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.
Associations of horse age, joint type, and osteochondral injury with serum and synovial fluid concentrations of type II collagen biomarkers in Thoroughbreds. To determine the effects of horse age, osteochondral injury, and joint type on a synthesis biomarker and 3 degradative biomarkers of type II collagen in Thoroughbreds. Methods: Healthy rested adult (3- to 12-year-old) Thoroughbreds (n = 19), yearling (1- to 2-year-old) Thoroughbreds (40), and Thoroughbred racehorses (2 to 7 years old) undergoing arthroscopic surgery for removal of osteochondral fragments that resulted from training or racing (41). Methods: Samples of blood and metacarpophalangeal, metatarsophalangeal, or carpal joint synovial fluid (SF) were collected from all horses. Commerci...
Modified tenoscopic method for carpal flexor retinaculum release in a horse. To report the use of a proximolateral endoscopic portal with a distolateral instrument portal for carpal retinaculum release in a horse clinically affected with carpal canal syndrome. Methods: Clinical report. Methods: A 4-year-old Thoroughbred female. Methods: Carpal canal syndrome secondary to traumatic suppurative tenosynovitis was treated by accessory carpal bone debridement and carpal retinaculum release using a tenoscopic approach to the carpal flexor synovial sheath through a proximolateral endoscope portal and a distolateral instrument portal. Results: Resolution of carpal sheath effus...
Effect of exercise and osteochondral injury on synovial fluid and serum concentrations of carboxy-terminal telopeptide fragments of type II collagen in racehorses. To investigate the effects of exercise and osteochondral injury on concentrations of carboxy-terminal telopeptide fragments of type II collagen (CTX-II) in synovial fluid (SF) and serum of Thoroughbred racehorses and to compare findings with radiographic and arthroscopic scores of joint injury severity. Methods: 78 Thoroughbreds with (n = 38) and without (40) osteochondral injury. Methods: Serum and metacarpophalangeal or carpal joint SF samples were collected from noninjured horses before and at the end of 5 to 6 months of race training (pre- and postexercise samples, respectively) and from h...
Carpometacarpal osteoarthritis in thirty-three horses. To describe signalment, clinical, and radiographic changes associated with carpometacarpal osteoarthritis (CMC-OA) and to report long-term outcome. Methods: Case series. Methods: Horses (n=33) with CMC-OA. Methods: Medical records (1992-2007) of horses diagnosed with CMC-OA were reviewed and signalment, clinical, and radiographic findings retrieved. Owners were contacted for information on the impact of lameness on intended use, response to treatment, progression of lameness, outcome, and owner satisfaction with response to treatment. Results: CMC-OA identified in 39 limbs, occurred predominan...
Influence of early conditioning exercise on the development of gross cartilage defects and swelling behavior of cartilage extracellular matrix in the equine midcarpal joint. To investigate the influence of early conditioning exercise on the development of gross cartilage defects and swelling behavior of cartilage extracellular matrix (ECM) in the midcarpal joint of horses. Methods: 12 Thoroughbreds. Methods: 6 horses underwent early conditioning exercise from birth to 18 months of age (CONDEX group), and 6 horses were used as control animals (PASTEX group). The horses were euthanized at 18 months of age, and the midcarpal joints were harvested. Gross defects of the cartilage surface were classified and mapped. Opposing surfaces of the third and radial carpal bones...
Evaluation of the effect of extracorporeal shock wave treatment on experimentally induced osteoarthritis in middle carpal joints of horses. 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...
Evaluation of topically administered diclofenac liposomal cream for treatment of horses with experimentally induced osteoarthritis. To assess the clinical, biochemical, and histologic effects of topically administered diclofenac liposomal cream (DLC) in the treatment of horses with experimentally induced osteoarthritis. Methods: 24 horses. Methods: 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 resonance imaging, synovial fluid, gross...
