Topic:Arthrocentesis
Arthrocentesis, also known as joint aspiration, is a procedure used to obtain synovial fluid from a horse's joint capsule. This technique is employed to diagnose, monitor, and manage joint disorders by analyzing the fluid for abnormalities. Synovial fluid analysis can provide information on cell count, protein levels, and the presence of infectious agents or crystals, aiding in the identification of conditions such as septic arthritis, osteoarthritis, and other joint pathologies. This page includes peer-reviewed research studies and scholarly articles that explore the methodologies, applications, and clinical relevance of arthrocentesis in equine veterinary practice.
Platelet-derived mitochondrial preparation did not alter early inflammatory markers in a bilateral lipopolysaccharide-induced model of equine synovitis. To evaluate IA autologous platelet-derived mitochondrial preparation versus vehicle control in a bilateral lipopolysaccharide (LPS)-induced model of equine synovitis. Unassigned: 2 ng of LPS was injected into bilateral intercarpal joints of 6 horses over 3 months. Autologous mitochondria, isolated with a commercial kit, were injected into one joint, while the contralateral joint received a vehicle control, a within-subject controlled experimental design. Mitochondrial organelle appearance was visualized on transmission electron microscopy. Outcome measures included synovial fluid and whole-blo...
Safety study of leucoreduced allogeneic pooled freeze-dried platelet-rich plasma in healthy equine joints. Clinical use of blood-derived intra-articular therapies, such as platelet-rich plasma (PRP), have increased in equine athletes due to their proposed disease-modifying effects. Need for a shelf-stable, allogeneic PRP product with known composition for standardized treatment exists. The objective of this study was to compare systemic and local effects of a single intra-articular injection of equine leucoreduced allogeneic pooled freeze-dried PRP (alloPRP) to a placebo control (saline) in normal, healthy equine joints. Unassigned: Twelve healthy horses were randomly assigned to either control (sa...
PRP and hyaluronic acid reduce synovitis in horses after arthroscopic OCD removal in Andalusian horses. This study was performed to evaluate the efficacy of intra-articular (IA) injections of a combination of platelet rich plasma (PRP) and hyaluronic acid (HA) on joint effusion following arthroscopic removal of OCD in the tarso-crural joint (TCJ) in young Andalusian horses. Methods: Forty Andalusian horses diagnosed with OCD of the distal intermediate ridge of the tibia (DIRT) were included in the study. Horses enrolled in this study had persisting synovial effusion after arthroscopic removal of OCD in the TCJ. A subjective semi-quantitative effusion score was adopted in the study to define the ...
Evaluation of an intra-articular carboxymethylcellulose crosslinked hydrogel in horses with osteoarthritis. Numerous treatment strategies have been proposed to manage osteoarthritis (OA) in sport horses. Carboxymethylcellulose (CMC), is used in veterinary medicine for various purposes. Objective: This study aimed to assess the efficacy of a CMC hydrogel in reducing clinical lameness in horses with OA affecting joint. The hypothesis was that intra-articular CMC would produce a sustained reduction in lameness compared to a control treatment. Methods: Thirty client-owned horses diagnosed with OA-related lameness in the metacarpophalangeal joint were enrolled. Horses were randomly assigned to two groups...
Analysis of different techniques for injection of the interspinal space in horses. Impingement of spinous processes (SPs) is commonly diagnosed in the equine athlete. For diagnostic and therapeutic purposes, local injections are performed at the level of the space between adjacent spinous processes in affected horses. Objective: To assess the accuracy of different techniques for the local injection of the interspinal space in the equine thoracolumbar spine. Methods: Ex vivo experimental study. Methods: Equine thoracolumbar spine specimens were used to compare three techniques for needle insertion (midline; bilateral abaxial; unilateral oblique), two needles (20G-1½″; 20G-...
