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.
Computer-assisted three-dimensional gait analysis of amphotericin-induced carpal lameness in horses. Motion of 6 clinically sound horses trotting at a speed of 4 m/s on a treadmill was captured by video cameras before and 9, 16, and 23 days after amphotericin-induced lameness to determine the quantitative variables of three-dimensional computer-assisted image analysis that objectively describe carpal lameness. Amphotericin-B was used to induce lameness, and phenylbutazone (2.2 mg/kg of body weight, PO, once) and butorphanol tartrate (0.1 mg/kg IM, q 6 h, to effect) were used to control discomfort. Four 60-Hz cameras were symmetrically placed around the treadmill to capture 6 seconds of images...
Removal of a fracture fragment from the palmar aspect of the intermediate carpal bone in a horse. A 10-year-old Dutch Warmblood gelding sustained a fracture of the palmar tuberosity of the intermediate carpal bone 2 weeks prior to admission. The dorsolateral-palmaromedial oblique and flexed lateromedial radiographic views revealed the fracture line. The palmar fracture fragment from the intermediate carpal bone was removed by arthrotomy of the palmar intercarpal joint, which was approached through the carpal canal. Twenty months after surgery, the horse was show jumping without evidence of lameness.
Use of scintimetry to assess effects of exercise and polysulfated glycosaminoglycan on equine carpal joints with osteochondral defects. Combined blood pool and delayed images produced by use of 99mTc-methylene diphosphonate (99mTcMDP) were evaluated as an objective measurement of the response of equine joints with osteochondral defects to postoperative exercise and intra-articularly administered polysulfated glycosaminoglycan (PSGAG). Osteochondral defects (approx 2.4 x 0.9 cm) were induced arthroscopically in the dorsodistal radial carpal bones of 18 ponies. These ponies were randomized (while balancing for age [range 2 to 15; median, 5.0; mean, 5.1 years]) to 2 treatment groups. Nine ponies were assigned to be exercised, and...
The incidence and severity of intercarpal ligament damage in the equine carpus. The arthroscopic findings in 104 intercarpal joints in 76 horses were reviewed to determine the incidence and severity of changes in the medial intercarpal ligament. Damage to the intercarpal ligament was observed in 43 joints in 35 horses, ranging from mild fraying of the edges of the ligament to complete disruption of all fibres. This represented an incidence of 41% of joints being affected. In 9 joints examined arthroscopically primarily as a further diagnostic procedure, ligament damage was evident in all cases. In horses undergoing arthroscopic surgery primarily for the treatment of osteo...
Kinematic gait analysis in equine carpal lameness. Gait analysis plays a major role in the clinical evaluation of equine lameness. It is generally accepted that the clinician expresses the grade of lameness as a subjective score. In this study lameness was objectively assessed using a standardized transient lameness model, in which lameness was induced by intra-articular injection of bacterial endotoxin into the radiocarpal joint of ponies. Lameness was scored by an experienced clinician, and locomotion was recorded simultaneously using a CODA-3 apparatus. The obtained kinematic gait parameters correlated well with the clinical lameness score ...
Arthroscopic removal of a palmar radial osteochondroma causing carpal canal syndrome in a horse. A 5-year-old Arabian stallion with moderate effusion in the right carpal canal and intermittent lameness in this limb was diagnosed to have an osteochondroma projecting from the distal portion of the radius into the carpal canal. oral phenylbutazone treatment over the next 3 years allowed the stallion to continue its show career. Right forelimb lameness returned at that time, and ultrasonography revealed the osteochondroma impinging on the dorsal surface of the deep digital flexor tendon. The owner elected to have the osteochondroma surgically removed. The horse was anesthetized, and the carpa...
An arthroscopic biopsy procedure for obtaining osteochondral samples from the equine midcarpal joint. An in vivo biopsy technique was developed to harvest cylindrical osteochondral core samples (2 mm diameter x 2 mm depth) from the articular surfaces of radial carpal bones in adult horses for use in osteoarthritis drug kinetic studies. A 25 degree arthroscope was introduced into the midcarpal joint through the dorsolateral surface, and a custom-built motorized core drill was introduced through the dorsomedial surface to create the osteochondral core samples. A total of 24 core samples were sequentially harvested in vivo, and 16 at postmortem, from eight horses on four different occasions withi...
