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Objective—To determine the effect of limb positioning on the radiographic appearance of the distal and proximal interphalangeal joint spaces of the forelimbs of horses during evaluation of dorsopalmar radiographs.
Animals—14 forelimbs from 9 adult horses.
Procedures—Each horse was in standing position with its forelimbs positioned on blocks. Dorsopalmar radiographs of each foot were obtained with the forelimbs positioned squarely (the metacarpus of both forelimbs was perpendicular to the ground as determined by visual examination [abducted 0°]; baseline) and abducted 5° and 10°. The width of the space at the medial and lateral aspects of the distal and proximal interphalangeal joints (medial and lateral joint space width, respectively) was measured. Mediolateral joint balance was calculated as the difference between the widths of the lateral and medial joint spaces, and joint space width and mediolateral joint balance were compared among all 3 positions.
Results—As the extent of limb abduction increased, the medial aspect of the proximal and distal interphalangeal joints became narrower, compared with the corresponding lateral aspect of those joints. For both the distal and proximal interphalangeal joints, the mediolateral joint balance differed significantly among all limb positions.
Conclusions and Clinical Relevance—Forelimb position significantly affected the mediolateral joint balance of the interphalangeal joints of horses. Thus, it is crucial that the forelimbs of horses be squarely positioned when dorsopalmar radiographs are obtained for accurate evaluation of interphalangeal joint space and balance.
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 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.
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.
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.
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 evaluate the use of a combination of avocado and soybean unsaponifiable (ASU) extracts for the treatment of experimentally induced osteoarthritis in horses.
Procedures—Osteoarthritis was induced via osteochondral fragmentation in 1 middle carpal joint of each horse; the other joint underwent a sham operation. Horses were randomly allocated to receive oral treatment with ASU extracts (1:2 [avocado-to-soybean] ratio mixed in 6 mL of molasses; n = 8) or molasses (6 mL) alone (placebo treatment; 8) once daily from days 0 to 70. Lameness, response to joint flexion, synovial effusion, gross and histologic joint assessments, and serum and synovial fluid biochemical data were compared between treatment groups to identify effects of treatment.
Results—Osteochondral fragmentation induced significant increases in various variables indicative of joint pain and disease. Treatment with ASU extracts did not have an effect on signs of pain or lameness; however, there was a significant reduction in severity of articular cartilage erosion and synovial hemorrhage (assessed grossly) and significant increase in articular cartilage glycosaminoglycan synthesis, compared with placebo-treated horses.
Conclusions and Clinical Relevance—Although treatment with ASU extracts did not decrease clinical signs of pain in horses with experimentally induced osteoarthritis, there did appear to be a disease-modifying effect of treatment, compared with findings in placebotreated horses. These objective data support the use of ASU extracts as a disease-modifying treatment for management of osteoarthritis in horses.
Objective—To determine clinical outcome following intrathecal injection of the podotrochlear (navicular) bursa for signs of foot pain in horses evaluated via magnetic resonance imaging (MRI) and evaluate efficacy of corticosteroids administered with or without hyaluronate.
Design—Retrospective case series.
Procedures—Data collected included signalment, history, intended use, duration and severity of lameness, results of diagnostic anesthesia, radiographic abnormalities, MRI abnormalities, and outcomes for return to use.
Results—MRI was conducted on 23 horses with lameness localized to the foot. Thirteen horses had bilateral forelimb lameness, and 10 had unilateral forelimb lameness. Mean duration of lameness was 10.5 months. Seventeen of 23 (74%) horses had excellent outcomes and returned to intended use within 2 to 4 weeks after navicular bursa injection. Hyaluronate treatment was not associated with outcome; however, horses receiving < 10 mg of trimacinolone had significantly worse outcomes than those treated with hyaluronate. Among horses with excellent outcomes, mean duration of soundness was 7.3 months. Seven of 8 horses with erosive lesions of the flexor surface of the distal sesamoid (navicular) bone diagnosed via MRI had a poor outcome. Horses with navicular bursitis responded optimally to injection, compared with horses with other problems.
Conclusions and Clinical Relevance—Results suggested that intrathecal injection of corticosteroid in horses with erosions of the flexor surface of the navicular bone associated with deep digital flexor tendon adhesions yielded a poor response. Treatment of horses with navicular bursitis via injection of the navicular bursa should be highly effective in alleviating lameness.
OBJECTIVE To evaluate the effects of exercise in an underwater treadmill (UWT) on forelimb biomechanics and articular histologic outcomes in horses with experimentally induced osteoarthritis of the middle carpal joint.
ANIMALS 16 horses.
PROCEDURES An osteochondral fragment was induced arthroscopically (day 0) in 1 middle carpal joint of each horse. Beginning on day 15, horses were assigned to exercise in a UWT or in the UWT without water (simulating controlled hand walking) at the same speed, frequency, and duration. Thoracic and pelvic limb ground reaction forces, thoracic limb kinematics, and electromyographic results for select thoracic limb muscles acting on the carpi were collected on days -7 (baseline), 14, 42, and 70. Weekly evaluations included clinical assessments of lameness, response to carpal joint flexion, and goniometric measurements of thoracic limb articulations. At study conclusion, articular cartilage and synovial membrane from the middle carpal joints was histologically examined.
RESULTS Exercise in a UWT significantly reduced synovial membrane inflammation and resulted in significant clinical improvements with regard to symmetric thoracic limb loading, uniform activation patterns of select thoracic limb muscles, and return to baseline values for carpal joint flexion, compared with results for horses with simulated hand walking.
CONCLUSIONS AND CLINICAL RELEVANCE Overall improvements in thoracic limb function, joint range of motion, and synovial membrane integrity indicated that exercise in a UWT was a potentially viable therapeutic option for the management of carpal joint osteoarthritis in horses.