Influence of dietary Saccharomyces cerevisiae fermentation product on markers of inflammation and cartilage metabolism in young exercising horses challenged with intra-articular lipopolysaccharide. The objective was to evaluate dietary fermentation product (SCFP) on joint inflammation and cartilage metabolism in exercising yearlings challenged with intra-articular lipopolysaccharide (LPS), hypothesizing dietary SCFP (TruEquineC, Diamond V Mills, Inc.) would ameliorate joint inflammation and increase cartilage metabolism. Thirty Quarter Horse yearlings were stratified by bodyweight (BW), age, sex, and randomly assigned to dietary treatments (n = 10/treatment): control (0), 46, or 92 mg/kg BW/d SCFP. Treatments were top-dressed to 1% BW/d concentrate void of added microbials. Horses ...
Synovial fluid parameters following acute articular fracture in the horse. The objective was to investigate synovial sample appearance, total nucleated cell count (TNCC), total protein concentration (TP), and neutrophil percentage in horses with acute articular fractures to aid decision making in acutely lame horses. Methods: Retrospective case series. Methods: Synovial fluid samples (n = 55). Methods: Synovial fluid records were analyzed over an 11 year period from horses undergoing lag screw fixation or arthroscopic fragment removal of intra-articular fractures within 48 h of occurrence. Horses were excluded when presented with wounds close to the joint or ...
Early effects of anti-TNFα antibodies in horses with osteoarthritis. Osteoarthritis (OA) is the most common pathology in sport horses, presenting a chronic and recurrent course. Traditional anti-inflammatory treatments provide only temporary clinical improvement and pain relief; however, they have been associated with metabolic disorders in articular cartilage in the medium term. In this study, we generated a llama polyclonal antibody against equine TNF-α, which was used for intra-articular treatment in horses with OA. Treatment effects were assessed through clinical examination and the determination of inflammatory parameters (MMP-2, MMP-9, LDH, and GAGs) in ...
Interleukin-1β as an articular process joint intra-articular model induces synovitis and signs of acute neck pain in horses. To develop and define a model of acute neck pain in an equine cervical articular process joint (APJ) using recombinant equine IL-1β (reIL-1β). Unassigned: 12 horses in this experimental study received a randomly assigned, unilateral intra-articular injection of 50 ng (n = 6) or 100 ng (n = 6) of reIL-1β and saline (contralateral side as control) into the C5-to-C6 APJ. Blinded ultrasonographic, clinical, and biomechanical parameters were evaluated between 4 hours and 14 days. Unassigned: There was a significant increase in APJ effusion on ultrasonographic examination that peaked at 24 hours ...
A Safety and Efficacy Study of a Synthetic Biolubricant in an Equine Model of Post-Traumatic Osteoarthritis. Post-traumatic osteoarthritis (PTOA) is a common cause of lameness in the horse. There is no cure, therefore treatments are aimed at reducing pain and improving the joint environment by modifying inflammatory pathways or by viscosupplementation. Here, we report the safety and efficacy of the biolubricant (poly(2-methacryloyloxyethyl phosphorylcholine; pMPC) to mitigate the physical, gross, histological, and biochemical effects of arthritis. We created an osteochondral fragment in the middle carpal joint of one limb in 16 horses to induce PTOA; the contralateral limb served as a sham-operated j...
The concurrent use of 2.5% polyacrylamide hydrogel and betamethasone esters for intra-articular injection is well tolerated in 10 healthy horses. This study assessed the safety and tolerability of concurrent intra-articular (IA) injection of 2.5% polyacrylamide hydrogel (2.5% iPAAG) and betamethasone sodium phosphate and betamethasone acetate esters (BME) in the metacarpophalangeal joints (MCPJs) of healthy horses. Methods: 10 healthy therapeutic riding horses were enrolled in this open-label safety study from August 1 to September 14, 2023. Inclusion criteria required normal physical examinations, insulin level, hematology, biochemistry, soundness at all gaits, and negative forelimb flexion tests. Screening occurred from days -14 to -0...