Tearing of the medial palmar intercarpal ligament in the equine midcarpal joint. Tearing of the medial palmar intercarpal ligament is described in 45 intercarpal (midcarpal) joints in 42 horses (37 racehorses, 5 non-racehorses). Of the 37 racehorses, there were 20 Quarter Horses, 14 Thoroughbreds and 3 Standardbreds. The patients had been referred for arthroscopic surgery for removal of osteochondral chip fragments that had been diagnosed radiographically or diagnostic arthroscopy of a persistent carpal problem. The problem was unilateral in 39 horses and bilateral in 3. The presenting clinical signs were lameness and/or persistent synovial effusion. In one instance, the p...
Fate and effect of autogenous osteochondral fragments implanted in the middle carpal joint of horses. Four autogenous osteochondral fragments removed from the lateral trochlear ridge of the talus were arthroscopically placed as loose bodies in a randomly selected middle carpal joint in each of 10 horses. The contralateral middle carpal joint, subjected to a sham procedure, served as control. Postoperative treatment was consistent with that for clinical arthroscopic patients. Lameness evaluation, radiographic examination, carpal circumference measurement, and synovial fluid analysis were performed before and at scheduled intervals after surgery. After a 2-month confinement, horses were subjecte...
Healing of full-thickness cartilage compared with full-thickness cartilage and subchondral bone defects in the equine third carpal bone. The effect of lesion depth on the quality of third carpal bone cartilage repair was examined. A 1-cm diameter articular defect penetrating the calcified cartilage in one limb and the subchondral bone plate in the opposite limb was created in the radial facet of the third carpal bones. Clinical and xeroradiographic examinations were performed every 4 weeks until 4 months (3 horses) and 6 months (3 horses) after surgery. The synovial membrane, non-opposing articular surfaces and articular defects were examined grossly, histologically and histochemically. Grossly, deeper defects contained thicker...
Evaluation of intra-articularly administered sodium monoiodoacetate-induced chemical injury to articular cartilage of horses. Three doses of sodium monoiodoacetate (MIA) were used to induce degenerative changes in articular cartilage in middle carpal joints of horses. Twelve young (2- to 5-year-old) horses, free of lameness, were randomly allotted to 3 groups. One middle carpal joint of each horse was injected with 0.9% NaCl solution (control joint). The contralateral middle carpal joint was injected with 0.09 mg of MIA/kg of body weight (group 1); 0.12 mg/kg (group 2); or 0.16 mg/kg (group 3). After MIA administration, horses were allowed ad libitum exercise in a 2-acre paddock for 12 weeks. At the end of the study,...
Regional perfusion of the equine carpus for antibiotic delivery. Regional perfusion of carpal tissues by forced intramedullary administration of fluids was evaluated in 10 horses. Results of subtraction radiography after perfusion with a contrast medium demonstrated that perfusate was delivered to the carpal tissues by the venous system. Perfused India ink was distributed uniformly in the antebrachiocarpal and middle carpal synovial membranes. Histologically, the ink was within the venules of the synovial villi. Immediately after perfusion with gentamicin sulfate (1 g), the gentamicin concentrations in the synovial fluid and synovial membrane of the antebra...
Racing performance of Thoroughbred horses after arthroscopic surgery of the carpus. The case record, and subsequent racing performance, of 110 horses that had undergone arthroscopic surgery of the carpus, were reviewed. Of these, 87% resumed racing, with 43% able to win at least one race, after surgery. Horses with chip fractures from the distal radius had the best prognosis, while horses with sagittal fractures of the third carpal bone had the poorest. The performance of horses with bilateral lesions was similar to those with unilateral lesions. It was concluded that arthroscopic surgery was a suitable technique for the diagnosis and treatment of carpal lesions in the horse....
Proteoglycan synthesis and content in articular cartilage and cartilage repair tissue in horses. Hexosamine concentration, DNA concentration, and [35S]sulfate incorporation for articular cartilage obtained from various sites in the metacarpophalangeal and carpal joints of horses were measured. The same measurements were made on the repair tissue filling full-thickness articular defects in the intermediate carpal bone and on cartilage surrounding partial-thickness defects 6 weeks after the defects were created arthroscopically. Cellularity (measured as DNA concentration), proteoglycan content (measured as hexosamine concentration), and proteoglycan synthesis (measured as [35S]sulfate incor...
