Hyaluronic acid is a naturally occurring glycosaminoglycan found in various tissues and fluids of horses, including synovial fluid, cartilage, and skin. It is involved in maintaining the viscoelastic properties of synovial fluid, contributing to joint lubrication and shock absorption. Hyaluronic acid is often studied for its role in joint health and its potential therapeutic applications in managing equine osteoarthritis and other joint-related conditions. Research explores its physiological functions, the effects of supplementation or intra-articular injections, and its impact on equine locomotion and performance. This page compiles peer-reviewed research studies and scholarly articles that investigate the biological properties, therapeutic potential, and clinical applications of hyaluronic acid in equine medicine.
Welch RD, Watkins JP, DeBowes RM, Leipold HW.The effects of intra-articular administration of dimethylsulfoxide (DMSO) on chemically induced synovitis in the middle carpal joint of 6 weanling horses were evaluated. Following aseptic collection of synovial fluid, the middle carpal joint of each forelimb was injected with 50 mg of Na-monoiodoacetate to induce synovitis. Eight days after injection, synovial fluid was obtained and the right middle carpal joints were injected with 2 ml of 40% DMSO in lactated Ringer solution. The corresponding joints of the left limb (control) were injected with 2 ml of lactated Ringer solution. Sampling and ...
Little CB, Hilbert BJ, Wickstrom S, Hedlund BE.An alcian blue precipitation method for quantifying the hyaluronic acid (HA) and sulphated glycosaminoglycan concentration (SGAG) in solutions containing both compounds was assessed. The assay was found to be rapid and reliable in solutions containing 0 to 200 mg of HA/dl and 50 to 1,000 micrograms of SGAG/dl, and was not affected by the presence of protein, hemoglobin, or methemoglobin in concentrations normally found in synovial fluid. The HA and SGAG concentrations in intercarpal synovial fluid from 13 clinically normal and 11 arthritic horses were evaluated. A relationship was not found be...
Tulamo RM, Saari H, Konttinen YT.Concentration of hyaluronate (HA) in equine serum was determined by a recently developed specific radioassay. The mean +/- SD HA concentration in equine serum was 288 +/- 145 micrograms/L, was age dependent, and varied widely between horses (range, 190 to 760 micrograms/L). Light or moderate exercise increased serum HA concentration from baseline values by 1.5- to 3-fold. In all horses, serum HA concentration returned to or below the original resting values 1 and 2 hours after exercise.
Saari H, Konttinen YT, Tulamo RM, Antti-Poika I, Honkanen V.In addition to its well-known physicochemical properties, hyaluronate (HA) has recently been shown to have important biological and pathophysiologic regulatory effects on granulocytes, monocytes, fibroblasts, and endothelial cells, as well as on the healing of wounds and various joint disorders. Many of these effects depend on or are reflected in the concentration and degree of polymerization of HA. Therefore, high-performance liquid chromatography with size-exclusion column was used to characterize the concentration and degree of polymerization of HA in equine synovial fluid (SF). The mean (+...
Balazs EA, Denlinger JL.The availability of elastoviscous solutions of highly purified hyaluronan has created two new therapeutic methods in human and veterinary medicine: viscosurgery and viscosupplementation. Viscosurgical tools and implants are widely used in ophthalmology and have been suggested for use in otology. Visco-supplementation of joint fluid using elastoviscous hyaluronan solutions is widely used in the treatment of equine traumatic arthritis. It was also suggested for use in idiopathic osteoarthritis in humans, but this application has not received wide acceptance. Cross-linked forms of hyaluronan have...
White KK, Hodgson DR, Hancock D, Parry BW, Cordell C.The effects of repeated arthrocentesis and injection of local anesthetic agents, lidocaine HCl or mepivacaine HCl on the equine middle carpal joint were investigated. Synovial fluid samples were evaluated before, and 12, 24 and 48 hours following, treatment. The greatest changes from pretreatment values occurred in synovial fluid cellularity. Repeated arthrocentesis caused a moderate increase in cell counts, while injection of local anesthetics caused a greater increase. Alterations in mucin clot quality, hyaluronic acid content, fluid viscosity, total protein and immunoglobulin G were general...
