Topic:Carpal Joint
The carpal joint in horses, also known as the knee, is a complex structure composed of bones, cartilage, ligaments, and synovial fluid that facilitates movement and weight-bearing in the forelimb. It consists of three main articulations: the radiocarpal joint, the midcarpal joint, and the carpometacarpal joint. These articulations are supported by a series of ligaments and tendons that provide stability and flexibility. The carpal joint is susceptible to various conditions such as osteoarthritis, fractures, and synovitis, which can affect the horse's mobility and performance. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, biomechanics, common disorders, diagnostic techniques, and treatment options related to the carpal joint in horses.
Outcome of arthroscopic debridement for the treatment of incomplete third carpal bone slab fractures in racehorses. To describe the outcomes of arthroscopic debridement of third carpal bone (C3) incomplete slab fractures (ISF) in racehorses. Methods: Retrospective case study. Methods: Horses undergoing arthroscopic debridement of ISF of C3. Methods: The medical records of horses surgically treated for ISF of C3 were reviewed. Age, sex, breed, limb, fracture configuration, preoperative radiographs, arthroscopic findings, postoperative intraarticular therapies, and exercise recommendations were recorded. Racing performance was obtained from online databases. Univariable analyses were used to determine associa...
Racing and sales performance in Thoroughbred yearlings after carpal osteochondral fragment removal. While radiographically evident carpal osteochondral fragments (COF) in Thoroughbred yearlings impair sales, their impact on future racing performance has been minimally investigated. Objective: To assess the impact of COF on Thoroughbred yearling sales and racing performance, and whether these are improved by arthroscopic removal. We hypothesised that surgical removal of COF improves Thoroughbred yearling sales and racing performance. Methods: Retrospective observational. Methods: Using clinical records from years 2015-2018, 46 Thoroughbred yearlings with COF were identified and allocated to a...
Treatment outcomes for equine osteoarthritis with mesenchymal stromal cells and hyaluronic acid. Mesenchymal stromal cells (MSCs) are widely used to treat osteoarthritis (OA). Optimising dose, timing, and safety while comparing efficacy with standard therapies like hyaluronic acid (HA) is essential for their standardisation. Objective: To assess the safety and efficacy of equine umbilical cord-derived (eCB) MSCs in client-owned horses with fetlock or carpus OA. Methods: Prospective single-blinded randomised clinical study. Methods: Horses diagnosed with fetlock or carpus OA via intra-articular (IA) anaesthesia were randomly assigned to receive either 10 or 20 million eCB-MSCs in HA or 3â€...
Distribution of race and training-related musculoskeletal injuries by track and location in Thoroughbred and Arabian racehorses. Musculoskeletal injuries (MSI) are a major concern in the horse racing industry, often leading to career-ending outcomes. Contributing factors include conformation, limb and joint defects, hoof structure, age, and hard track surfaces. Objective: This study aimed to evaluate the distribution of MSI in Thoroughbred and Arabian racehorses during racing and training, categorised by breed and track surface. Methods: Retrospective cohort study. Methods: The data from 2018 to 2023 were collected at the Turkish Jockey Club's Şirinyer Hippodrome (38°23'03.7″ N 27°09'01.0″ E), covering 553 MSI ca...
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 ...
Visualization of anatomical structures in the carpal region of the horse using cone beam computed tomography in comparison with conventional multidetector computed tomography. In the diagnostics of orthopedic diseases in the horse, diagnostic imaging often plays a decisive role. Cone beam computed tomography (CBCT) imaging is used in both human and small animal medicine and becoming increasingly popular. To see whether CBCT imaging can be useful in the diagnosis of orthopedic diseases of the carpal region of the horse and to explore possible limitations we compared CBCT images with multidetector computed tomography (MDCT) images of the carpal region of equine cadaveric specimens. Unassigned: Twenty-eight forelimbs from fifteen horses, slaughtered for reasons unrelat...
Distal forelimb radiographic bone morphology in Thoroughbred foals during the first 10 months post-partum. Part 1: Carpus. The risk of carpal injury in racehorses may be related to the morphology, yet whether carpal morphologies are set from birth or change through growth remains unclear. Objective: To quantify carpal bone changes through growth. Methods: Twenty privately owned Thoroughbred foals born between January 2022 and May 2023 were radiographed bimonthly from birth to 10 months of age. Imprint training was used to take radiographs safely without chemical restraints. Fifteen individual and 11 relative angular carpal parameters were measured using ImageJ on dorsopalmar radiographs of the carpus at zero degre...
