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- Author or Editor: Christopher E. Kawcak x
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Abstract
OBJECTIVE
To evaluate bone mineral content patterns between fracture configurations using novel CT image analysis.
ANIMALS
CT images from 97 Thoroughbred racehorses with third metacarpal/tarsal condyle fractures provide the case population for analysis.
PROCEDURES
Fractures were grouped by radiographic appearance. Image analysis objectively measured area of highly attenuating pixels (aHAP), areal density of highly attenuating pixels (dHAP) utilizing novel convex hull analysis, and subjective assessment of apparent attenuation intensity ranking (AAIR) for each fracture. Differences between fracture configuration groups were evaluated.
RESULTS
Analysis of dHAP identified lower-density regions of highly attenuating pixels in propagating fractures and higher-density regions of highly attenuating pixels in unicortical fractures (P = .028). Complete and incomplete configurations were almost indistinguishable in dHAP (P = 1.000). The ratio of dHAP between fractured and nonfractured condyles revealed higher density gradients between condyles in unicortical (P = .040) and incomplete (P = .031) fractures than propagating fractures.
CLINICAL RELEVANCE
Differences in patterns of bone mineral content were identified between propagating, bicortical (incomplete and complete), and unicortical fractures of third metacarpal/tarsal bone condyles. Computer-assisted geometric measurement of dHAP identified on CT images could help to assess fracture risk in equine athletes. This application may have greater relevance as standing CT screening becomes more available.
Abstract
Objective—To characterize medial femoral condyle (MFC) morphometrics and subchondral bone density patterns in Thoroughbred racehorses and to determine whether these variables differ between left and right limbs.
Sample—Stifle joints harvested from 6 Thoroughbred racehorses euthanized for reasons other than hind limb lameness.
Procedures—The distal portion of the left and right femurs of each cadaver was scanned via CT. Hounsfield units were converted to dipotassium phosphate equivalent densities through use of a phantom on each specimen. Medial femoral condyle width, length, height, and curvature; subchondral bone plate densities; and subchondral trabecular bone densities were analyzed in multiple sections in 5 frontal planes and 3 sagittal planes and were compared between left and right MFCs.
Results—MFC width, length, and height did not differ between left and right limbs. Regions of interest in the right caudoaxial subchondral bone plate and subchondral trabecular bone were significantly denser than their corresponding left regions of interest in the frontal and sagittal planes. A concavity in the otherwise convex articular surface of the cranial aspect of the MFC was identified in 11 of 12 specimens.
Conclusions and Clinical Relevance—A disparity was identified between left and right subchondral bone density patterns at the caudoaxial aspect of the MFC, which could be attributable to the repetitive asymmetric cyclic loading that North American Thoroughbred racehorses undergo as they race in a counterclockwise direction. The uneven region at the cranial aspect of the MFC could be associated with the development of subchondral bone cysts in horses.
Abstract
Objective—To assess clinical, radiographic, histologic, and biochemical effects of sodium pentosan polysulfate (NaPPS) administered IM for treatment of experimentally induced osteoarthritis in horses.
Animals—18 horses.
Procedures—Osteoarthritis was induced arthroscopically in 1 middle carpal joint of all horses. Nine horses received NaPPS (3 mg/kg, IM) on study days 15, 22, 29, and 36. Nine control horses received the same volume of saline (0.9% NaCl) solution IM on study days 15, 22, 29, and 36. Clinical, radiographic, gross, histologic, histochemical, and biochemical findings as well as findings of synovial fluid analysis were evaluated.
Results—No adverse treatment-related events were detected. Induced osteoarthritis caused a substantial increase in lameness, response to flexion, joint effusion, radiographic findings, synovial membrane inflammation, and articular cartilage fibrillation. Articular cartilage fibrillation was substantially reduced by NaPPS treatment, and concentrations of chondroitin sulfate 846 epitope were significantly increased in the synovial fluid of osteoarthritic and nonosteoarthritic joints of treated horses.
Conclusions and Clinical Relevance—Results indicated that NaPPS has some beneficial disease-modifying effects and may be a therapeutic option for osteoarthritis in horses.
Abstract
Objective—To assess the clinical, biochemical, and histologic effects of extracorporeal shock wave therapy (ESWT) in the treatment of horses with experimentally induced osteoarthritis (OA).
Animals—Twenty-four 2- to 3-year-old horses without evidence of lameness.
Procedures—OA was induced arthroscopically in 1 middle carpal joint of each horse. Fourteen days after induction of OA, horses were treated with a sham ESWT probe (placebo; n = 8), polysulfated glycosaminoglycan (PSGAG) administered IM every 4 days for 28 days as a positive control treatment (8), or ESWT administered on days 14 and 28 with a focused shock wave unit (8). Evaluations included clinical assessments of degree of lameness every 2 weeks and weekly synovial fluid analyses. Horses were euthanized 70 days after induction of OA, and gross pathologic and histologic examinations of cartilage and synovial membrane specimens were performed at necropsy. A generalized linear mixed model was used to compare outcomes among treatment groups.