Desmotomy of the accessory ligament of the superficial digital flexor muscle in equine cadaver limbs. Effects of longitudinal compression before and after transection of the accessory ligament of the superficial digital flexor (SDF) muscle were measured in eight equine cadaver forelimbs. When compression was increased from 890 N to 3115 N, the metacarpophalangeal (MCP) and carpal joints hyperextended 20 degrees and 4 degrees, respectively, and strain in the SDF and deep digital flexor tendons was increased 3.5% and 1.4%, respectively. The accessory ligament did not elongate. Immediately after transection of the accessory ligament at 3115 N load, a 2.8 mm gap formed between the transected ends ...
Mechanical and morphometric analysis of the third carpal bone of Thoroughbreds. The third carpal bone (C3) was collected from both forelimbs of 27 Thoroughbreds. On the basis of age, training, and history, specimens were assigned to 1 of 5 groups: yearling, untrained horses (group 1, n = 4); 2- to 3-year-old, untrained horses (group 2, n = 7); trained 2-year-old horses (group 3, n = 6); trained 3-year-old horses (group 4, n = 6); and 3-year-old, trained horses with carpal pathologic features (group 5, n = 4). A transverse section of subchondral bone 5-mm thick was cut in a precise fashion 10 mm below the proximal articular surface of all specimens. After high-detail radio...
Pulsed radio frequency therapy of experimentally induced arthritis in ponies. The effect of pulsed radio frequency therapy (PRFT) was evaluated on seven ponies with no arthritis and in 28 ponies in which arthritis was created using intra-articular amphotericin B to induce synovitis in the right middle carpal joint. The ponies were divided into five treatment and two control groups. Two levels of arthritis were created and two dosage levels of PRFT were evaluated. The effect of PRFT on arthritic and nonarthritic joints was measured by comparing synovial fluid parameters, the degree and duration of lameness, the range of carpal motion, and carpus circumference, for treate...
Effects of intra-articular administration of methylprednisolone acetate on normal equine articular cartilage. The effects of the corticosteroid 6-alpha-methylprednisolone acetate on normal equine articular cartilage were evaluated, using the middle carpal joint in 4 clinically normal young horses. One middle carpal joint of each horse was injected 3 times with 100 mg of 6-alpha-methylprednisolone acetate, at 14-day intervals. The opposite middle carpal joint (control) was injected with 2.5 ml of lactated Ringer solution at the same intervals. Effects were studied until 8 weeks after the first injection. Evaluation included clinical and radiographic examination, and gross, microscopic, and biochemical ...
[Soft tissue lesions of the equine carpus: roentgenological and echographic studies]. Common soft tissue disorders of the equine carpus are fluctuating or firm soft tissue swellings, wounds and draining tracts. Survey radiography may show the size, position and origin of the swellings and reveals soft tissue calcification, accumulation of air and radiopaque foreign material. Contrast radiography enables accurate visualization of the size, shape, position and origin of fluctuating soft tissue swellings, demonstrates abnormal intersynovial communication and allows precise demonstration of the extent of puncture wounds and draining tracts. Ultrasonography allows differentiation be...
Unusual polydactylism in a foal. A case report. A 2 month old quarter horse colt had multiple skeletal abnormalities of the left fore limb, including two supernumerary metacarpal bones, two supernumerary carpal bones, abnormal carpal bone development, and a valgus deformity originating at the carpal joint. The largest supernumerary metacarpal bone was removed completely, a portion of the smaller supernumerary metacarpal bone was removed, and the leg was placed in a tube cast. Surgical treatment improved the clinical appearance and prevented further injury to the limb. The carpal joint width remained increased but the carpal valgus deformity...
Correlation between radiographic and arthroscopic findings in the equine carpus. The radiographic and arthroscopic findings in 150 carpal joints in 114 lame horses were compared. Chip, slab, or sagittal fractures were identified in 130 (87%) joints. In 101 (78%) of these there was good agreement between radiographic and arthroscopic findings on the number and position of fractures. In 23 (18%) joints, chip fractures additional to those seen radiographically were found arthroscopically. In one joint a large chip fracture from the craniolateral aspect of the distal radius was identified only by arthroscopy, while in 6 joints fractures were identified only by radiography. Obs...
