Joints Of Horses Research Articles

Ultrasonographic Appearance of Elbow Joints in a Population of Amiata Donkeys

Ultrasound (US) is a well-established technique for investigating joint diseases in horses, complementary to radiography. Few studies have been performed on the ultrasonographic aspect of the elbow joint in horses and no reports are available on donkeys. The aim of this study is to describe the ultrasonographic appearance of the elbow joint in healthy donkeys. Descriptive cohort study included 34 elbow joints, which were evaluated in 17 donkeys. Inclusion criteria included no lameness or musculoskeletal diseases in the donkeys. The structures evaluated were the lateral and medial collateral ligaments, ulnaris lateralis proximal tendon, distal biceps brachii tendon, triceps brachii tendon, and the articular space. For each structure, one good-quality image was recorded. The structures were retrospectively assessed for echogenicity, fiber orientation, bone appearance, and shape. The prevalence of the visualized structures was calculated. Cohen κ coefficient was calculated for the repeatability (intraoperator agreement), the reproducibility (interoperator agreement), and the influence of the operator’s experience in US examination. The US appearance of the structures was described. Statistical analysis showed scarce-to-moderate agreement concerning the repeatability and mostly scarce-to-good agreement concerning the reproducibility of the US examination; finally, low-to-discrete agreement concerning the operator’s experience. Technical difficulties precluded an accurate description of the medial collateral ligament. The healthy animals included were limited. The US examination of the elbow joint in donkeys were similar to the features reported in horses. Individual experience partially influences the execution and the assessment of the US images.

Assessment of Vein Diameter and Body Surface Temperature after High-Intensity Laser Therapy (HILT) on the Tarsal Joint in Healthy Horses

The aim of the study was to assess the influence of high-intensity laser therapy (HILT) on vein diameter and on body surface temperature changes in the tarsal joint area in a group of clinically healthy racehorses. The hypothesis of the study was that HILT increases vein diameter and body surface temperature in healthy tissue. The study involved 16 Thoroughbreds being subjected to ultrasonographic examination to assess changes of diameter of the cranial branch of the medial saphenous vein and thermographic examination to indicate temperature change of the dorsal surface of the tarsal joint, just before and immediately after HILT treatment. Vein diameter and mean surface temperature of the tarsal joint significantly increased after HILT treatment. In addition, the study was the first to describe the photothermal effect of HILT in healthy horses. More studies are necessary to specify the parameters of the procedure, that is, wavelength, energy density, or time of the procedure, depending on the patient’s individual characteristics and type of tissue.

Effects of intra-articular administration of lidocaine, mepivacaine, and the preservative methyl parahydroxybenzoate on synovial fluid biomarkers of horses.

To compare the extent of inflammation and catabolic collagen response in the middle carpal joints (MCJs) of healthy horses following intra-articular injection of 2% lidocaine, 2% mepivacaine, lactated Ringer solution (LRS), or 0.1% methyl parahydroxybenzoate. 17 adult horses. In the first of 2 experiments, the left middle carpal joint (MCJ) of each of 12 horses was injected with 10 mL of 2% lidocaine (n = 3), 2% mepivacaine (3), or LRS (control; 6). After a 4-week washout period, the right MCJ of the horses that received lidocaine or mepivacaine was injected with 10 mL of LRS, and the right MCJ of horses that received LRS was injected with 10 mL of 2% lidocaine (n = 3) or 2% mepivacaine (3). In experiment 2, the left MCJ of each of 5 horses was injected with 10 mL of 0.1% methyl parahydroxybenzoate. After a 48-hour washout period, the right MCJ of each horse was injected with 10 mL of LRS. Synovial fluid (SF) samples were aseptically collected before and at predetermined times after each injection. Synovial fluid WBC count, neutrophil percentage, and total protein, neutrophil myeloperoxidase, neutrophil elastase, and Coll2-1 concentrations were compared among treatments. Both lidocaine and mepivacaine induced SF changes indicative of inflammation and a catabolic collagen response, but the magnitude of those changes was more pronounced for lidocaine. Methyl parahydroxybenzoate did not cause any SF changes indicative of inflammation. Results suggested that mepivacaine was safer than lidocaine for intra-articular injection in horses.