Locking compression plates for pancarpal arthrodesis in a Thoroughbred filly. To report treatment of a comminuted ulnar carpal (UC) bone fracture associated with carpal instability by pancarpal arthrodesis using 2 locking compression plates (LCP). Methods: Case report. Methods: A 2-year-old Thoroughbred filly. Methods: An UC fracture and luxation of the proximal row of carpal bones was diagnosed radiographically. Pancarpal arthrodesis was performed with 2 LCP positioned dorsolaterally and dorsomedially and centered over the carpus through a single skin incision. The filly was maintained in a full limb cast for 15 days, followed by a tube cast for 14 days, and subsequent...
Osteochondral injury increases type II collagen degradation products (C2C) in synovial fluid of Thoroughbred racehorses. To investigate the effects of exercise and osteochondral (OC) injury on type II collagen degradation products (collagenase cleavage neoepitope commercially known as C2C) in synovial fluid (SF) from Thoroughbred (TB) racehorses and to compare these results with radiographic and arthroscopic scores of severity of joint injury. Methods: Metacarpophalangeal/metatarsophalangeal (MCP/MTP) and carpal SF was obtained from (1) 20 normal rested horses, (2) the same horses after 5 to 6 months of race training, and (3) 27 horses with OC injury from racing. For group 3, radiographic and arthroscopic scores...
Anatomical features of the carpal flexor retinaculum of the horse. This study aims to elucidate the topographical anatomy of the carpal flexor retinaculum or palmar anular carpal ligament (PACL) in the horse. Ten specimen of the carpus of five healthy horses were studied by dissection in layers. Slices of 5 mm in thickness facilitated observation of the soft tissues. The superficial layer of the PACL subdivides into five compartments: one for the palmar nerve and the arterial and venous branches, one for only the radial artery, one for the radial vein, and one for the tendon of the radial carpal flexor muscle, and finally for the deep layer that supports all ...
Effects of exercise vs experimental osteoarthritis on imaging outcomes. To identify changes in imaging outcomes in a controlled model of osteoarthritis (OA) vs exercise. Methods: Sixteen 2-year-old horses were randomly assigned to an exercise control (n=8) or an exercise OA (n=8) group. All horses had middle carpal joints arthroscopically explored and an osteochondral fragment was induced in one middle carpal joint of the OA group. All horses were treadmill exercised for the duration of the study (91 days). Clinical, radiographic, nuclear scintigraphic, computed tomographic and magnetic resonance imaging (MRI) examinations were performed and outcomes of these were...
Surgical treatment of carpal flexural deformity in 72 horses. Carpal flexural deformities (CFD) are frequently encountered in the horse, with both congenital and acquired forms described. The success of surgical correction of CFD, both in terms of the ability to achieve a straight palmar carpal angle and the impact on future athletic performance, requires further investigation. Objective: To report the surgical management and outcome of treatment of flexural deformity of the carpus in 72 horses up to 12 months of age. Methods: Information was obtained from the medical records of horses surgically treated for CFD and through follow-up contact with owners....
Comparison of magnetic resonance contrast arthrography and arthroscopic anatomy of the equine palmar lateral outpouching of the middle carpal joint. The objective of this report was to provide an anatomic description of the equine palmar lateral outpouching of the middle carpal joint by comparing its arthroscopic and magnetic resonance (MR) contrast arthrography appearance and to define the structures within the palmar lateral outpouching of the middle carpal joint that can be assessed arthroscopically. MR contrast arthrography was performed on seven cadaveric limbs; images were compared with those obtained during arthroscopic exploration of the palmar lateral outpouching of the middle carpal joint. Gross dissection was performed to confir...
Determination and use of mechanical nociceptive thresholds of the thoracic limb to assess pain associated with induced osteoarthritis of the middle carpal joint in horses. To establish reference mechanical nociceptive threshold (MNT) values of the equine thoracic limb and to assess the use of MNT values to detect pain associated with induced osteoarthritis in the middle carpal joint. Methods: 24 adult horses. Methods: MNT values were evoked by a pressure algometer at 17 sites within each thoracic limb during 2 baseline sessions conducted an average of 5 days apart. Effects of age, sex, weight, and wither height on MNT values were assessed separately for each site. Tolerance of horses to the procedure was graded subjectively and correlated with MNT values. Synovi...