Development of an ultrasound-guided proximo-medial approach for injection of the carpal flexor tendon sheath in horses and comparison with the conventional proximo-lateral ´blind` technique. The aim of this prospective case-control study was to describe and implement a reliable, accurate, and straightforward ultrasound-guided proximo-medial approach technique for injecting the carpal flexor tendon sheath in horses. The proximo-medial ultrasound-guided approach for intrathecal access to the carpal canal, as described in this study, was firstly developed on ten cadaveric limbs using an undiluted ionic iodinated contrast medium. Landmarks were identified, and the access point was established. Subsequently, the technique was validated in ten horses, and its efficacy was compared with ...
Effect of a dietary nutraceutical “STRUCTURE-Joint” on response of horses to intra-articular challenge with IL-1: implications for tissue adaptation to stress. The purpose was to determine local (articular) and systemic effects of intra-articular interleukin-1 in horses supplemented with a dietary PUFA supplement [STRUCTURE-Joint (ST-J)]. Sixteen (16) healthy, mature, light breed horses were randomly assigned to diets containing 0 or 120 mL (n = 8 per group) of ST-J for 30 d. On days 0 (prior to beginning supplementation) and 27, recombinant equine interleukin-1β (reIL-1 β) (75 ng) was injected into the left or right intercarpal joint to induce mild, transient synovitis. Synovial fluid was obtained by aseptic arthrocentesis at postinjection hou...
Double-blinded, randomized tolerance study of a biologically enhanced Nanogel with endothelin-1 and bradykinin receptor antagonist peptides via intra-articular injection for osteoarthritis treatment in horses. Osteoarthritis is a leading cause of pain and retirement in athletic horses. Hydro-expansive functionalized nanogels, acting as Drug Delivery Systems, constitute one of the current therapeutic prospects. These nanogels have the potential to combine mechanical benefits through polymers with the biological effect of prolonged release of bioactive molecules. The purpose of this double-blinded randomized tolerance study versus negative control was to evaluate the response of healthy joints to a single injection of the expected efficient dose (further referred to as the trial dose) and overdose of ...
Administration of sodium hyaluronate to adult horses prior to and immediately after exercise does not alter the range of motion in either the tarsus or metacarpophalangeal joints. Hyaluronic acid (HA), a glycosaminoglycan found in joint synovial fluid, is administered to horses as an anti-inflammatory with lubrication properties. This experiment examined the effects of HA administered before and shortly after an exercise test on metacarpophalangeal (MCP; fetlock) and tibiotarsal (hock) joint range of motion (ROM). Horses were injected intravenously (IV) with placebo (4 mL, saline) or HA (4 mL, 40 mg) 24 h before performing a standardized exercise test (SET) on a high-speed treadmill and again at 6-h post-SET. Passive fetlock flexion was measured at 4 and 24 h post-...
Association of Borrelia burgdorferi with nuchal bursitis and elevated outer surface protein A-specific serum antibodies in horses of the northeastern United States. Evaluate the incidence of Borrelia burgdorferi in cases of equine nuchal bursitis (NB) and investigate the relationship between elevated serum outer surface protein A (OspA) antibodies and the molecular identification of B burgdorferi in bursal tissue or synovial fluid. Additionally, describe clinical cases and compare the histologic changes in NB with and without detection of B burgdorferi. Methods: This was a retrospective multicenter cohort study (2013 to 2022). Medical records from horses with a diagnosis of NB and B burgdorferi PCR testing on NB tissue or synovial fluid were reviewed. The...
Ultrasound-guided caudal cervical articular process arthrocentesis is accurate in live horses with and without arthropathy. Cervical articular process joint (CAPJ) therapy is advocated for horses with neck disorders. Several ultrasound-guided CAPJ techniques have been described in cadaver studies with 72%-89% intra-articular injection accuracy; however, the CAPJ injection accuracy in clinical equine practice has not been extensively reported. Objective: To describe a modified cranial approach for ultrasound-guided caudal CAPJ injections, to investigate the accuracy of this CAPJ injection technique in live horses, and to assess the effect of CAPJ injection location, laterality, operator, and radiographic CAPJ enlarg...