Results—No adverse treatment-related events were detected in any horse. The degree of lameness in horses treated with ESWT improved significantly, compared with the degree of lameness in placebo- or PSGAG-treated horses. No disease-modifying effects were evident in results for synovial fluid, synovial membranes, or cartilage from the ESWT- or PSGAG-treated horses.
Conclusions and Clinical Relevance—Although a disease-modifying effect of ESWT was not detected, the significant clinical effect of ESWT suggested that this modality should be considered for treatment of horses with OA in combination with another modality that does affect the disease process.
Abstract
OBJECTIVE To evaluate the efficacy of IV administration of a product containing hyaluronan, sodium chondroitin sulfate, and N-acetyl-d-glucosamine for prevention or treatment of osteoarthritis in horses.
ANIMALS 32 healthy 2- to 5-year-old horses.
PROCEDURES The study involved 2 portions. To evaluate prophylactic efficacy of the test product, horses received 5 mL of the product (n = 8) or saline (0.9% NaCl) solution (8; placebo) IV every fifth day, starting on day 0 (when osteoarthritis was induced in the middle carpal joint of 1 forelimb) and ending on day 70. To evaluate treatment efficacy, horses received either the product or placebo (n = 8/treatment) on days 16, 23, 30, 37, and 44 after osteoarthritis induction. Clinical, diagnostic imaging, synovial fluid, gross anatomic, and histologic evaluations and other tests were performed. Results of each study portion were compared between treatment groups.
RESULTS Limb flexion and radiographic findings were significantly worse for horses that received the test product in the prophylactic efficacy portion than for placebo-treated horses or product-treated horses in the treatment efficacy portion. In the prophylactic efficacy portion, significantly less articular cartilage erosion was identified in product-treated versus placebo-treated horses. In the treatment efficacy portion, joints of product-treated horses had a greater degree of bone edema identified via MRI than did joints of placebo-treated horses but fewer microscopic articular cartilage abnormalities.
CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that caution should be used when administering the evaluated product IV to horses, particularly when administering it prophylactically, as it may have no benefit or may even cause harm.
Abstract
OBJECTIVE To determine the ability of an accelerometer within a commercially available portable media device (PMD) to measure changes in postural stability of standing horses during various stance conditions and to compare these results with data obtained by use of a stationary force platform.
ANIMALS 7 clinically normal horses.
PROCEDURES A PMD was mounted on a surcingle; the surcingle was placed immediately caudal to the highest point of the shoulders (withers). Each horse was examined while standing on a stationary force platform system in a normal square stance, forelimb base-narrow stance, and normal square stance at 5 and 10 minutes after sedation induced by IV administration of xylazine hydrochloride. A minimum of 5 trials were conducted for each stance condition. Ranges of craniocaudal and mediolateral motion as well as SDs were collected for the PMD and force platform system. Analyses were performed with mixed-model ANOVAs, and correlation coefficients were calculated.
RESULTS Stance condition significantly altered craniocaudal accelerations measured by use of the PMD, all craniocaudal and mediolateral displacements of the center of pressure, and velocities measured by use of the stationary force platform. For both the PMD and force platform, SDs were significantly affected by stance condition in both craniocaudal and mediolateral directions. Correlation coefficients between the systems for all variables were low to moderate (r = 0.18 to 0.58).
CONCLUSIONS AND CLINICAL RELEVANCE Body-mounted PMDs should be investigated for use in assessment of postural stability in horses with neuromuscular abnormalities.
Abstract
Objective—To evaluate the sedative and analgesic effects of subanesthetic doses of ketamine in horses sedated with xylazine, with or without butorphanol.
Design—Prospective, randomized, controlled study.
Animals—10 adult horses.
Procedures—Each horse was sedated multiple times by administration of xylazine (treatment X), xylazine and butorphanol (treatment XB), xylazine with 1 of 2 dosages of ketamine (treatment XK1 or XK2), or xylazine and butorphanol with 1 of 2 dosages of ketamine (treatment XBK1 or XBK2). Head height and various behaviors, including responses to noise, insertion of a dental float, needle prick on the flank, algometer pressure on the scapula, and bilateral carpal arthrocenteses, were evaluated.
Results—No significant differences were detected among sedation treatments for head height, response to noise, or response to arthrocenteses. Insertion of a dental float was easiest with treatment XBK2 and most difficult with treatments XK1 and XK2. Response to a needle prick on the flank was lowest with treatment XB and highest with treatment XK2. Tolerance to algometer pressure over the scapula was highest with treatment XBK2 and lowest with treatment X.