Interleukin-6 and tumour necrosis factor in synovial fluid from horses with carpal joint pathology. The carpal joints are common sites of traumatic arthritis and osteoarthritis (OA) in athletic horses. The pro-inflammatory cytokines interleukin (IL)-6 and tumour necrosis factor (TNF) may be of great importance in the development of intra-articular lesions. The aim of the present study was to investigate possible associations between synovial fluid levels of bioactive IL-6 and TNF and different types of joint lesions seen in traumatic arthritis and OA. Synovial fluid was collected from horses with carpal lameness immediately before arthroscopic surgery. Articular cartilage, synovial membranes...
Outcome of lag-screw treatment of incomplete fractures of the frontal plane of the radial facet of the third carpal bone in horses. To describe outcomes for horses diagnosed with incomplete, non-displaced fractures of the frontal plane of the radial facet (INFR) of the third carpal bone (C3) treated by placement of a lag screw across the fracture under arthroscopic guidance. Methods: Horses (n=13) diagnosed with INFR and treated between December 1999 and January 2005 using a lag screw placed over the fracture were studied. For each case, five horses matched for sire, age and sex which were not known to have INFR were sought for comparison. Racing performance data were collected from a commercial online database. The racing...
Clinical evaluation of a titanium, headless variable-pitched tapered cannulated compression screw for repair of frontal plane slab fractures of the third carpal bone in thoroughbred racehorses. To report clinical evaluation of third carpal bone (C3) frontal plane slab fracture repair with the Acutrak screw system. Methods: Prospective case series. Methods: Racing Thoroughbreds (n=17) with frontal C3 slab fractures. Methods: C3 slab fractures in Thoroughbred racehorses (1999-2004) were repaired by use of the Acutrak screw system. Data collected were (1) preoperative variables--gender, age at injury, limb involved, injury occurrence, fracture thickness, complexity, and displacement, race starts and earnings and (2) postoperative variables were: surgical complications, days to first sta...
Carpal and fetlock conformation of the juvenile Thoroughbred from birth to yearling auction age. There is little information available about conformational changes in the forelimbs of growing foals. Objective: To describe the conformation of the carpus and fetlock of Thoroughbred foals from birth to yearling sale age. Methods: Subjective assessments of the fetlock and carpal conformation of 119 Thoroughbred foals were made within the first month of life and then at 30 day intervals until at least age 120 days. At least 70 subjects were examined further at 60 day intervals until September of their second year. Conformation grades are reported for 5 age groups: first 7 days and at a mean of...
Injuries in the event horse: training versus competition. Two related studies on injuries sustained by event horses during competition and during training are reported. During the cross-country phase of competition, the most common injuries were lacerations and abrasions to the carpus and stifle. Superficial digital flexor tendonitis and exertional rhabdomyolysis were significantly more common during Cours Complete Internationale (CCI) competitions compared to one-day event (ODE) competitions. The difference in injury types at ODEs and CCI competitions probably relates to the increased athletic demands of the CCI and the closer veterinary observation...
Computed tomographic documentation of a comminuted fourth carpal bone fracture associated with carpal instability treated by partial carpal arthrodesis in an Arabian filly. To report treatment of a unilateral comminuted fourth carpal bone (C4) fracture associated with carpal instability by partial carpal arthrodesis (PCA) of the middle carpal joint (MCJ) and carpometacarpal joint (CMCJ). Methods: Case Report. Methods: An 8-month-old Arabian filly. Methods: A C4 slab fracture was diagnosed radiographically; however, fracture comminution was conclusively diagnosed after computed tomographic (CT) imaging. PCA of the MCJ and CMCJ was performed with 2 narrow dynamic compression plates. Results: PCA provided appropriate carpal stability and correct limb alignment immed...
Palmar carpal osteochondral fragments in racehorses: 31 cases (1994-2004). To evaluate records of racehorses with palmar carpal osteochondral fragments and determine whether the fragments were indicators of the severity of pathologic joint changes or prognosis. Methods: Retrospective case series. Methods: 31 racehorses. Methods: Medical records, radiographs, and videos of arthroscopic procedures were reviewed. Information gathered included signalment; location, number, and size of the primary lesion; number and size of palmar carpal fragments; and details pertaining to surgical procedures. Outcome variables were obtained from race records. Results: 31 horses met the ...
