal maturity using micro–CT Bone Morphometry Evaluation (μCT BME, n = 8 horses) and clinical CT evaluation (n = 10 horses). The μCT BME was performed on the left front medial PSB in 8 horses ranging from 4 d to 5 years of age. When graphed, the following were observed: 2nd order polynomic relationships with a positive trend between age and bone volume fraction (R 2 = 0.8125), trabecular thickness (R 2 = 0.8084), and degree of anisotropy (R 2 = 0.914); a 2nd order polynomic relationship with a negative trend between age and trabecular number (R 2 = 0.9242); a negative logarithmic relationship between age and connectivity density (R 2 = 0.9439); and a positive exponential relationship between age and trabecular spacing (R 2 = 0.7818). Clinical CT evaluations were performed on medial and lateral PSBs from the respective right and left forelimbs in 10 horses ranging in age from 2 to 5 years of age utilizing Mindways CT Bone Investigational Toolkit for bone mineral density (BMD) analysis. A one-way ANOVA indicates no significant differences ( P = 0.755) in BMD between the 20 PSB in the left forelimb and the contralateral 20 PSB in the right forelimb. However, significant differences, measured though one-way ANOVA, existed between the 20 lateral PSB (10 from the left forelimb and 10 from the right forelimb) and the 20 medial PSB ( P = 0.006). These findings provide a first of its type reference on the development and maturation timeline of equine PSBs, as well as confirming structural differences between lateral and medial PSBs. The data also document rapid PSB changes between birth and 18 mo of age. The long-term objective of this project is to define normal structural and morphological characteristics of Thoroughbred PSBs as a basis for comparison to PSB pathologies.

Catastrophic musculoskeletal injuries in Thoroughbred racehorses on racetracks in Gauteng, South Africa.

The incidence and types of catastrophic musculoskeletal injuries in Thoroughbreds that resulted in euthanasia on selected racetracks in South Africa between 1998 and 2012 were investigated by an observational retrospective investigation. Data from the National Horseracing Authority of Southern Africa for these racetracks were used to calculate incidence rates in Thoroughbreds (n = 114) that sustained catastrophic musculoskeletal injuries during racing that required immediate euthanasia, based on the diagnosis made by the on-site veterinarian as well as on fetlock radiographs and dissections of 53 cadaver limbs of horses that sustained a catastrophic musculoskeletal injury. The proximal sesamoid bones and the distal suspensory ligament were involved in 55.26% of horses; 73.58% of the cadaver limb radiographs were of the left forelimb, 64.15% were closed fractures, and 74.47% had biaxial proximal sesamoid bone fractures. Catastrophic musculoskeletal injuries occurred almost exclusively unilaterally and involved mostly the left front leg. The average incidence rate for a catastrophic musculoskeletal injury occurring in a year at any of the tracks was 0.6 of 1000 starts.

18 F-sodium fluoride positron emission tomography of the racing Thoroughbred fetlock: Validation and comparison with other imaging modalities in nine horses.

Early and accurate detection of stress remodelling in racehorses is of utmost importance to prevent catastrophic injuries. Current imaging techniques have limitations in assessing early changes predisposing to catastrophic breakdowns. Positron emission tomography (PET) using 18 F-sodium fluoride (18 F-NaF) is a sensitive method for the detection of early bone turnover and may improve early recognition of subtle injuries. To validate the clinical use of 18 F-NaF PET in Thoroughbred racehorses, to assess the value of PET in the detection of bone lesions and to compare PET results with findings of other advanced imaging modalities, clinical examination and pathology. Experimental exploratory study. Twenty fetlocks from nine Thoroughbred racehorses were imaged using 18 F-NaF PET, computed tomography (CT) and scintigraphy. Five fetlocks were also imaged with magnetic resonance imaging and four fetlocks were also examined histologically. Imaging findings were independently reviewed by three board certified radiologists. Imaging, clinical and histopathological findings were correlated. PET imaging was well-tolerated by all horses. PET detected focal areas of 18 F-NaF uptake in instances where other imaging modalities did not identify abnormalities, in particular in the proximal sesamoid bones. Maximal standardised uptake values could be measured to quantify the activity of lesions. Areas of 18 F-NaF uptake corresponded to regions of increased vascularity and increased osteoblastic activity. Limited number of cases. 18 F-NaF PET imaging of the Thoroughbred fetlock is feasible and compares favourably with other imaging modalities in detecting stress remodelling in Thoroughbred racehorses. PET appears to be a beneficial imaging modality when used for early detection of stress remodelling in an effort to prevent catastrophic musculoskeletal injuries in this population of horses.

Relationship Between Historical Lameness, Medication Usage, Surgery, and Exercise With Catastrophic Musculoskeletal Injury in Racehorses.

Background: The rate of catastrophic musculoskeletal injuries (CMI) in racehorses is high in the United States compared to other countries. Few modifiable risk factors related to lameness, medication, and surgery history have been identified.Objective: To detect management factors that increase risk of CMI by comparing medical histories between horses that sustained, and horses that did not sustain, a CMI.Study design: Case-control.Methods: Racehorse necropsy data (May 2012-June 2013) were obtained through the California Horse Racing Board Postmortem Program. Attending veterinarians of Thoroughbreds (TB) and Quarter Horses (QH) that experienced CMI, and of three matched control horses, were invited to complete an online veterinary medical history survey. We investigated associations between CMI and lameness, medication, surgery, and exercise history using multivariable logistic regression.Results: There were 146 TB (45 cases, 101 controls) and 17 QH (11 cases, 6 controls) surveys completed. TB cases were more likely to show signs of lameness within the 3 months prior to death compared to controls. A high proportion of both cases (64.3%) and controls (76.8%) were administered medications, but unraced TB case horses were more likely to have been administered systemic medications compared to those that previously raced. TB cases were more likely to have raced with greater intensity during their career, but had eased off in the month preceding CMI. For QHs, there was insufficient power to detect significant differences between cases and controls that showed signs of lameness, or that were administered medications. Surgery history was not associated with CMI.Main limitation: Insufficient power to detect small effect sizes.Conclusions: The study provides information that can be used to aid in identification of horses at high risk for catastrophic injury, and management factors that can be modified to reduce the risk for all horses.