Lameness diagnosis and treatment in the quarter horse racehorse. Lameness problems constitute a major part of racing Quarter Horse practice. This article considers the diagnosis, prognosis, and treatment of the frequently encountered lamenesses. The main conditions included are synovitis, intra-articular fractures, osteochondritis dissecans, and degenerative joint disease as they relate to the coffin, fetlock, carpal, and tarsal joints. Intra-articular injection techniques and medications are discussed because of the frequency of joint disease. Bucked shins and stress fractures are also reviewed.
Local anesthetics and nuclear medical bone images of the equine fore limb. The effects of two local anesthetic agents on the diagnostic quality of nuclear medical bone images (NMBIs) of distal parts of the equine fore limb were investigated. Local effects on bone uptake of technetium 99m methylene diphosphonate (99mTc-MDP) 4 and 24 hours after perineural and intraarticular injection of mepivacaine hydrochloride and bupivacaine hydrochloride were evaluated in the carpal and metacarpophalangeal regions of 12 horses and ponies. Neither mepivacaine hydrochloride nor bupivacaine hydrochloride significantly altered the diagnostic quality of the NMBIs. The injection and sub...
Comparison of the effect of polysulfated glycosaminoglycan, corticosteroids, and sodium hyaluronate in the potentiation of a subinfective dose of Staphylococcus aureus in the midcarpal joint of horses. Four groups of 8 horses each had 1 midcarpal joint injected with 33 colony-forming units (CFU) of viable Staphylococcus aureus plus: 1 ml of saline solution (group 1, control), 250 mg of polysulfated glycosaminoglycan (PSGAG, group 2), 100 mg of methylprednisolone acetate (group 3), or 20 mg of sodium hyaulronate (group 4). Horses were euthanatized, and samples were obtained on the basis of clinical signs of septic arthritis that were nonresponsive to phenylbutazone administration. One group-1 horse, all 8 group-2 horses, 3 group-3 horses, and 4 group-4 horses were culture-positive for S aureu...
Subchondral lucency of the third carpal bone in Standardbred racehorses: 13 cases (1982-1988). Thirteen Standardbreds had subchondral lucency of the third carpal bone (C3), described as single or multiple central areas of C3 bone loss in the radial fossa. Sclerosis of the radial fossa was also detected. The mean age of 9 stallions, 3 mares, and 1 gelding was 4.1 years (range, 3 to 7 years). All horses had an acute moderate to severe lameness referable to the middle carpal joint. A dorsoproximal dorsodistal (skyline) radiographic projection was most useful and identified mild (3 horses), moderate (6 horses), and severe (4 horses) subchondral lucency and sclerosis of the radial fossa. The...
Pancarpal arthrodesis for treatment of carpal collapse in the adult horse. A report of two cases. Two mares with multiple carpal bone fractures, malarticulation and degenerative joint disease were successfully treated with unilateral arthrodeses of the antebrachiocarpal, middle carpal, and carpometacarpal joints. Arthrodesis was achieved by removal of articular cartilage, autogenous cancellous bone graft, and double dynamic compression plating. In one horse, wedge ostectomy corrected the severe, acquired angular limb deformity. External coaptation supplemented the internal fixation. Postoperative complications were limited to cast sores that healed with treatment, although protracted in on...
Evaluation of the effects of intra-articular injection of dimethylsulfoxide on normal equine articular tissues. To evaluate the effects of intra-articular injection of dimethylsulfoxide (DMSO) on normal equine articular structures, 7 adult horses with clinically normal carpi were allotted to 2 treatment groups (group A, n = 4; group B, n = 3). In each horse after collection of synovial fluid samples, the right antebrachial carpal and middle carpal joints were aseptically injected with 2 ml of a 40% solution of 90% medical grade DMSO in lactated Ringer solution, and the corresponding joints of the left forelimb (controls) were injected with 2 ml of lactated Ringer solution. In group-A horses, 2 ml of syn...
The effect of exercise on the healing of articular cartilage defects in the equine carpus. Arthroscopic surgery was performed on 12 horses (2-4 years of age) to create a 7 x 14 mm full-thickness cartilage defect in one radial carpal bone and in the contralateral third carpal bone. Six horses remained confined to a small paddock and six horses underwent a program of increasing exercise consisting of walking, trotting, and cantering for 13 weeks. All lesions showed evidence of healing at week 6 that progressed to more complete healing at week 13. There was no difference in the amount of repair tissue covering the defect. Histologically, the lesions healed with a combination of fibrous...