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.
Heritability estimates of fractures in Japanese Thoroughbred racehorses using a non-linear model. Thoroughbred racehorses are produced by mating small numbers of Arabian stallions and native British mares, and have been improved by selection of horseracing performance for about 300 years. While these improvements led to good performance as racehorses, they exposed horses to numerous medical disorders, aggravated by extensive exercise. Fractures are frequent medical disorders in Thoroughbred racehorses. In this study, fracture heritability was estimated using 3,927 Japanese Thoroughbred racehorses to elucidate the risk of racehorse fractures. The heritability estimates of all examined frac...
Variability in plasma concentrations of methylprednisolone 6 days after intrasynovial injection of methylprednisolone acetate in racing horses: A field study. Methylprednisolone (MP) acetate is a commonly used corticosteroid for suppression of inflammation in synovial structures in horses. Its use is often regulated in equine sports by plasma MP concentrations. Objective: To describe variability in MP plasma concentrations after MP acetate injection in different synovial structures and with co-administration with hyaluronic acid (HA). Methods: Field study in actively racing horses in three disciplines (Thoroughbred, Standardbred and Quarter Horse). Methods: Seventy-six horses (15 Thoroughbreds, 20 Standardbreds and 41 Quarter Horses) were included i...
Induction of Synovitis Using Interleukin-1 Beta: Are There Differences in the Response of Middle Carpal Joint Compared to the Tibiotarsal Joint? The effects of recombinant interleukin-1β (rIL-1β) have been described for the middle carpal joint (MCJ). However, we are unaware of any studies that have described the cytological response of the tibiotarsal joint (TTJ) to rIL-1β or compared the clinical and cytological responses of the MCJ to the TTJ following the administration of intra-articular rIL-1β. Such information is critical for researchers planning to use rIL-1β to create acute synovitis models in horses. To compare the clinical and cytological responses of the MCJ to the TTJ following administration of intra-articular rIL-1...
A novel radiographic projection for the detection of sagittal plane slab fracture of the equine third carpal bone. Some sagittal plane fractures of the equine third carpal bone are difficult to detect with conventional radiographic projections. Objective: To describe a novel radiographic projection for the detection of sagittal plane slab fractures of the equine third carpal bone. Methods: Retrospective study of radiological records. Methods: From a first opinion Thoroughbred racehorse caseload, cases were included for analysis if sagittal fracture of the third carpal bone was evident on a dorsoproximal lateral-palmarodistal medial oblique (DPrL-PDiMO) projection of the distal row of carpal bones and not v...
Effect of bandaging techniques on sub-bandage pressures in the equine distal limb, carpus, and tarsus. To determine the influence of 3 types of bandages on sub-bandage pressures over the distal limb, carpus, and tarsus. Methods: Observational study. Methods: Eight healthy horses. Methods: Each of the 6 following bandages was applied on each horse in randomized order: (1) distal limb compression bandage (DLC), (2) double layer bandage (DL), (3) inner sanctum bandage (IS), (4) carpal compression bandage (CC), (5) tarsal compression bandage (TC), and (6) adhesive elastic carpal bandage (C-ELA). Sub-bandage pressures were measured with the Picopress compression measuring system (Microlab Electonica...
Pancarpal and partial carpal arthrodesis with 3 locking compression plates in 6 horses. To report the outcome of horses after pancarpal or partial carpal arthrodesis with 3 locking compression plates (LCP). Methods: Case series. Methods: Six horses ranging in age from 8 months to 16 years and weighing 227-580 kg with severe carpal pathology including acute fractures, chronic osteoarthritis, and chronic angular limb deformity. Methods: Pancarpal or partial carpal arthrodesis was performed with 3 LCP. Autologous cancellous bone grafts were used in 5 of 6 cases to facilitate joint arthrodesis. Results: External coaptation was maintained for 4 to 6 weeks after surgery. Radiographic...
Critical-sized cartilage defects in the equine carpus. The horse joint, due to its similarity with the human joint, is the ultimate model for translational articular cartilage repair studies. This study was designed to determine the critical size of cartilage defects in the equine carpus and serve as a benchmark for the evaluation of new cartilage treatment options. Circular full-thickness cartilage defects with a diameter of 2, 4, and 8 mm were created in the left middle carpal joint and similar osteochondral (3.5 mm in depth) defects in the right middle carpal joint of 5 horses. Spontaneously formed repair tissue was examined macroscopically, ...