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...
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 ...
IL-1ra gene therapy in equine osteoarthritis improves physiological, anatomical, and biological outcomes of joint degeneration. To evaluate the effects of a gene transfer approach to IL-1β inhibition in an equine osteochondral chip fragment model of joint injury using a self-complementary adeno-associated virus with interleukin receptor antagonist transgene cassette (scAAVIL-1ra), as posttraumatic osteoarthritis in horses, similar to people, is a significant clinical problem. Methods: 16 horses were utilized for the study. Methods: All horses had an osteochondral chip fragment induced arthroscopically in one middle carpal joint while the contralateral joint was sham operated. Eight horses received either scAAVIL-1ra o...
Intraarticular treatment with integrin α10β1-selected mesenchymal stem cells affects microRNA expression in experimental post-traumatic osteoarthritis in horses. Osteoarthritis (OA) remains a major cause of lameness in horses, which leads to lost days of training and early retirement. Still, the underlying pathological processes are poorly understood. MicroRNAs (miRNAs) are small non-coding RNAs that serve as regulators of many biological processes including OA. Analysis of miRNA expression in diseased joint tissues such as cartilage and synovial membrane may help to elucidate OA pathology. Since integrin α10β1-selected mesenchymal stem cell (integrin α10-MSC) have shown mitigating effect on equine OA we here investigated the effect of integrin α10...
A polymer network architecture provides superior cushioning and lubrication of soft tissue compared to a linear architecture. We report the relationships between linear network polymer architecture and biomechanical outcomes including lubrication and cushioning when the polymers are applied to the surface of articulating knee cartilage. Aqueous formulations of the bioinspired polymer poly(2-methacryloyloxylethyl phosphorylcholine) (pMPC) exhibit tuneable rheological properties, with network pMPC exhibiting increased elasticity and viscosity compared to linear pMPC. Application of a polymer network, compared to a linear one, to articulating tissue surfaces reduces friction, lessens tissue strain, minimizes wear, and ...
Intra-articular triamcinolone acetonide injection results in increases in systemic insulin and glucose concentrations in horses without insulin dysregulation. Corticosteroids are a commonly used, inexpensive intra-articular treatment for osteoarthritis which may increase the risk for laminitis in horses due, in part, to hyperinsulinaemia. Humans with metabolic syndrome experience increases in insulin and glucose concentrations post-injection, but responses in horses are unknown. Objective: To determine the effect of a single intra-articular (IA) dose of triamcinolone acetate (TA) on blood insulin and glucose concentrations. Methods: Before-after study. Methods: Ten horses with normal insulin regulation as assessed by an oral sugar test received 18â€...
Longitudinal evaluation of fentanyl concentrations in equine plasma and synovial fluid following application of transdermal fentanyl patches over one carpal joint. To determine if transdermally delivered fentanyl can achieve greater concentrations of fentanyl in synovial fluid when applied over a synovial structure. Conclusion: Application of fentanyl matrix patches directly over the CMCJ did not result in increased fentanyl concentrations in the synovial fluid of the treated intercarpal joint in normal horses.
Radiographic Appearance of the Fore Digit and Carpal Joint in the Mule Foal from Birth to 3 Months of Age. Few studies have established the normal radiographic anatomical development of the donkey foal and, to date, no data are available for mules. Our aim was thus to evaluate the radiographic development of the fore digit and carpal joint in the mule foal from 0 to 3 months of age. Ten forelimbs of five healthy full-term mule foals were included. Radiographs of the fore digit lateromedial and dorsopalmar and the carpus dorsopalmar were performed weekly for the first month of age, and bi-monthly during the following two months. Fore digit growth plate closure times, morphological, angular, and line...
Comparison of radiography and CT for the evaluation of third carpal bone slab fractures in Thoroughbred racehorses. Slab fractures of the third carpal bone (C3) are a common cause of lameness in Thoroughbred racehorses. Information on fracture morphology is commonly obtained from radiographs or CT. This retrospective, methods comparison aimed to explore the agreement between radiography and CT for imaging C3 slab fractures and discuss the contribution of the latter to clinical case management. Thoroughbred racehorses with a slab or incomplete slab fracture of C3 identified on radiographs that subsequently underwent CT examination were included. Fracture characteristics (location, plane, classification, disp...