Hardy J, Marcoux M, Eisenberg H.A suspected lesion of osteochondrosis dissecans involving the anconeal process of the humeroradial joint (elbow) was found in 2 horses. In horse 1, the lesion was found during routine lameness examination, during which alleviation of the lameness was achieved after intra-articular anesthesia of the elbow. In horse 2, the lesion was found at necropsy. Horse 1 responded satisfactorily to intra-articular treatment with hyaluronic acid. Both horses also had other joints affected with osteochondrosis dissecans.
Hilbert BJ, Rowley G, Antonas KN, McGill CA, Reynoldson JA, Hawkins CD.Sodium hyaluronate was injected into normal horse joints and joints that had undergone an arthrotomy and experimental cartilage damage. The elimination half-life for hyaluronic acid in normal joints was found to be approximately 96 h. The injection caused a non-significant increase (42%) in synovial fluid protein concentration and a fall in the intrinsic viscosity of the fluid. In the arthrotomy group the synovial fluid hyaluronic acid concentration fell after surgery but it was unaffected by the injection of sodium hyaluronate. An initial rise in the intrinsic viscosity of the synovial fluid ...
Owen RA, Marsh JA, Hallett FR, Lumsden JH, Johnson J.Methylprednisolone acetate was injected repeatedly into both intercarpal joints of a horse that had a 3rd carpal bone fracture in 1 limb. Synovial fluid from intercarpal and radiocarpal joints of both limbs were obtained serially for study. Arthropathy developed in the fractured joint following prolonged corticosteroid therapy and exercise. In the corticosteroid-injected normal joint, the hyaluronic acid concentration initially decreased, then increased. A depletion in cartilage matrix was seen at necropsy, 175 days after onset of treatment. Determination of total protein content in synovial f...
Hilbert BJ, Rowley G, Antonas KN.A method previously described was used to determine the hyaluronic acid concentration in synovia from normal and arthritic horse joints. The concentration of hyaluronic acid in the synovia from arthritic joints was found to be significantly lower than the concentration in fluid from normal joints.
Rowley G, Antonas KN, Hilbert BJ.An assay for the determination of hyaluronic acid concentration in equine synovia (synovial fluid) was investigated. The method involved the degradation of hyaluronic acid, using a highly specific microbial enzyme. The unsaturated tetra- and hexasaccharide products were oxidized with periodate and caused to react with thiobarbituric acid for form a chromophore which absorbed in the visible range of the spectrum. The method was precise within acceptable limits for synovia and compared favorably with the widely used carbazole method of Bitter and Muir (Anal Biochem 4:330-334, 1962). The between-...
Nizolek DJ, White KK.Degenerative arthrosis is perhaps the most common debilitating disease of performance horses. Treatment should be based upon a knowledge of the anatomy and physiology of normal joints and upon an understanding of the processes of degeneration and repair. These topics are briefly reviewed. Although rest is probably, the most beneficial therapy, physical and pharmaceutical treatments are often employed in an effort to speed recovery. The effects and relative benefits of intrasynovial injections of corticosteroids, hyaluronica cid, and Arteparon are considered in detail. Although local corticoste...
Gingerich DA, Auer JA, Fackelman GE.A single intra-articular injection of 20 or 40 mg of purified hyaluronic acid of rooster comb origin resulted in restoration of normal joint function in horses with experimentally induced osteoarthritis. The functional improvement, measured by pressure sensitive force plate techniques, was detectable within one week after treatment and persisted throughout a four week experimental period despite continued use of the joints. The response was dose dependent in that injection of 0 (saline), 5 or 10 mg hyaluronic acid per joint space resulted in no significant change in joint function while dosage...
Auer J.Degenerative joint disease is the most frequently diagnosed problem of the carpus. Horses afflicted with this disease should not be injected with corticosteroids, but should be rested for several months. Swimming exercise and intra-articular injections of hyaluronic acid during this time help to restore the integrity of the involved joints. Chip fractures of the various carpal bones and the distal radius are commonly diagnosed as the cause of the lameness. Not all horses with carpal fractures are candidates for surgery. It is important that the severity of the problem be realized and that the ...