Arthroscopic approaches to and anatomy of the shoulder joint of cattle: a cadaver study

BackgroundArthroscopic surgery is described as a minimally invasive technique for diagnosis, exploration and treatment of joint disorders. It allows intraarticular structures to be assessed accurately, thereby improving the diagnostic capabilities, and it broadens the spectrum of surgical techniques feasible for treatment of articular pathologies in cattle.This study aimed to assess for cattle the described arthroscopic approaches to the shoulder joint of horses, and to describe the appearance of the corresponding intraarticular structures of the shoulder joint. Additionally, to perform histological examination where tissues were identified and assessed arthroscopically, but the tissue type was uncertain using cadaveric limbs from cattle of different age categories without any signs of orthopedic diseases of the front limbs.ResultsAn anatomic and arthroscopic investigation with 34-cadaveric forelimbs from 20-cattle was performed. The arthroscope was inserted either immediately cranial or 1-cm caudal to the tendon of the infraspinatus muscle for the cranial and caudal approaches, respectively. The shoulder joints were examined with the limbs in either horizontal non-pulled position, abducted non-pulled position using a three-pod limb holder adjustable in height, or horizontal manually pulled position. Arthroscopy was performed using a rigid 30°arthroscope (18-cm length, 4-mm outer diameter) to view the synovial pouches with their synovial villi and the following structures: cranial rim of the glenoid, cranial portion of the humeral head, incisura-glenoidalis, caudal rim of the glenoid, caudal portion of the humeral head, and cranial and caudal cul-de-sac. Abduction of the limb allowed improved visualization of the lateral portion of the joint. Pulling the limb facilitated investigation of the medial portion of the joint. Generally, the distention range was higher in younger as compared to adult cattle, and visualization of the medial portion of the joint was, therefore, facilitated in younger animals. The main complications observed were subcutaneous fluid extravasations and partial-thickness articular cartilages wear-lines.ConclusionThe described arthroscopic techniques allowed good overall visualization of the most relevant anatomical structures within the healthy cadaveric joint. Further investigations are warranted to evaluate the diagnostic and therapeutic applications of these techniques and the prognosis of arthroscopic surgery as a tool for the treatment of joint lesions.

The correlation between score-based protocol for equine joint assessment and subsequent arthroscopic intervention outcomes

This study aimed to grade joint abnormalities in horses submitted to therapeutic arthroscopy using score-based protocols for equine joint assessment, correlated with arthroscopic treatment outcomes and owner satisfaction. In this prospective study, we evaluated 126 joints of athletic horses referred for arthroscopy. The joints were scored according to findings of medical history and physical, radiographic, ultrasonographic and arthroscopic examination. Lameness, positive response to flexion test and decreased maximum joint flexion angle were detected in more than 50% of joints. Soft tissue swelling, sclerosis, subchondral bone osteolysis and single osteochondral fragments were the most common radiographic findings. Ultrasonographic examination revealed changes in synovial fluid volume and appearance, and subchondral bone irregularities. Increased vascularity of the synovial villi, chondral fibrillation, chondral fissures and superficial cartilage erosions were the most significant arthroscopic findings. The approaches that demonstrated greater sensitivity and correlation with treatment outcome and owner satisfaction were medical history, ultrasonographic and arthroscopic examination. The scoring protocol employed to grade joint abnormalities enabled the creation of a joint score system for the objective assessment, thus determining the most frequent findings and establishing an injury severity score for each joint.