Articular Cartilage Regeneration by Hyaline Chondrocytes: A Case Study in Equine Model and Outcomes. Cartilage injury defects in animals and humans result in the development of osteoarthritis and the progression of joint deterioration. Cell isolation from equine hyaline cartilage and evaluation of their ability to repair equine joint cartilage injuries establish a new experimental protocol for an alternative approach to osteochondral lesions treatment. Chondrocytes (CCs), isolated from the autologous cartilage of the trachea, grown in the laboratory, and subsequently arthroscopically implanted into the lesion site, were used to regenerate a chondral lesion of the carpal joint of a horse. Biop...
Variation in palmaromedial articulations of carpometacarpal joints in Thoroughbred and Standardbred racehorses. Carpal conformation is an important factor in relation to joint soundness. The equine carpometacarpal joint (CMCJ) was reported to have variations in its three palmaromedial articulations. Lacking one or more of these articulations has not been radiographically evaluated in Thoroughbred (TB) and Standardbred (SB) racehorses. The study aimed to identify the prevalence of the variation in the palmaromedial articulation of the carpometacarpal joint (PM-CMCJ) in TB and SB horses. Additionally, to detect the probability of having each of the three articulations within and between the breeds. Finall...
Magnetic Resonance Imaging Measurements of the Proximal Palmar Cortex of the Third Metacarpal Bone and the Suspensory Ligament in Non-Lame Endurance Horses before and after Six Months of Training. Proximal metacarpal injury is common in endurance horses, yet exercise-induced changes in this region have not been described. This study aimed to document objective exercise-induced changes in the proximal palmar cortex of the third metacarpal bone (PcMcIII) and the suspensory ligament (SL). Low-field magnetic resonance (MR) images of both proximal metacarpal regions were obtained from six novice and six experienced horses, before and after six months of endurance training. Measurements were acquired in T1-weighted transverse MR images at four levels and included the thickness of the PcMcIII,...
Effects of a Single Intra-Articular Injection of 2% Lidocaine or 0.5% Bupivacaine on Synovial Fluid Acute Phase Protein Concentrations in Healthy Horses. The purpose of this study was to compare the extent of inflammation response in the middle carpal joints of healthy horses following intra-articular injection of 2% lidocaine, 0.5% bupivacaine, or 0.9% saline solution. The right middle carpal joint of 20 horses was injected with 5 mL of 0.5% bupivacaine (GB, n = 10) or 5 mL of 2% lidocaine (GL, n = 10). The left middle carpal joint of horses was used as a control (5 mL 0.9% saline). Serum and synovial fluid (SF) were aseptically collected before and at predetermined times after each injection. Serum and synovial fluid protein, albumin, tra...
Effects of High-Intensity Laser Therapy (HILT) on Skin Surface Temperature and Vein Diameter in Healthy Racehorses with Clipped and Non-Clipped Coat. The aim of this study was to investigate the differences in the effects of high-intensity laser therapy (HILT) on skin surface temperature and vein diameter in the carpal joint region in racehorses with clipped and non-clipped treatment areas. The study included 20 Thoroughbreds split into two equal groups: clipped coat and non-clipped coat. Horses underwent thermographic examination to detect changes in skin surface temperature at the medial surface of the carpal joint, followed by ultrasonographic examination to assess changes in the diameter of the medial palmar vein before and after HILT. ...
Use of Locking Compression Plate and Locking Compression T-Plate for Surgical Arthrodesis of the Carpometacarpal and Distal Tarsal Joints in 13 Horses.  The aim of this study was to describe the use of the locking compression plate (LCP) and locking compression T-plate (LCTP) in cases of carpometacarpal and distal tarsal arthrodesis for the treatment of osteoarthritis and small carpal or tarsal bone fractures, and to document clinical outcomes. Methods:  Case records of horses treated with carpometacarpal or distal tarsal arthrodesis via internal fixation using an LCP or LCTP between 2013 and 2021 were reviewed. All cases were evaluated retrospectively. Follow-up information was gained via phone conversation with owners and referring vete...
Computed tomographic arthrography, gross anatomy and histology demonstrate a communication between synovial invaginations in the proximal aspect of the third interosseous muscle and the carpometacarpal joint in horses. This descriptive anatomical study investigates the relationship between the third interosseous muscle, also known as the suspensory ligament, and the carpometacarpal joint in forelimbs of horses, with the hypothesis that there was a direct synovial communication between these structures as shown by computed tomographic arthrography, histology, and gross anatomy sections. Computed tomography of the carpus and metacarpal region was performed on two groups. Group 1 consisted of eight cadaver limbs undergoing computed tomographic arthrography following injection of a mixture of positive contrast m...