Arthroscopic approaches to the palmar aspect of the equine carpus. To identify sites for arthroscopic access to the palmar aspects of the antebrachiocarpal (AC) and middle carpal (MC) joints, and describe visible carpal bone surfaces for each approach. Methods: Prospective experimental study. Methods: Equine carpi: 16 cadavers, 8 live horses. Methods: A latex model was used to identify possible sites for arthroscopic access to the palmar aspects of the AC and MC joints. Carpi (n = 24) were examined arthroscopically and arthroscopic access sites and visible carpal bone surfaces were described. Results: Arthroscopic approaches and instrument portals were develo...
Clinical findings, diagnosis, prevalence and predisposing factors for lameness localised to the middle carpal joint in young Standardbred racehorses. Lameness related to the middle carpal joint (MCJ) occurs in up to 30% of young Standardbred horses in race training and the incidence increase with radiographic severity of third carpal bone (C3) sclerosis on DPr-DDIO (skyline) view of the carpus. Factors predisposing horses to carpal injury have not been well investigated. Objective: To determine the importance of MCJ lameness as a cause of wastage in young Standardbred racehorses, stage of training at which it occurs and predisposing factors, and to describe clinical findings and diagnosis. Methods: Standardbred horses (n = 114) entering the...
Treatment of a second carpal bone fracture by removal under ultrasonographic guidance in a horse. To report an unusual 2nd carpal bone (C2) slab fracture and its treatment, using an ultrasonographically assisted, minimally invasive arthrotomy technique, for fragment removal. Methods: Case report. Methods: An 11-year-old crossbred Warmblood gelding. Methods: A bone fragment, spanning the height of C2, identified on the palmaromedial aspect of C2 was demarcated intraoperatively using ultrasonographically guided needles and removed by arthrotomy. Results: Fracture fragment removal was achieved using a small, ultrasonographically guided arthrotomy. The horse has become sound after treatment an...
Carpal collateral ligament desmopathy in three horses. The radiographic and ultrasonographic findings in three horses with severe damage to the collateral ligaments of the carpus, associated with degenerative joint disease, are described. The horses remained lame despite prolonged rest and medical management, primarily because of the progression of the joint disease. Ultrasonography was found to be an accurate method for diagnosing the injury to the ligaments and is recommended as part of a routine examination in suspected carpal injuries.
Surgical and nonsurgical management of sagittal slab fractures of the third carpal bone in racehorses: 32 cases (1991-2001). To compare results (ie, return to racing and earnings per race start) of surgical versus nonsurgical management of sagittal slab fractures of the third carpal bone in racehorses. Methods: Retrospective study. Methods: 32 racehorses (19 Thoroughbreds, 11 Standardbreds, and 2 Arabians). Methods: Medical records and radiographs were reviewed to obtain information regarding signalment and treatment. Follow-up information was obtained from race records. Robust regression analysis was performed to evaluate earnings per start in horses that raced at least once before and after injury. Results: 22 (69...
Effects of racetrack exercise on third metacarpal and carpal bone of New Zealand thoroughbred horses. The response of equine bone to training has not been quantified in racetrack trained horses, only in treadmill exercised horses. Seven two-year-old thoroughbred fillies were trained on sand and grass at a racetrack, in a typical New Zealand flatrace training regime. The horses were exercised 6 days per week for up to 13 weeks. During the day the horses were confined in 4 x 4m sand yards, and were stalled at night. Another 7 fillies of the same age were allowed free exercise in grass yards. The bones of the animals were available after the 13 week experimental period, and were examined using a ...
Three-dimensional carpal kinematics of trotting horses. Descriptions of 3D kinematics assist in understanding joint function and dysfunction, and are an essential step toward 3D inverse dynamic analysis. Objective: To measure 3D carpal joint motion during trotting. Methods: Three-dimensional trajectories of bone-fixed markers on the radius and third metacarpus of the right forelimb of 3 healthy horses were recorded at 120 Hz using a 6-camera analysis system. Joint kinematics were calculated in terms of helical angles between the 2 segments using a spatial attitude method. Results: All horses showed carpal extension and internal rotation of the meta...