Morphine synovial fluid concentrations after intravenous regional limb perfusion in horses during standing sedation. Addition of morphine to the perfusate while performing intravenous regional limb perfusion (IVRLP) may be helpful in treating painful infectious orthopaedic conditions of the distal limb. Objective: The main objective of this study was to determine synovial morphine concentrations following IVRLP with morphine alone or in combination with amikacin. Methods: Randomised cross-over in vivo experiment. Methods: Six horses underwent IVRLP with 0.1 mg/kg morphine sulphate diluted to 60 mL using 0.9% NaCl (M group) or combined with 2 g amikacin and 0.9% NaCl (MA group) with a 2-week washout per...
Multicenter study investigating long-term survival after synovial lavage of contaminated and septic synovial structures in horses presented to 10 UK referral hospitals. To report the long-term survival of adult horses that were subjected to synovial lavage for treatment of contaminated and septic synovial structures. Methods: Multicenter, prospective observational trial. Methods: Horses (n = 240) presented for synovial sepsis at 10 UK referral centers. Methods: Data for horses presented for treatment of synovial sepsis were collected over a 15 month recruitment period. Owners were contacted a minimum of 365 days after surgery using a structured client interview to assess long term survival. Descriptive statistics, and univariable and Cox proportional haza...
Functional infrared thermography imaging can be used to assess the effectiveness of Maxicam Gel® in pre-emptively treating transient synovitis and lameness in horses. Diagnosing and treating lameness in horses is essential to improving their welfare. In equine orthopedic practice, infrared thermography (IRT) can indirectly detect soreness. Non-steroidal anti-inflammatory drugs can treat painful and inflammatory processes in horses. Using IRT, the efficacy of meloxicam (Maxicam Gel) was evaluated in pre-treating transient synovitis in horses induced by a middle carpal joint injection of lipopolysaccharides (LPS) from 055:B5 at a dose of 10 endotoxin units. Unassigned: In a cross-over design, six healthy horses were randomly assigned to receive either 0.6 ...
Systemic absorption of triamcinolone acetonide is increased from intrasynovial versus extrasynovial sites and induces hyperglycemia, hyperinsulinemia, and suppression of the hypothalamic-pituitary-adrenal axis. Steroid-associated laminitis remains a major concern with use of corticosteroids in horses. Individual case factors such as joint pathology, pre-existing endocrinopathies, or corticosteroid type, dose, and timing influencing steroid-induced laminitis risk have not been investigated. This study aimed to determine if systemic absorption of triamcinolone acetonide (TA) varies between intrasynovial (antebrachiocarpal) and extrasynovial (sacroiliac) injection sites, and to determine the effects of TA absorption on glucose, insulin, cortisol, and adrenocorticotropic hormone (ACTH). Twenty adult hors...
Pressure pain mapping of equine distal joints: feasibility and reliability. Osteoarthritis is a prevalent degenerative joint disease initiating chronic pain and lameness in horses. While several objective gait analysis systems have been developed and validated to quantify lameness severity in horses, methods to evaluate whether peripheral sensitization contributes to the pain experienced are missing. Unassigned: To evaluate whether periarticular pressure pain mapping could be proposed as an auxiliary assessment tool in horses. Specific aims were to evaluate the feasibility and intra- and inter-rater reliability of pressure pain thresholds (PPT) determination at sites ...
Histologic and cytologic changes in normal equine joints after injection with 2.5% injectable polyacrylamide hydrogel reveal low-level macrophage-driven foreign body response. The data presented in this paper are derived from an in vivo study performed to characterize the nature of the synovial integration process of a 2.5% synthetic cross-linked injectable polyacrylamide hydrogel (2.5 iPAAG) injected IA in horses. Methods: 10 healthy horses not suffering from OA or signs of joint disease were administered 50 or 100 mg 2.5 iPAAG in a total of 13 metacarpophalangeal or middle carpal joints. Methods: Injected joints were examined at 0, 14, 42, and/or 90 days postinjection. Parameters investigated included clinical examination, synoviocentesis, gross pathology, histolo...
