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- Author or Editor: Chris E. Kawcak x
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Objective—To quantitatively evaluate contact area under 2 loads and subjectively compare contact areas with subchondral bone (SCB) density patterns in intact metacarpophalangeal joints of horses.
Sample Population—6 forelimbs from horses without musculoskeletal disease.
Procedures—Computed tomographic scans of intact metacarpophalangeal joints were analyzed to obtain SCB density measurements. Each limb was loaded on a materials testing system to 150° and 120° extension in the metacarpophalangeal joint, and the joint was stained via intra-articular injection with safranin-O or toluidine blue, respectively. Each joint was disarticulated, and the surface area was digitized. Total articular surface area, contact area, and percentage contact area at each angle were calculated for the distal third metacarpal condyles, the proximal phalanx, and the proximal sesamoid bones.
Results—Contact area on the third metacarpal condyles, proximal sesamoid bones, and the proximal phalanx significantly increased with increased load. Areas of contact subjectively appeared to have a higher density on computed tomographic scans.
Conclusions and Clinical Relevance—Areas consistently in contact under higher load were associated with increased SCB density. This supports the idea that the SCB adapts to the load applied to it. As load increased, contact area also increased, suggesting that areas not normally loaded may have a high degree of stress during impact loading. Quantifying how contact in the joint changes under different loading conditions and the adaptation of the bone to this change in normal and abnormal joints may provide insight into the pathogenesis of osteochondral disease.
Objective—To evaluate effects of extracorporeal shock wave therapy (ESWT) and polysulfated glycosaminoglycan treatment (PSGAGT) on subchondral bone (SCB), serum biomarkers, and synovial fluid biomarkers in horses with induced osteoarthritis.
Animals—24 healthy 2- to 3-year-old horses.
Procedures—An osteochondral fragment was created on the distal aspect of the radial carpal bone in 1 middle carpal joint of each horse. Horses were randomly allocated to receive local application of ESWT (days 14 and 28; n = 8), PSGAGT (IM, q 4 d for 28 days; 8), or a sham ESWT probe (placebo; days 14 and 28; 8). Serum biomarkers were measured every 7 days, and synovial fluid biomarkers were measured every 14 days. Bone density was measured by use of computed tomography on days 0 and 70, and microdamage and bone formation variables were compared among groups at the end of the study (day 70).
Results—There was no significant effect of ESWT or PSGAGT on any bone variable. Serum osteocalcin concentration was significantly greater in horses that received ESWT, compared with placebo-treated horses, and serum concentration of the C-terminal telopeptide of type I collagen was significantly higher in horses that received ESWT, compared with placebo- and PSGAG-treated horses. Concentrations of the synovial fluid epitope CS846 were significantly higher in joints with osteoarthritis treated with ESWT
Conclusions and Clinical Relevance—Treatment of osteoarthritis with ESWT had no effect on SCB but did induce increases in serum biomarkers indicative of bone remodeling. Treatment of osteoarthritis with PSGAG had no effect on SCB or biomarkers.
Objective—To assess clinical, biochemical, and histologic effects of polysulfated glycosaminoglycan (PSGAG) or sodium hyaluronan administered intra-articularly in treatment of horses with experimentally induced osteoarthritis.
Procedures—Osteoarthritis was induced arthroscopically in 1 middle carpal joint of all horses. Eight horses received hyaluronan (20 mg) and amikacin (125 mg) intra-articularly on study days 14, 21, and 28. Eight horses received PSGAG (250 mg) and amikacin (125 mg) intra-articularly on study days 14, 21, and 28. Eight control horses received 2 mL of saline (0.9% NaCl) solution and amikacin (125 mg) intra-articularly on study days 14, 21, and 28. Clinical, radiographic, synovial fluid analysis, gross, histologic, histochemical, and biochemical findings were evaluated.
Results—No adverse treatment-related events were detected. Induced osteoarthritis caused a substantial change in lameness, response to flexion, joint effusion, and radiographic findings, and of these, synovial fluid effusion was reduced with PSGAG, compared with control horses. No changes in clinical signs were seen with PSGAG or hyaluronan, compared with control horses. Histologically, the degree of synovial membrane vascularity and subintimal fibrosis was significantly reduced with PSGAG treatment, compared with controls. Histologically, significantly less fibrillation was seen with hyaluronan treatment, compared with controls.
Conclusions and Clinical Relevance—Results indicated that PSGAG and hyaluronan had beneficial disease-modifying effects and are viable therapeutic options for osteoarthritis in horses.
Objective—To evaluate the use of serum concentrations of biochemical markers of bone metabolism (osteocalcin [OC], bone-specific alkaline phosphatase [BS-ALP], and deoxypyridinoline [DPYR]) to compare healing in infected versus noninfected fractures and in fractures with normal repair versus delayed (nonunion) repair in rabbits.