Comparison between magnetic resonance imaging, computed tomography, and arthrography to identify artificially induced cartilage defects of the equine carpal joints. While articular cartilage changes are considered to be one of the initial events in the pathological cascade leading to osteoarthritis, these changes remain difficult to detect using conventional diagnostic imaging modalities such as plain radiography. The aim of this prospective, experimental, methods comparison study was to compare the sensitivity of magnetic resonance imaging (MRI), magnetic resonance arthrography, computed tomography (CT), and CT arthrography in the detection of artificially induced articular cartilage defects in the equine carpal joints. Defects were created in the antebr...
A retrospective study of radiographic abnormalities in the repositories for Thoroughbreds at yearling sales in Japan. This study aimed to evaluate whether radiographic abnormalities at yearling sales were associated with the failure to start racing at 2-3 years of age. Radiographic abnormalities in the carpal (n=852), tarsal (n=976), metacarpophalangeal (n=1,055), and metatarsophalangeal joints (n=1,031) from 1,082 horses, recorded at yearling sale, were reviewed. Eighty-two horses (7.6%) failed to start racing. Radiographic abnormalities such as wedged or collapsed tarsal bones, irregular lucency of a sagittal ridge at the distal aspect of the distal third metatarsal bone, and proximal dorsal fragmentation o...
Evaluation of clinical and tenoscopic findings in the carpal flexor sheath of horses. OBJECTIVE To evaluate clinical and tenoscopic findings in a large group of horses undergoing surgery of the carpal flexor sheath (CFS) and determine whether any of the presurgical clinical signs were associated with tenoscopic findings. ANIMALS 242 horses that had undergone diagnostic and therapeutic tenoscopy of the CFS because of aseptic tenosynovitis. PROCEDURES Medical and tenoscopic video records (when available) of 242 horses undergoing tenoscopy of the CFS at a single equine clinic between January 2005 and June 2014 were reviewed. Tenoscopic findings were categorized as present or absen...
A diagnostic pathologist’s guide to carpal disease in racehorses. As a pathologist, postmortem examination of the equine carpus can be daunting. The anatomy is complex and oftentimes, small or subtle lesions have significant impact on lameness and secondary lesions such as catastrophic musculoskeletal fractures and other injuries. In performance horses, particularly racehorses, the carpus is a common site of injury and source of lameness. Given the predisposition of racehorses to developing carpal disease, familiarity with clinically relevant anatomy and common developmental, degenerative, traumatic, and inflammatory processes are imperative for thorough pos...
Biomechanical and histologic evaluation of the effects of underwater treadmill exercise on horses with experimentally induced osteoarthritis of the middle carpal joint. 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, a...
Age-related effects on markers of inflammation and cartilage metabolism in response to an intra-articular lipopolysaccharide challenge in horses. Eighteen Quarter Horses were used in a randomized complete design for a 28-d experiment to evaluate age-related effects on inflammation and cartilage turnover after induction of a single inflammatory insult using lipopolysaccharide (LPS). Horses were grouped by age as yearlings (3 males and 3 females), 2 to 3 yr olds (2/3 yr old; 2 males and 4 females), and skeletally mature 5 to 8 yr olds (mature; 2 males and 4 females). On d 0, all horses were individually housed and fed diets that met or exceeded requirements. On d 14, horses were challenged with an intra-articular injection of LPS. Radial ...
The effect of ambient temperature on infrared thermographic images of joints in the distal forelimbs of healthy racehorses. The aim of the study was to describe the dependence on ambient temperature of distal joint temperature at the forelimbs of racehorses. The study also investigated the influence of differing ambient temperatures on the temperature difference between joints: this was measured ipsilaterally (i.e. between the carpal and fetlock joints along each forelimb) and contralaterally (i.e. between the same joints of the left and right forelimbs). Sixty-four healthy racehorses were monitored over 10 months. At each session, three thermographic images were taken of the dorsal, lateral and medial aspects of t...
Effect of Dose on Intra-Articular Amikacin Sulfate Concentrations Following Intravenous Regional Limb Perfusion in Horses. To compare synovial concentrations of amikacin following intravenous regional limb perfusion (IVRLP) with two different doses, and to compare their ability to reach target concentrations for bacterial isolates from common orthopedic conditions. Methods: Randomized crossover experiment. Methods: Six adult horses. Methods: Horses received IVRLP with 2 and 3 g of amikacin in the cephalic vein of alternate limbs (20 minutes tourniquet application and ≥14 days washout period). Amikacin concentrations were quantified in synovial fluid collected from the middle carpal and metacarpophalangeal joints...