Morphovolumetric Analysis of the Hoof in Standardbred Horses

Hoof conformation has been linked to catastrophic musculoskeletal injuries. Previous studies have been focused on two-dimensional measurements, thus existing knowledge on three-dimensional hoof analysis is very limited. The objective of this study was to examine the morphogeometric properties of the equine hoof using magnetic resonance imaging technology and provide a benchmark for volumetric internal and external anatomy of the hoof and to investigate the correlation between those measurements. Eighteen horses (5.8 ± 2.6 years) with no known hoof pathologies had undergone magnetic resonance imaging; transverse and mid-sagittal (T1-weighted) images were analyzed. Calibrated digital conformational pictures were also taken. In total, 14 internal and 18 external anatomy measurements were performed using Image J software. Patterns of pairwise correlations were found, that is, the distal phalanx volume was correlated with its width (r = 0.739), but not its length. Digital cushion volume was correlated with its length (r = 0.802). Navicular bone width was correlated with distal phalanx width (r = 0.710), but not deep digital flexor tendon width (r = 0.541). The distal phalanx volume and total hoof volume were correlated with the weight of the horse. Our results provide valuable linear and volumetric data for three-dimensional hoof anatomy and provide valuable information for clinicians and researchers to better identify internal hoof anatomy and differentiate pathological cases.

Biomarkers for equine joint injury and osteoarthritis.

We report the results of a symposium aimed at identifying validated biomarkers that can be used to complement clinical observations for diagnosis and prognosis of joint injury leading to equine osteoarthritis (OA). Biomarkers might also predict pre-fracture change that could lead to catastrophic bone failure in equine athletes. The workshop was attended by leading scientists in the fields of equine and human musculoskeletal biomarkers to enable cross-disciplinary exchange and improve knowledge in both. Detailed proceedings with strategic planning was written, added to, edited and referenced to develop this manuscript. The most recent information from work in equine and human osteoarthritic biomarkers was accumulated, including the use of personalized healthcare to stratify OA phenotypes, transcriptome analysis of anterior cruciate ligament (ACL) and meniscal injuries in the human knee. The spectrum of "wet" biomarker assays that are antibody based that have achieved usefulness in both humans and horses, imaging biomarkers and the role they can play in equine and human OA was discussed. Prediction of musculoskeletal injury in the horse remains a challenge, and the potential usefulness of spectroscopy, metabolomics, proteomics, and development of biobanks to classify biomarkers in different stages of equine and human OA were reviewed. The participants concluded that new information and studies in equine musculoskeletal biomarkers have potential translational value for humans and vice versa. OA is equally important in humans and horses, and the welfare issues associated with catastrophic musculoskeletal injury in horses add further emphasis to the need for good validated biomarkers in the horse. © 2017 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 36:823-831, 2018.

Diagnostic approach to catastrophic musculoskeletal injuries in racehorses.

Catastrophic musculoskeletal injuries are the most common cause of euthanasia or spontaneous death in racehorses, and the most common cause of jockey falls with potential for serious human injury. Horses are predisposed to the vast majority of these injuries by preexisting lesions that can be prevented by early diagnosis and adequate bone injury management. A thorough examination of the musculoskeletal system in racehorses often determines the cause of these injuries and generates data to develop injury prevention strategies. We describe the diagnostic approach to musculoskeletal injury, review the methodology for the examination of racehorse limbs, and provide anatomy and pathology tools to perform an organized and thorough postmortem examination of the musculoskeletal system in equine athletes.

Frequency of and risk factors associated with catastrophic musculoskeletal injuries in Quarter Horses at two Midwestern racetracks: 67 cases (2000–2011)

To determine the incidence and anatomic location of and potential risk factors for catastrophic musculoskeletal injuries (CMIs) in racing Quarter Horses. Retrospective matched case-control study. 67 racing Quarter Horse racehorses euthanized because of CMIs and 134 matched controls. Data for Quarter Horses that sustained CMIs and the total number of race starts for each year were obtained from 2 Midwestern racing jurisdictions from 2000 through 2011. Information for each horse with a CMI and for 2 randomly selected control horses that ran in the same race but did not incur a CMI were obtained from race records, past performance reports, and video analysis. There were 61,797 race starts and 82 CMIs from 2000 through 2011 at the 2 racetracks studied, for an overall CMI incidence of 1.33 CMIs/1,000 starts. Sixty-seven horses with CMIs for which complete data were available and 134 matched control horses were included in the study. There was no difference in the incidence of CMIs between the 2 racetracks or over the years studied. The right forelimb was injured in 38 of the 67 (56.7%) horses. Injures to the carpus (24/67 [35.8%]) and metacarpophalangeal joint (fetlock joint; 23/67 [34.3%]) occurred most frequently. Case-control data indicated that the horses with a CMI had fewer starts, were more likely to have stumbled at the break, had a more erratic stride, were fatigued, and trailed in the race, compared with matched controls from the same races. Irrespective of race distance, most of the horses (47/67 [70.1%]) were injured after or within 10 yards before the finish line. The results of the present study may aid in the identification of racing Quarter Horses at risk for CMIs. The cluster of injuries near the finish line provides a specific focus for future research into methods of injury prevention in this population of racehorses.