Metatarsophalangeal Arthrodesis through the Modified Steel Basket Technique in Foal

Background: The metacarpophalangeal and metatarsophalangeal joints are very demanded during high intensity exercises, and may be affected by osteoarthritis, fractures, luxations and rupture of the suspensory apparatus. Thus, arthrodesis may be indicated to restore joint stability and accelerate the ankylosis process. The most commonly used surgical techniques have been associated with postoperative complications, including infection and failure of the implants, so it is important to develop procedures that are less invasive procedures and promoting stable fixation. Therefore, the aim of this work is to report the use of the modified steel basket technique for metatarsophalangeal arthrodesis in a foal with hyperextension of the joint due to rupture of the digital flexor muscles. Case: A 2-day-old male foal was admitted to clinical care, presenting multiple cutaneous wounds caused by dogs bites, located in the tarsus and thigh of the hindlimb. The animal presented in standing position and had no difficulty of movement, being initially treated through daily cleaning of the cutaneous wounds and systemic antibiotic therapy. Hyperextension of the metatarsophalangeal joint was evidenced after 20 days, being approached through tenotomy and tendon shortening, followed by tenorrhaphy and immobilization for 30 days. Due to the failure of the treatment, it was opted for metatarsophalangeal arthrodesis by modified steel basket technique. The procedure involved the implantation of a steel basket of 25.0 mm in diameter x 25.0 mm long in a 24.0 mm hole created on the dorsal surface between the third metacarpal and the proximal phalanx. The basket was filled with bone extracted from drilling and fixed with two cortical screws at an angle of 25° toward proximoplantar and distoplantar direction. Immobilization of the limb was performed postoperatively with synthetic plaster cast for 45 days and, due to the persistence of lameness, maintained with Robert Jones banding and plantar splint for another 15 days. At 90 days after surgery, radiographic control showed signs of degeneration and joint fusion, and grade 2 claudication (1-5) was observed during locomotion. At six months after surgery, discrete claudication (grade 1/1-5) was evident. The aesthetic and functional result was considered satisfactory and the animal was then ridden and used for leisure. Discussion: In this report, arthrodesis was indicated due to hyperextension of the metatarsophalangeal joint caused by the rupture of the digital flexor muscles, since these structures, together with the suspensory apparatus, assist in the support of the joint. Several techniques have been descrited for arthrodesis of metacarpal/metatarsophalangeal joints in horses, being the technique described by Bramlage the most employed and successful one. However, complications related to the techniques such as infection and implant failure were evidenced in one study. The technique of the modified steel basket is characterized by the promotional of effective intervertebral arthrodesis in cases of cervical instability in horses. In this report, the technique was effective in promoting metatarsophalangeal arthrodesis, as well as easy and quick to perform. Therefore, it is suggested that the technique may be used as an alternative for metacarpal/metatarsophalangeal arthrodesis in horses with osteoarthritis or hyperextension of the joint due to suspensory apparatus failure. However, studies are needed to evaluate the effectiveness of the technique in metacarpophalangeal arthrodesis in adult horses.

Do Muscle Activities of M. Splenius and M. Brachiocephalicus Decrease Because of Exercise-Induced Fatigue in Thoroughbred Horses?

Muscle activities of the major hindlimb muscles have been reported to decrease with fatigue in horses. However, those in other muscles have been scarcely reported. We aimed to quantify fatigue-induced electromyographic changes in head and neck muscles and muscles around the shoulder joints in horses. Surface electromyographic recording of the splenius, brachiocephalicus, infraspinatus, and deltoid muscles was performed on a total of nine healthy Thoroughbred horses. Horses galloped on a treadmill inclined to 3% at a constant speed (12.7–14.6 m/second) to make them fatigued after approximately 5 minutes. They trotted at 3.5 m/second before and after this exercise. Stride frequency, integrated electromyographic values for a stride, and median frequency of the muscle discharge were calculated every 30 seconds. These parameters were compared at the start and end of the gallop exercise for the lead and trailing limbs and while trotting before and after the exercise using a paired t-test. The stride frequency significantly decreased at the end of the gallop (P < .001), whereas it did not change while trotting. Integrated electromyographic values of the splenius and brachiocephalicus muscles in both lead and trailing limbs at the gallop and those of both left and right sides at the trot significantly decreased with fatigue (P < .05), whereas those of infraspinatus and deltoid muscles did not change at either gallop or trot. No changes were observed in median frequency in any muscles with fatigue. These results suggest that splenius and brachiocephalicus muscle activities can be associated with stride frequency and speed.