Animals—32 female 9- to 10-month-old New Zealand White rabbits.
Procedure—A femoral fracture defect was made in each rabbit. Rabbits were assigned to the following groups: the bone morphogenetic-2 gene treatment group with either noninfected nonunion or infected (ie, inoculation of defects with Staphylococcus aureus) nonunion fractures or the luciferase (control) gene treatment group with either noninfected nonunion or infected nonunion fractures. Serum samples were obtained before surgery (time 0) and 4, 8, 12, and 16 weeks after surgery. Callus formation and lysis grades were evaluated radiographically at 16 weeks.
Results—Serum OC and BS-ALP concentrations decreased from time 0 at 4 weeks, peaked at 8 weeks, and then decreased. Serum DPYR concentration peaked at 4 weeks and then decreased, independent of gene treatment group or fracture infection status. Compared with rabbits with noninfected fractures, those with infected fractures had lower serum OC and BS-ALP concentrations at 4 weeks, higher serum OC concentrations at 16 weeks, and higher serum DPYR concentrations at 4, 8, and 16 weeks. Combined serum OC, BS-ALP, and DPYR concentrations provided an accuracy of 96% for prediction of fracture infection status at 4 weeks.
Conclusions and Clinical Relevance—Measurement of multiple serum biochemical markers of bone metabolism could be useful for clinical evaluation of fracture healing and early diagnosis of osteomyelitis. ( J Am Vet Med Assoc 2003;64:727–735)
Objective—To determine the effects of exercise at an early age on tissues in the metacarpophalangeal joints of horses.
Animals—Twelve 18-month-old horses.
Procedures—All horses were pasture reared, but 6 horses had additional exercise starting at 3 weeks of age until 18 months of age. At that time, computed tomography, articular cartilage metabolism evaluation, and histologic assessments of synovial membrane, articular cartilage, and subchondral bone were performed.
Results—Exercised horses had fewer gross lesions, less articular cartilage matrix staining in the dorsal aspect of the condyle, greater bone fraction in the dorsolateral aspect of the condyle, and higher bone formation rate, compared with nonexercised horses.
Conclusions and Clinical Relevance—Exercise at a young age may be protective to joints, although more research is needed to characterize changes in articular cartilage matrix. Results suggested that exercise can be safely imposed at an early age.
Objective—To describe and measure histologic features of midcarpal joint cartilage defects in Thoroughbreds and evaluate the influence of early conditioning exercise on defect development.
Sample—24 midcarpal joints from twelve 18-month-old Thoroughbreds.
Procedures—Midcarpal joints from 12 horses (6 exercised spontaneously at pasture only and 6 given additional conditioning exercise beginning at a mean age of 3 weeks were evaluated. Gross cartilage defects were assessed histologically. Third and radial carpal bones were categorized with regard to the presence or absence of calcified cartilage (CC) abnormalities at the dorsoproximal and dorsodistal articular surfaces, respectively; histomorphometric assessment and statistical analysis were conducted for the third carpal bone.
Results—Number and severity of defects did not appear different between exercise groups. Nine third or radial carpal bones had thickened CC with microcracks, matrix and osteochondral junction changes, and increased vascularity, without histologic changes in the hyaline cartilage. Third carpal bones with CC abnormalities had significantly thicker CC (452 vs 228 μm) than did those without CC abnormalities in the evaluated region. However, in the same region, there were no significant differences in hyaline cartilage thickness (681 vs 603 μm), vascular channel area in the subchondral bone (624,894 vs 490,320 μm2), or number of vascular channels (15.9 vs 18.0).
Conclusions and Clinical Relevance—Early exercise did not appear to influence the distribution or severity of cartilage defects in the midcarpal joint. Calcified cartilage abnormalities beneath the undisrupted hyaline cartilage in the dorsoproximal aspect of the third carpal bone may represent the first changes in the pathogenesis of midcarpal osteochondral disease.
Objective—To assess the clinical, biochemical, and histologic effects of topically administered diclofenac liposomal cream (DLC) in the treatment of horses with experimentally induced osteoarthritis.
Procedures—Osteoarthritis was induced arthroscopically in 1 middle carpal joint of all horses. Eight horses treated with DLC were given 7.3 g twice daily via topical application. Eight horses treated with phenylbutazone were given 2 g orally once daily. Eight control horses received no treatment. Evaluations included clinical, radiographic, magnetic reso-nance imaging, synovial fluid, gross, and histologic examinations as well as histochemical and biochemical analyses.
Results—No adverse treatment-related events were detected. Horses that were treated with DLC or phenylbutazone had significant clinical improvement of lameness, unlike the control horses. Treatment with DLC induced significant improvement in staining and total articular glycosaminoglycan content, compared with no treatment. Treatment with phen-ylbutazone induced significant reduction in synovial fluid prostaglandin E2 concentration, compared with DLC and no treatment. Treatment with DLC induced significantly less radial carpal bone sclerosis and overall gross cartilage erosion, compared with phenylbutazone.