Use of equine cadaver limb models to enhance veterinary student self-efficacy during arthrocentesis. To determine if equine cadavers modified with joint distension would yield higher fluid volumes, require fewer needle redirects, and improve student self-efficacy. Methods: 19 third-year veterinary students. Methods: Voluntary participation was sought during 4 sessions of an equine arthrocentesis and diagnostic analgesia laboratory. Half of the sessions were provided with unmodified cadavers and half were provided with cadavers modified with joint distention. Prior to and after the laboratory, participating students completed surveys regarding their self-efficacy with arthrocentesis of the met...
The Frequency of Communication Between the Synovial Compartments of the Equine Temporomandibular Joint: A Contrast-Enhanced Computed Tomographic Assessment. There is conflicting evidence regarding communication between the two compartments of the equine temporomandibular joint (TMJ). Understanding the inter-relationship between TMJ compartments is critical for diagnostic and clinical management purposes. To determine the frequency of communication between the discotemporal joint (DTJ) and the discomandibular joint (DMJ) of the equine TMJ in horses free of overt disease. A randomized, blinded, controlled cadaveric study. Equine cadaver heads ( = 20), with no reported history of potential TMJ disease, were collected and stored frozen until use. ...
Investigation of synovial fluid lubricants and inflammatory cytokines in the horse: a comparison of recombinant equine interleukin 1 beta-induced synovitis and joint lavage models. Lameness is a debilitating condition in equine athletes that leads to more performance limitation and loss of use than any other medical condition. There are a limited number of non-terminal experimental models that can be used to study early inflammatory and synovial fluid biophysical changes that occur in the equine joint. Here, we compare the well-established carpal IL-1β-induced synovitis model to a tarsal intra-articular lavage model, focusing on serial changes in synovial fluid inflammatory cytokines/chemokines and the synovial fluid lubricating molecules lubricin/proteoglycan 4 and hya...
Time to Peak Concentration of Amikacin in the Antebrachiocarpal Joint Following Cephalic Intravenous Regional Limb Perfusion in Standing Horses. The aim of this study was to determine the time (T) to the maximum concentration (C) of amikacin sulphate in synovial fluid of the radiocarpal joint (RCJ) following cephalic intravenous regional limb perfusion (IVRLP) using 2 g of amikacin sulphate. Methods: Cephalic IVRLP was performed with 2 g of amikacin sulphate diluted in 0.9% NaCl to a total volume of 100 mL in six healthy adult mixed breed mares. An Esmarch's rubber tourniquet was applied for 30 minutes and the antibiotic solution was infused through a 23-gauge butterfly catheter. Synovial fluid was collected from the RCJ ...
Ultrasound-guided arthrocentesis of the temporomandibular joint in healthy adult horses is equivalent to blind arthrocentesis. Equine temporomandibular joint (TMJ) diseases are increasingly recognized as a problem for the well-being and performance of horses. Diagnosis is confounded by overlap of clinical signs associated with pathology of the oral cavity, poll, and cervical vertebrae. Arthrocentesis for intra-articular analgesia, sampling of synovial fluid, and medication is needed for diagnostic and therapeutic purposes. Ultrasound features of the normal TMJ and a blind arthrocentesis technique have been described, but a systematic approach to ultrasound-guided (USG) arthrocentesis has not been reported. Ultrasound ...
Arthrographic Study of the Communication between the Tarsal Joints in Crioulo Horses. The aim of the present study is to assess an arthrographic technique based on the access to the equine tarsus via distal intertarsal and on the existence and frequency of communication between distal and tarsocrural joints in the tarsus of Crioulo horses. Methods: Fifty Crioulo horses of both sexes from 3 to 8 years old were included in the experiment. Animals with radiographic signs of tarsal osteoarthritis and joint space loss were excluded from the experiment. Contrast was injected in the distal intertarsal joint and radiographs were taken at two different times - Time 0 (after contra...
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. Methods: 45 warmblood horses and 30 Thoroughbreds (age range, 4 to 16 years). Methods: 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 rheologica...