Magnetic Resonance Imaging Scoring of an Experimental Model of Post-Traumatic Osteoarthritis in the Equine Carpus. Magnetic resonance imaging (MRI) is the most sensitive imaging modality to detect the early changes of osteoarthritis. Currently, there is no quantifiable method to tract these pathological changes over time in the horse. The objective of this experimental study was to characterize the progression of MRI changes in an equine model of post-traumatic osteoarthritis using a semiquantitative scoring system for whole-organ evaluation of the middle carpal joint. On day 0, an osteochondral fragment was created in one middle carpal joint (OCI) and the contralateral joint (CON) was sham-operated in 10 ...
Validity and repeatability of goniometry in normal horses. To assess validity and inter- and intra-tester reliability of equine goniometry and to establish values for carpal, metacarpophalangeal, tarsal, and metatarsophalangeal flexion and extension in horses. Methods: Seventeen healthy equine subjects of varied breeds were used. Methods: Three investigators blindly and independently measured in triplicate the extension and flexion of carpal, metacarpophalangeal, tarsal, and metatarsophalangeal joints of 17 horses after sedation. Radiographs of these joints in flexion and extension were acquired while under sedation. Goniometric and radiographic measu...
Standing placement of transphyseal screw in the distal radius in 8 Thoroughbred yearlings. This retrospective study describes placement of distal radial transphyseal screws in Thoroughbred yearlings with carpal varus deformities while standing, and identifes short- and long-term complications following the procedure. Data gathered from 2009 to 2013 identified 8 yearlings that met the inclusion criteria. Horses were sedated intravenously and a single 4.5-mm cortical screw was placed in the distal lateral radial physis following application of local anesthetic and surgical preparation of a pre-placed hole. All horses were evaluated weekly after surgery and screw removal was performed ...
High density infill in cracks and protrusions from the articular calcified cartilage in osteoarthritis in standardbred horse carpal bones. We studied changes in articular calcified cartilage (ACC) and subchondral bone (SCB) in the third carpal bones (C3) of Standardbred racehorses with naturally-occurring repetitive loading-induced osteoarthritis (OA). Two osteochondral cores were harvested from dorsal sites from each of 15 post-mortem C3 and classified as control or as showing early or advanced OA changes from visual inspection. We re-examined X-ray micro-computed tomography (µCT) image sets for the presence of high-density mineral infill (HDMI) in ACC cracks and possible high-density mineralized protrusions (HDMP) from the ACC...
Arthroscopic removal of discrete palmar carpal osteochondral fragments in horses: 25 cases (1999-2013). To characterize discrete palmar carpal osteochondral fragmentation in horses and to document the effect of osteoarthritis and surgical removal of these fragments on functional outcome. Methods: Retrospective case series. Methods: 25 horses. Methods: Medical records and radiographic views were reviewed to identify horses that had radiographic evidence of palmar carpal fragmentation, which was subsequently treated by arthroscopic removal. Information collected included cause of fracture, initial and long-term clinical and radiographic findings, and functional outcome. Results: Palmar carpal frag...
Radiofrequency Probe and Sharp Transection for Tenoscopic-Guided Desmotomy of the Accessory Ligament of the Superficial Digital Flexor Tendon. To compare intra and postoperative clinical features of desmotomy of the accessory ligament of the superficial digital flexor tendon (ALSDFT) using the Saber radiofrequency (SaberRF) electrosurgical probe versus sharp transection with a tenotomy knife. Methods: Randomized, controlled, blocked (horse) design. Methods: Adult horses (n = 6). Methods: Each horse received bilateral, tenoscopic-guided ALSDFT desmotomy with a SaberRF and tenotomy knife, randomly assigned to left, or right limb. The desmotomy duration and intraoperative hemorrhage grades were recorded. Postoperatively, the grades ...
Improvement in Bilateral Carpal Valgus Deviation in 9 Foals After Unilateral Distolateral Radial Periosteal Transection and Elevation. To evaluate the effect of periosteal transection and elevation in foals with naturally occurring carpal valgus deviation. Methods: Prospective clinical study. Methods: Foals (n = 9) with bilateral carpal valgus. Methods: Foals with bilateral carpal valgus had distolateral radial periosteal transection and elevation (PE) including distal ulnar transection on 1 limb. Foals were stall confined until the skin incisions healed, and then allowed free exercise in a small paddock or round pen. Dorsopalmar carpal radiographs were obtained at 14 day intervals to determine the carpal valgus angle (CV...