Biomechanical Comparison of a Headless Compression Screw Fastener and AO Cortical Bone Screw for Fixation of a Simulated Equine Third Carpal Bone Slab Fracture. Frontal plane slab fractures account for the majority of third carpal bone (C3) fractures in racing and performance horses. Recommended treatment is stabilization with a lagged AO cortical screw. Associated complications are fragment splitting, fragment spinning, and irritation of dorsal soft tissue structures. A novel, headless, cannulated screw with interlocking threads the Headless Compression Screw Fastener (HCSF) has been developed to resist multidirectional forces and bending moments; however, it has not been applied in the horse. Simulated C3 frontal plane slab fractures were created in...
A detailed macroscopic scoring system for experimental post-traumatic Osteoarthritis in the equine middle carpal joint. Osteoarthritis (OA) is a significant health issue in humans as well as horses. Experimental models of equine carpal OA have been used to investigate OA pathogenesis and potential therapeutic candidates. A 5-scale scoring system (OARSI) for macroscopic pathological cartilage changes already exists, but there is a need for a scoring system with better differentiation of severity. The aim of this study was therefore to develop and validate such a scoring system. Results: New scoring system were developed for cartilage erosions (Copenhagen Equine Total Cartilage Score, CEqTCS) along with synovial ...
Site- and Zone-Dependent Changes in Proteoglycan Content and Biomechanical Properties of Bluntly and Sharply Grooved Equine Articular Cartilage. In this study, we mapped and quantified changes of proteoglycan (PG) content and biomechanical properties in articular cartilage in which either blunt or sharp grooves had been made, both close to the groove and more remote of it, and at the opposing joint surface (kissing site) in equine carpal joints. In nine adult Shetland ponies, standardized blunt and sharp grooves were surgically made in the radiocarpal and middle carpal joints of a randomly chosen front limb. The contralateral control limb was sham-operated. At 39 weeks after surgery, ponies were euthanized. In 10 regions of interest (...
A Descriptive Study of the Carpal Joint of Healthy Donkeys Using Ultrasonography, Computed Tomography, and Magnetic Resonance Imaging. This study was conducted to establish a detailed anatomic reference for the carpal joint of apparently healthy donkeys using ultrasonography (US), computed tomographic (CT), and magnetic resonance imaging (MRI). Ten orthopedically sound adult donkeys were used for US examination of the carpal joint in each forelimb. Additionally, the carpi of ten donkey cadavers were subjected to CT and MRI examinations. The carpal joint was divided into four zones to simplify examination. US assessment of the carpal joint included transverse and longitudinal sonograms. CT was performed using three planes: axi...
Ultrasound screening protocol for osteochondrosis at selected predilection sites in thoroughbred yearlings. Osteochondrosis is a common condition of young horses where there is a failure of endochondral ossification, usually at predisposed sites. The estimated prevalence of osteochondrosis is 33-44%, with radiographic screening of yearlings being used to identify lesions. Radiography has two major limitations: poor sensitivity in detecting cartilaginous lesions and secondly, the exposure of the horse and personnel to ionising radiation. Ultrasonography allows imaging of the articular cartilage and subchondral bone margins and has been shown to be more sensitive in identifying osteochondrosis lesions...
Arthroscopic removal of palmar intermediate carpal bone fracture fragments in four horses using a transthecal approach through the carpal flexor tendon sheath. To describe the removal of palmar intermediate carpal bone (ICB) fracture fragments using a transthecal approach through the carpal flexor tendon sheath. Methods: Case series. Methods: Four horses with fractures of the palmar aspect of the ICB. Methods: Two horses were injured when falling and two during recovery from general anesthesia. Three horses underwent MRI to supplement conventional imaging. Three horses had concurrent fractures of the radial and/or accessory carpal bones. Conventional proximolateral carpal sheath arthroscope and instrument portals were used, supplemented with a medial...
Validation of ultrasonography for measurement of cartilage thickness in the equine carpus. Articular cartilage thinning is an important hallmark of osteoarthritis (OA), and ultrasonography (US) is a clinically accessible tool potentially suitable for repeated evaluation. The aim of the present prospective methods comparison study was to validate US as a tool for measuring cartilage thickness in the carpus of the horse. Eight Standardbred trotters underwent US examination with 9 and 15Â MHz linear transducers. Six anatomical locations in the radiocarpal joint (RCJ) and middle carpal joint (MCJ) were examined. The same joints were assessed by ultrahigh field (9.4 Tesla) magnetic reson...