Surgical repair of radial carpal bone fractures in two racehorses

SummaryA 3‐year‐old Standardbred gelding (Case 1) and a 2‐year‐old Thoroughbred gelding (Case 2) were referred for surgical evaluation of a left radial carpal bone (RCB) fracture, sustained during training. Clinical findings at the time of initial examination included a palpable effusion within the left middle carpal joint in both horses and marked signs of pain and reduced range of motion on flexion of the affected carpus. In both horses, the RCB fracture was evident on the following radiographic views of the carpus: dorsolateral–palmaromedial oblique (30° off lateromedial) and flexed lateromedial. An additional loose wedge‐shaped osteochondral fragment at the proximal articular surface of the RCB could be seen in Case 2. Both horses underwent surgical reduction and repair of the fracture between 1 and 2 days following the initial injury, which consisted of arthroscopic removal of any intra‐articular osteochondral fragments, and arthroscopic assisted‐interfragmentary compression via a standard dorsomedial and dorsolateral approach to the antebrachiocarpal joint (ACJ) and middle carpal joints (MCJ). The two horses returned to function as racehorses, 6 months (Case 1) and 16 months (Case 2) after surgery. The RCB is a relatively uncommon site for large carpal fractures in horses. The clinical presentation and findings from this report were similar to that of third carpal bone (C3) slab fractures, confirming that surgical repair is indicated in selected cases of RCB fractures.

Histologic assessment of age-related changes in the temporomandibular joints of horses

To describe histologic changes in the temporomandibular joints (TMJs) of horses of various ages. 22 TMJs from cadavers of 11 horses. Horses were categorized into 3 age groups (group 1, 2 to 10 years old [n = 3]; group 2, 11 to 20 years old [3]; and group 3, > 20 years old [5]). Each TMJ was sectioned into 5-mm slices, preserved in formalin, decalcified in formic acid, and routinely processed for histologic analysis. Joints were systematically assessed by use of previously described methods. Multilevel mixed-effects models were used to examine the data. The number of changes was significantly fewer and degree of changes was significantly less within the TMJs of group 1 horses, compared with those of group 3 horses. Comparison among groups revealed that the combination of temporal and mandibular scores for group 1 was significantly lower than for groups 2 or 3. Disk score did not differ significantly between groups 1 and 2, but disk scores of groups 1 and 2 were significantly lower than the disk score of group 3. The assessed lesions were associated with osteoarthritis, and they accumulated in the TMJs as horses aged. In the absence of signs of pain manifested as changes in mastication, behavior, or performance, it would be difficult to determine the point at which accrued pathological changes represented the onset of clinically important osteoarthritis of the TMJs.

Tarsocrural joint polymyxin B concentrations achieved following intravenous regional limb perfusion of the drug via a saphenous vein to healthy standing horses.

To determine whether therapeutic concentrations (> 0.5 to 1.0 μg/mL) of polymyxin B (PB) were achieved in the tarsocrural joint of horses when the drug was administered by IV regional limb perfusion (IV-RLP) via a saphenous vein at doses of 25, 50, and 300 mg and to describe any adverse systemic or local effects associated with such administration. 9 healthy adult horses. In the first of 2 experiments, 6 horses each received 25 and 50 mg of PB by IV-RLP via a saphenous vein with at least 2 weeks between treatments. For each treatment, a tourniquet was placed at the midmetatarsus and another was placed midway between the stifle joint and tarsus. Both tourniquets were removed 30 minutes after the assigned dose was administered. Blood and tarsocrural joint fluid samples were collected for determination of PB concentration before and at predetermined times after drug administration. In experiment 2, 4 horses were administered 300 mg of PB by IV-RLP in 1 randomly selected pelvic limb in a manner identical to that used in experiment 1. For all 3 doses, the mean synovial fluid PB concentration was > 10 times the therapeutic concentration and below the level of quantification at 30 and 1,440 minutes after drug administration, respectively. No adverse systemic or local effects were observed following PB administration. Results suggested that IV-RLP of PB might be a viable alternative for treatment of horses with synovial infections caused by gram-negative bacteria.

The association between collagen and bone biomarkers and radiographic osteoarthritis in the distal tarsal joints of horses.