Humoral and cell-mediated immune response, and growth factor synthesis after direct intraarticular injection of rAAV2-IGF-I and rAAV5-IGF-I in the equine middle carpal joint. Intraarticular (IA) administration of viral vectors expressing a therapeutic transgene is an attractive treatment modality for osteoarthritis (OA) as the joint can be treated as a contained unit. Humoral and cell-mediated immune responses in vivo can limit vector effectiveness. Transduction of articular tissues has been investigated; however, the immune response to IA vectors remains largely unknown. We hypothesized that IA rAAV2 and rAAV5 overexpressing insulin-like growth factor-I (IGF-I) would result in long-term IGF-I formation but would also induce neutralizing antibodies (NAb) and anti-c...
Comminuted fracture of the accessory carpal bone removed via an arthroscopic-assisted arthrotomy. A 16-year-old American paint horse gelding was presented for evaluation of a left forelimb lameness grade III/V. Radiographs and computed tomography revealed a comminuted fracture of the accessory carpal bone involving the entire articulation with the distal radius and the proximal aspect of the articulation with the ulnar carpal bone. Multiple fragments were present in the palmar pouch of the antebrachiocarpal joint. An arthroscopic-assisted open approach was necessary to remove all fractured fragments. Subsequently the horse was re-admitted for lameness and was treated successfully with anti...
Musculoskeletal lesions and lameness in 121 horses with carpal sheath effusion (1999-2010). Equine carpal sheath effusion has multiple etiologies. The purpose of this retrospective study was to describe the prevalence of distinct musculoskeletal lesions lameness in a sample of horses with a clinical diagnosis of carpal sheath effusion. A total of 121 horses met inclusion criteria. Seventy-four percent (89/121) of horses were lame at presentation; middle-aged (9-18 years, 80%) and older (> 18 years, 85%) horses were lame more frequently than young horses (< 9 years, 44%). Ninety-three percent (113/121) were diagnosed with osseous and/or soft tissue abnormalities. Of these 113 ho...
Physiological and analgesic effects of continuous-rate infusion of morphine, butorphanol, tramadol or methadone in horses with lipopolysaccharide (LPS)-induced carpal synovitis. Continuous-rate infusion (CRI) of drugs results in more stable plasma drug concentrations than administration of intermittent boluses, thus providing greater stability of physiological parameters. The aim of this study was to evaluate the physiologic and analgesic effects of the administration of morphine, butorphanol, tramadol or methadone by CRI in horses with induced synovitis of the radiocarpal joint. Results: Increased values of cardiorespiratory parameters and body temperature were observed in all groups after initiation of opioid administration, and these increases were sustained throug...
Frequency of and risk factors associated with catastrophic musculoskeletal injuries in Quarter Horses at two Midwestern racetracks: 67 cases (2000-2011). To determine the incidence and anatomic location of and potential risk factors for catastrophic musculoskeletal injuries (CMIs) in racing Quarter Horses. Methods: Retrospective matched case-control study. Methods: 67 racing Quarter Horse racehorses euthanized because of CMIs and 134 matched controls. Methods: Data for Quarter Horses that sustained CMIs and the total number of race starts for each year were obtained from 2 Midwestern racing jurisdictions from 2000 through 2011. Information for each horse with a CMI and for 2 randomly selected control horses that ran in the same race but did not...
Ex vivo evaluation of carpal flexion after partial carpal arthrodesis in horses. To determine degrees of flexion after arthrodesis of the antebrachiocarpal (ABC) joint, middle carpal (MC), and carpometacarpal (CMC) joints combined (MC/CMC), and carpometacarpal (CMC) joint alone. Methods: Ex vivo study. Methods: Forelimbs (n = 9) from 2- to 10-year-old Quarter Horses (5), Thoroughbred (2), and American Paint Horse (2). Methods: Using 2 locking compression plates, 3 partial carpal arthrodesis techniques were performed. Cables and deadweights were connected to limbs and each angle of flexion determined 3 times using a protractor and then averaged. Control measurements were ob...
Second carpal bone slab fracture and subluxation of the middle carpal joint in a horse subsequent to arthrodesis of the carpometacarpal joint. To report complications of arthrodesis of the carpometacarpal (CMC) joint using a drilling technique in an adult horse. Methods: Case report. Methods: Horse (n = 1). Methods: A 12-year-old Quarter Horse mare with CMC osteoarthritis (CMC-OA) had arthrodesis under general anesthesia in right lateral recumbency. Under fluoroscopic guidance, a 4.5 mm drill bit was inserted at 3 drilling sites 5-6 cm into the CMC joint and was fanned 30-45° in the plane of the joint and 5-10° in the long axis of the limb to destroy articular cartilage and expose the subchondral bone. Results: The horse pr...