Conclusions and Clinical Relevance—Administration of a subanesthetic dosage of ketamine with xylazine and butorphanol may facilitate certain procedures, such as insertion of a dental float, in horses and enhance tolerance to pressure stimulation, but it may worsen responses to acute pain, such as that caused by a needle prick. Further evaluation is needed to determine whether subanesthetic dosages of ketamine might be useful when performing certain clinical procedures in horses.
Abstract
OBJECTIVE To determine the effects of altering location of right forelimb and pelvic sensors on kinematic data obtained with a commonly used inertial sensor system during gait analysis of trotting horses.
DESIGN Experimental study.
ANIMALS 12 horses with mild to moderate lameness of at least 1 hind limb, with or without lameness of the forelimbs.
PROCEDURES All horses were examined while trotting on a high-speed treadmill. The right forelimb sensor was tested at 3 anatomic locations in random order: dorsal midline and 2 cm medial and lateral to that midline. During another treadmill session, the pelvic sensor was tested at 5 anatomic locations in random order: dorsal midline, 2 cm to the right and left of midline, and 2 cm cranial and caudal to the tubera sacrale on the midline. Laterality of the pelvic sensor was analyzed in 2 ways: sensor toward the right or left and sensor toward or away from the lame or lamest hind limb. Maximum and minimum differences in head and pelvic motion and vector sum values were ranked and compared with values for the midline location by means of mixed-model ANOVA.
RESULTS Altering the location of the right forelimb sensor by 2 cm medially or laterally had no significant effect on forelimb or hind limb kinematics. However, location of the pelvic sensor had a significant effect on minimum difference in pelvic motion, regardless of whether the data were analyzed by laterality (right vs left) or toward versus away from the lame hind limb.
CONCLUSIONS AND CLINICAL RELEVANCE Results of this study indicated that a 2-cm change in the location of the pelvic sensor during kinematic gait analysis had a significant effect on hind limb kinematic data of the system used. Therefore, placement of this sensor needs to be anatomically accurate.
Abstract
Objective—To evaluate whether cutting equine subchondral bone to demarcate specific regions of interest (ROIs) influences the mean density for that bone as measured via quantitative computed tomography (QCT).
Sample population—2 metacarpophalangeal joints from equine cadavers.
Procedures—The distal portion of the third metacarpal bone of each intact metacarpophalangeal joint was scanned via CT to simulate in vivo conditions. Each joint was subsequently disarticulated and dissected, and the distal portion of the dissected third metacarpal bone in air was scanned. Then, six 1-cm2 areas representing ROIs were cut into the distal condylar surfaces to depths of approximately 1 cm, and the bone was scanned again. Three-dimensional CT models of the 3 bone preparations were generated for each third metacarpal bone on the basis of data from each set of scan images, and densities of the 6 ROIs were measured. Mean bone densities for the 6 ROIs were compared among models of intact, dissected, and cut third metacarpal bone scans.
Results—Mean bone density was significantly lower in cut bone preparations, compared with that in intact or dissected bone. Differences between mean bone densities for intact and dissected bone preparations were not significant.
Conclusions and Clinical Relevance—Cutting subchondral bone to demarcate specific ROIs prior to CT imaging significantly lowered mean bone density as measured via QCT and thus introduced substantial artifacts. These findings have direct implications on techniques for CT modeling of equine subchondral bone in the characterization of joint diseases in horses.
Abstract
Objective—To assess the clinical, biochemical, and histologic effects of intra-articular administration of autologous conditioned serum (ACS) in the treatment of experimentally induced osteoarthritis in horses.
Animals—16 horses.
Procedures—Osteoarthritis was induced arthroscopically in 1 middle carpal joint of all horses. In 8 placebo- and 8 ACS-treated horses, 6 mL of PBS solution or 6 mL of ACS was injected into the osteoarthritis-affected joint on days 14, 21, 28, and 35, respectively; PBS solution was administered in the other sham-operated joints. Evaluations included clinical assessment of lameness and synovial fluid analysis (performed biweekly); gross pathologic and histologic examinations of cartilage and synovial membrane samples were performed at necropsy.
Results—No adverse treatment-related events were detected. Horses that were treated with ACS had significant clinical improvement in lameness, unlike the placebo-treated horses. Among the osteoarthritis-affected joints, ACS treatment significantly decreased synovial membrane hyperplasia, compared with placebo-treated joints; although not significant, the ACS-treated joints also appeared to have less gross cartilage fibrillation and synovial membrane hemorrhage. The synovial fluid concentration of interleukin-1 receptor antagonist (assessed by use of mouse anti–interleukin-1 receptor antagonist antibody) was increased following treatment with ACS.
Conclusions and Clinical Relevance—Results of this controlled study indicated that there was significant clinical and histologic improvement in osteoarthritis-affected joints of horses following treatment with ACS, compared with placebo treatment. On the basis of these findings, further controlled clinical trials to assess this treatment are warranted, and investigation of the mechanisms of action of ACS should be pursued concurrently.