Conclusions and Clinical Relevance—Results indicated that DLC had both clinical sign–modifying and disease-modifying effects. Only clinical sign–modifying effects were detected in association with phenylbutazone administration. Treatment with DLC had significant beneficial effects, compared with phenylbutazone, and no detrimental effects. Results suggested that DLC is a viable therapeutic option for horses with osteoarthritis.
Objective—To investigate the influence of early conditioning exercise on the development of gross cartilage defects and swelling behavior of cartilage extracellular matrix (ECM) in the midcarpal joint of horses.
Procedures—6 horses underwent early conditioning exercise from birth to 18 months of age (CONDEX group), and 6 horses were used as control animals (PASTEX group). The horses were euthanized at 18 months of age, and the midcarpal joints were harvested. Gross defects of the cartilage surface were classified and mapped. Opposing surfaces of the third and radial carpal bones were used to quantify swelling behavior of the cartilage ECM.
Results—A wide range of gross defects was detected in the cartilage on the opposing surfaces of the bones of the midcarpal joint; however, there was no significant difference between the CONDEX and PASTEX groups. Similarly, no significant difference in swelling behavior of the cartilage ECM was evident between the CONDEX and PASTEX groups.
Conclusions and Clinical Relevance—In the study reported here, we did not detect negative influences of early conditioning exercise on the prevalence of gross defects in cartilage of the midcarpal joint or the quality of the cartilage ECM as defined by swelling behavior. These results suggested that early conditioning exercise may be used without negative consequences for the midcarpal joint and the cartilage ECM of the third and radial carpal bones.
Objective—To determine kinematic changes to the hoof of horses at a trot after induction of unilateral, weight-bearing forelimb lameness and to determine whether hoof kinematics return to prelameness values after perineural anesthesia.
Animals—6 clinically normal Quarter Horses.
Procedures—For each horse, a sole-pressure model was used to induce 3 grades (grades 1, 2, and 3) of lameness in the right forelimb, after which perineural anesthesia was administered to alleviate lameness. Optical kinematics were obtained for both forelimbs with the horse trotting before (baseline) and after induction of each grade of lameness and after perineural anesthesia. Hoof events were identified with linear acceleration profiles, and each stride was divided into hoof-contact, break-over, initial-swing, terminal-swing, and total-swing segments. For each segment, kinematic variables were compared within and between limbs by use of mixed repeated-measures ANOVA.
Results—During hoof-contact, the left (nonlame) forelimb hoof had greater heel-down orientation than did the right (lame) forelimb hoof, and during break-over, the nonlame hoof went through a larger range of motion than did the lame hoof. Maximum cranial acceleration during break-over for the lame hoof was greater, compared with that at baseline or for the nonlame hoof. Following perineural anesthesia, the sagittal plane orientation of the hoof during hoof-contact did not vary between the lame and nonlame limbs; however, interlimb differences in maximum cranial acceleration and angular range of motion during break-over remained.
Conclusions and Clinical Relevance—Results suggested that hoof kinematics may be useful for detection of unilateral, weight-bearing forelimb lameness in horses that are trotting.
Objective—To determine kinematic changes to the hoof of horses at a walk after induction of unilateral, weight-bearing forelimb lameness and to determine whether hoof kinematics return to prelameness (baseline) values after perineural anesthesia.
Animals—6 clinically normal Quarter Horses.
Procedures—For each horse, a sole-pressure model was used to induce 3 grades of lameness in the right forelimb, after which perineural anesthesia was administered to eliminate lameness. Optical kinematics were obtained for both forelimbs with the horse walking before (baseline) and after induction of each grade of lameness and after perineural anesthesia. Linear acceleration profiles were used to identify hoof events, and each stride was divided into hoof-contact, break-over, initial-swing, terminal-swing, and total-swing segments. Kinematic variables were compared within and between limbs for each segment by use of mixed repeated-measures ANOVA.
Results—During the hoof-contact and terminal-swing segments, the hoof of the left (nonlame) forelimb had greater sagittal-plane orientation than did the hoof of the right (lame) forelimb. For the lame limb following lameness induction, the break-over duration and maximum cranial acceleration were increased from baseline. After perineural anesthesia, break-over duration for the lame limb returned to a value similar to that at baseline, and orientation of the hoof during the terminal-swing segment did not differ between the lame and nonlame limbs.
Conclusions and Clinical Relevance—Subclinical unilateral forelimb lameness resulted in significant alterations to hoof kinematics in horses that are walking, and the use of hoof kinematics may be beneficial for the detection of subclinical lameness in horses.