Osteoarthritis (OA) of the distal intertarsal (DIT) and tarsometatarsal (TMT) joints occurs commonly. Synovial fluid (SF) biomarkers of collagen and bone turnover have potential clinical value. To measure SF biomarker concentrations from DIT and TMT joints in adult horses and determine if they correlate with radiographic OA severity and are higher in joints with radiographic OA compared to controls. Cross-sectional. Radiographic OA of DIT and TMT joints was evaluated from adult horses (5-35years old). Overall radiographic scores divided horses into those with mild or moderate radiographic OA (16 joints from 9 horses) or controls (13 joints from 9 horses). Direct biomarkers of OA (Carboxypropeptide of type II collagen=CPII, carboxy-neoepitope of type II collagen exposed after collagenase-cleavage=C2C, Bone alkaline phosphatase=BAP and Chondroitin sulfate epitope=CS846) were measured via ELISA and CPII/C2C was calculated. Biomarkers were correlated with radiographic findings and concentrations from those with radiographic OA to control joints and were compared. Concentrations of CPII (R=0.84, P<0.001), C2C (R=0.69, P<0.001) and BAP (R=0.41, P=0.03) as well as CPII/C2C (R=0.69, P<0.001) values positively correlated with overall radiographic scores. Adjusted means±s.d., after controlling for age, for CPII (P<0.001), C2C (P<0.001), CPII/C2C (P=0.004) and BAP (P=0.05) were significantly higher in DIT and TMT joints with radiographic OA (CPII: 2174.45±1064.01; C2C: 233.52±51.187; CPII/C2C: 9.01±4.09; BAP: 21.98±15.34) compared to controls (CPII: 594.53±463.05; C2C: 153.12±48.95; CPII/C2C: 3.96±2.38; BAP: 12.76±3.61). CPII (P<0.001), C2C (P=0.001) and CPII/C2C (P=0.001) were significantly higher with moderate radiographic OA (CPII: 2444.61±772.78; C2C: 248.90±44.94; CPII/C2C: 9.47±2.97) compared to controls (CPII: 658.38±417.36; C2C: 156.49±47.61; CPII/C2C: 4.15±2.04), with CPII also showing significantly higher concentrations (P=0.04) with mild radiographic OA compared (1515.00±584.95) to controls (658.38±417.36). There were no differences in CS846 concentrations between radiographic OA and control joints. Age positively correlated with CPII (R=0.48, P=0.01) and C2C (R=0.44, P=0.02) concentrations. Radiographic OA was assessed, not clinical lameness. Controls were not age-matched to those with spontaneous radiographic OA. There is an association between collagen (CPII, C2C and CPII/C2C) and bone (BAP) biomarkers and radiographic OA in the distal tarsal joints of horses.

Serotonin-evoked cytosolic Ca2+ release and opioid receptor expression are upregulated in articular cartilage chondrocytes from osteoarthritic joints in horses

Osteoarthritis is a pain-associated progressive disease and pain mediators, such as opioid receptors, expressed in articular cartilage could represent novel therapeutic targets. Acute and chronic stages of OA indicate different metabolic abilities of the chondrocytes depending on inflammatory state.This study aimed to investigate the response of healthy and osteoarthritic chondrocytes and their expression and release of pain mediators in response to acute inflammation.Interleukin-1 beta (IL-1β) and lipopolysaccharide (LPS) were used to induce an acute inflammatory response in cultured equine chondrocytes harvested from healthy joints (HC) and osteoarthritic joints (OAC), the latter representing acute exacerbation of a chronic inflammatory state. Intracellular Ca2+ release was determined after exposure to serotonin (5-hydroxytryptamine (5-HT), glutamate or ATP. Protein expression levels of F- and G-actin, representing actin rearrangement, and opioid receptors were investigated. Glutamate concentrations in culture media were measured. Cartilage was immunohistochemically stained for µ (MOR), κ (KOR), and δ (DOR) opioid receptors.Upon exposure to acute inflammatory stimuli, OAC showed increased intracellular Ca2+ release after 5-HT stimulation and increased expression of MOR and KOR. When cells were stimulated by inflammatory mediators, glutamate release was increased in both HC and OAC. Immunostaining for MOR was strong in OA cartilage, whereas KOR was less strongly expressed. DOR was not expressed by cultured HC and OAC and immunostaining of OA cartilage equivocal.We show that chondrocytes in different inflammatory stages react differently to the neurotransmitter 5-HT with respect to intracellular Ca2+ release and expression of peripheral pain mediators.Our findings suggest that opioids and neurotransmitters are important in the progression of equine OA. The inflammatory stage of OA (acute versus chronic) should be taken into consideration when therapeutic strategies are being developed.

Evaluation of four techniques for injection of the proximal interphalangeal joint in horses.

To describe a dorsoproximal midline (DPM) standing technique for proximal interphalangeal joint (PIPJ) injection and to compare it to established dorsolateral flexed (DLF), palmaroproximal (PP), and dorsolateral standing (DLS) techniques. Ex vivo study. Sixty cadaver equine thoracic limbs. Limbs were divided into four groups (n = 15 each group), DLF, DPM, PP, and DLS. For each technique, three operators injected radiopaque contrast and methylene blue into the PIPJ in five limbs. The number of attempts required was recorded. Successful injection was confirmed by radiographic presence of contrast media within the PIPJ. Iatrogenic cartilage damage was assessed by gross examination. Statistical analysis was performed by Wilcoxon signed-rank test (P < .05). The overall success rates were 86.6% to 93.3%. Although there was no difference in success rate, the frequency of needle repositioning was influenced by injection technique (P = .009). Dorsolateral standing had the highest mean ± SD value of attempts required to insert the needle in the joint space (2.62 ± 1.94). Injection technique influenced cartilage damage (P = .025), with the highest frequency recorded for DLS. All four techniques for injecting the PIPJ were highly successful; DLS was associated with the highest number of needle repositionings and the highest incidence of iatrogenic injury to cartilage. Dorsolateral flexed should be considered as an alternative to the DLS technique to reduce iatrogenic cartilage injury when injecting the PIPJ. Dorsoproximal midline and DLF techniques have success rates comparable to traditional techniques, with lower incidence of iatrogenic cartilage damage in cadaver limbs.

Effects of blood-derived products and sodium hyaluronate on equine synovial fluid cells and on synovial fluid from osteochondrotic joints of horses after arthroscopy and administration of treatment.

To compare effects of platelet-rich plasma (PRP), interleukin-1 receptor antagonist protein (IRAP), autologous processed plasma (APP), and sodium hyaluronate treatments on synovial fluid cells in vitro and on synovial fluid obtained from osteochondrotic joints of horses. Synovial fluid cells from 8 healthy equine tibiotarsal joints (in vitro experiment) and synovial fluid samples from 40 tibiotarsal joints of 25 horses with osteochondrosis dissecans (in vivo experiment). Effects of various treatments on concentrations of prostaglandin (PG) E2, interleukin (IL)-1β, tumor necrosis factor-α, IL-10, and IL-1 receptor antagonist (IL-1ra) were analyzed in cell medium supernatant, and production of reactive oxygen species was analyzed by use of flow cytometry. In an in vivo experiment, synovial fluid samples were collected before and 48 hours after arthroscopy and treatment administration (8 joints/treatment) and evaluated to determine concentrations of hyaluronic acid, chondroitin sulfate, PGE2, tumor necrosis factor-α, IL-1, IL-10, and IL-1ra. All in vitro treatments reduced reactive oxygen species production, PRP increased PGE2 concentrations, and PRP, IRAP, and APP increased IL-1ra concentrations. Only IRAP and APP increased IL-1 concentrations. For the in vivo experiment, PRP increased and IRAP decreased PGE2 concentrations in synovial fluid after arthroscopy. All treatments increased IL-1ra concentrations, but only sodium hyaluronate resulted in a significant increase in concentration, compared with the concentration for untreated joints. Also, IRAP reduced hyaluronic acid breakdown in synovial fluid. PRP should be used with caution in the period immediately after arthroscopy and treatment of osteochondrotic joints of horses. All treatments had antioxidant effects. Sodium hyaluronate, APP, and IRAP might help ameliorate joint inflammation.

Evaluation of the effect of experimentally induced cartilage defect and intra-articular hyaluronan on synovial fluid biomarkers in intercarpal joints of horses

BackgroundInflammatory and degenerative activity inside the joint can be studied in vivo by analysis of synovial fluid biomarkers. In addition to pro-inflammatory mediators, several anabolic and anti-inflammatory substances are produced during the disease process. They counteract the catabolic effects of the pro-inflammatory cytokines and thus diminish the cartilage damage. The response of synovial fluid biomarkers after intra-articular hyaluronan injection, alone or in combination with other substances, has been examined only in a few equine studies. The effects of hyaluronan on some pro-inflammatory mediators, such as prostaglandin E2, have been documented but especially the effects on synovial fluid anti-inflammatory mediators are less studied. In animal models hyaluronan has been demonstrated to reduce pain via protecting nociceptive nerve endings and by blocking pain receptor channels. However, the results obtained for pain-relief of human osteoarthritis are contradictory. The aim of the study was to measure the synovial fluid IL-1ra, PDGF-BB, TGF-β1 and TNF-α concentrations before and after surgically induced cartilage defect, and following intra-articular hyaluronan injection in horses. Eight Standardbred horses underwent bilateral arthroscopic surgeries of their intercarpal joints under general anaesthesia, and cartilage defect was created on the dorsal edge of the third carpal bone of one randomly selected intercarpal joint of each horse. Five days post-surgery, one randomly selected intercarpal joint was injected intra-articular with 3 mL HA (20 mg/mL).ResultsOperation type had no significant effect on the synovial fluid IL-1ra, PDGF-BB, TGF-β1 and TNF-α concentrations but compared with baseline, synovial fluid IL-1ra and TNF-α concentrations increased. Intra-articular hyaluronan had no significant effect on the biomarker concentrations but a trend of mild improvement in the clinical signs of intra-articular inflammation was seen.ConclusionsCreation of the cartilage defect and sham-operation lead to an increase of synovial fluid IL-1ra and TNF-α concentrations but changes in concentrations of anabolic growth factors TGF-β1 and PDGF-BB could not be documented 5 days after the arthroscopy. Intra-articular hyaluronan was well tolerated. Further research is needed to document possible treatment effects of intra-articular hyaluronan on the synovial fluid biomarkers of inflammation and cartilage metabolism.

Ultrasonography of the stifle

Stifle injuries are increasingly recognised as a major cause of hind limb lameness and commonly affect the soft tissues of the joint in adult horses, making ultrasonography a vital part of diagnostic imaging of this joint. This article aims to provide an introduction to stifle ultrasonography. To ensure comprehensive evaluation of the stifle, a systematic approach is necessary. The ultrasonographic examination is divided into five approaches: initially weight-bearing scans should be obtained of the cranial aspect (for the femoropatellar joint), medial aspect (for the medial femorotibial joint), and lateral aspect (for the lateral femorotibial joint), followed by flexed views from cranial (for the cranial aspect of the femorotibial joints) and, finally, in limited cases because pathology is rarer and the technique more demanding, weight-bearing views of the caudal aspect (for the caudal parts of both femorotibial joints). For the femoropatellar joint, ultrasound can be used to identify bruising (haematoma), injuries to the patellar ligaments, trochlear ridges (including osteochondrosis), and patella and tibial crest fractures. For the femorotibial joints, injuries to the menisci are the most common, but ultrasound can also identify rarer collateral and cruciate ligament injuries. and abnormalities of the weight-bearing surfaces of the femoral condyles, such as cartilage damage and subchondral bone cysts.

Quantitative characterization of viscoelastic properties of synovial fluid from forelimb joints of orthopedically normal Thoroughbreds and warmblood horses.

To determine whether differences existed in the viscoelastic properties of synovial fluid samples from the metacarpophalangeal, intercarpal, and distal interphalangeal joints of orthopedically normal athletic horses. 45 warmblood horses and 30 Thoroughbreds (age range, 4 to 16 years). Synovial fluid samples were aseptically obtained via arthrocentesis from 1 metacarpophalangeal, intercarpal, and distal interphalangeal joint of each horse, and nucleated cell counts were performed. A commercial ELISA was used to measure sample hyaluronic acid concentrations, and full rheological characterization of samples was performed to measure the elastic or storage modulus G' and viscous or loss modulus G" at 37.5°C (representing the body temperature of horses). Findings were compared among joints and between breed groups by means of ANOVA. Significant differences in synovial fluid G' and G" values were identified between Thoroughbreds and warmblood horses for the metacarpophalangeal joint, between the metacarpophalangeal and intercarpal joints of Thoroughbreds, and between the metacarpophalangeal and distal interphalangeal joints and intercarpal and distal interphalangeal joints of warmblood horses. No significant differences were identified between breed groups or among joints in synovial fluid hyaluronic concentrations or nucleated cell counts. Viscoelastic properties of the forelimb joints of orthopedically normal Thoroughbreds and warmblood horses differed within and between these 2 groups, mainly as a function of the evaluated joint. To the authors' knowledge, this was the first study of its kind, and additional research is warranted to better understand the viscoelastic properties of synovial fluid in horses to optimize their locomotive function.

A Standing Percutaneous Technique for Proximal Interphalangeal Joint Arthrodesis in Twelve Horses (2014–2017)

This report describes the use of a minimally invasive standing pastern arthrodesis technique for the treatment of osteoarthritis in horses and documents its clinical outcome in 12 horses. Medical records and radiographs of horses diagnosed with proximal interphalangeal joint osteoarthritis that underwent standing pastern arthrodesis using transarticular screws were reviewed. Follow-up information for determination of outcome was obtained via phone interview with the owners. Twelve horses (15 limbs) were included in the study. Radiographical findings revealed severe osteoarthritis in 12/15 limbs and moderate osteoarthritis in 3/15 limbs. Follow-up information was available for 11/12 cases (13/15 limbs). Phone surveys with the owners revealed that 8/11 horses were performing at their previous activity level or higher. Two horses remained lame. One horse developed a surgical site infection and was euthanatized. The average time for horses to return to their previous level of activity was 6.5 months (range: 1-18 months). Stabilization of the proximal interphalangeal joint in horses with moderate-to-severe osteoarthritis can be performed using this minimally invasive standing technique. This procedure can be performed safely and provides a similar outcome when compared with other described techniques.

Diagnostic techniques for the carpal and fetlock joints in horses with arthritis

The aim of this study was to compare diagnostic techniques for the assessment of cartilage damage in the carpal and fetlock joints in horses with arthritis. The techniques compared were synovial fluid analysis, as well as radiographic, thermographic, ultrasonographic, and arthroscopic examinations. Sixteen horses of both sexes with arthritis, weighing 438 + 51 kg and at different ages were used as material. Before a detailed examination, an evaluation of the conformation and symmetry of the musculoskeletal system was performed. Nerve blocks definitively localized lameness to a specific site. Thermographic, radiographic, ultrasonographic, and arthroscopic examinations were performed after routine clinical examination. Synovial fluid and sera were collected for further analysis. In conclusion, although all examination techniques may yield useful information, their severe limitations were revealed, particularly in the detection of early articular cartilage damage. Arthroscopy is more reliable than other methods in cases of joint capsule lesions and intra-capsular lesions, as well as cartilage and synovial hyperplasia. Arthroscopy is considered to be advantageous and necessary.

Veterinary use of thermal water and mud from Lake Hévíz for equestrian injury prevention and rehabilitation

Beneficial effects of thermal mud treatment in the human medical field have been known for many years. However, such treatments have never been studied and used in veterinary science. The aim of our study was to investigate how a mud treatment from Héviz Spa Lake affects the movement quality and flexibility of certain joints in horses. Wet sludge was applied on the knee, hock, elbow, shoulder, back, stifle, front and hind cannons and fetlock joints for a period of eight weeks. Our results show, that the mud treatment from Lake Héviz may have beneficial effects on the joints, and play an important role in the locomotion of horses.