Auer JA, Fackelman GE, Gingerich DA, Fetter AW.Effect of intraarticular injections of hyaluronic acid was evaluated in two groups of horses, using force plates to assess quantitatively the degree of lameness observed. In six horses, chip fractures were created surgically on the dorsomedial aspects of both radial carpal bones. After the horses were trained for 30 days, 40 mg of hyaluronic acid was injected intraarticularly into the limb showing the greater degree of lameness. Horses were worked for 2 more weeks and then were evaluated. A highly significant (P less than 0.01) increase in weight bearing on the treated limb was observed. Ten h...
Marsh JA, Hallett FR, Owen RR.A comparison of methods of preparing the hyaluronic acid of equine synovial fluid for quantitative spectrophotographic analysis is presented. A new method is proposed which appears superior to the previous methods.
Schumacher HR.The normal synovial membrane as seen by electron microscopy is bordered by one to three layers of lining cells that include some with phagocytic function, others rich in endoplasmic reticulum for protein synthesis and additional cells with mixed properties. Lining cells with prominent Golgi apparatus probably produce the synovial hyaluronic acid. The synovial matrix contains collagen and mucopolysaccharide. It offers little barrier to diffusion of most materials. Superficial capillaries and venules are fenestrated and presumably allow rapid exchange of fluid and electrolytes. Deeper venules ha...
Butler J, Rydell NW, Balazs EA.Twelve horses with traumatic arthritis were treated with intraarticular injection of hyaluronic acid mixed with cortisone and the results compared with 6 horses treated only with cortisone. There was a significantly better improvement in the group injected with a mixture of hyaluronic acid and cortisone. Further studies have given the same results in traumatic arthritis in horses if hyaluronic acid alone is injected. After injection of hyaluronic acid a large number of granulated monocytes appeared in the synovial fluid, but no inflammatory signs were observed. It is possible that this macroph...
Van Pelt RW.Physical, biochemical, and cytologic properties of synovial fluid from normal equine tarsal joints were investigated. Tarsal synovial fluid was pale yellow, clear, free of flocculent material, and did not clot. Volume varied in direct proportion to individual tarsal joint size. Relative viscosity was related to volume, polymerization and quantity of hyaluronic acid, and protein concentration. Mucinous precipitate quality (hyaluronic acid polymerization) was uniformly high. Results of certain analyses of serum were compared with those of tarsal synovial fluid. Tarsal synovial fluid protein conc...
Munoz Moran JA.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 ...
Meijer MC, Rijkenhuizen AB.A 12-year-old Dutch Warmblood mare was admitted to the clinic with a 1-month history of lameness of the left hind leg. After clinical and radiological examinations and an bursascopy, the diagnosis navicular disease was made. The therapy consisted of stallrest, non-steroidal anti-inflammatory drugs, and orthopaedic shoeing plus intrabursal injections of short-acting corticosteroids and hyaluronic acid. The therapy was repeated following recurrence of the lameness. According to the owner the horse is currently performing at its previous level.
Muttini A, Petrizzi L, Tinti A, Bertoluzza A.An investigation was carried out on most common synovial fluid parameters of normal and osteochondritic hocks of horses less than 12 months old in order to confirm the presence of an inflammatory process. Furthermore, a spectroscopic study was performed on synovial fluid from both normal and diseased hocks. A depolymerization of hyaluronic acid was demonstrated in synovial fluid from diseases joints, similar to that reported in human rheumatoid arthritis. A one month rest seem to normalize all parameters considered and in one joint, a return to normal infrared spectrum was demonstrated.
Rapp HJ, Becker M, Heisse K, Stechele M.This paper reviews the literature and describes our experiences in the diagnosis and treatment of tendinitis in horses. Ultrasonography provides a sensitive tool to diagnose tendinitis and quantitate the degree of damage to the tendon; as well as provide differential diagnoses such as peritendinitis. The principles in therapy of acute tendinitis are: Immediate reduced exercise or rest, physical therapy to reduce inflammation and administration of local and systemic antiinflammatory drugs. The goal is restoration of the tensile strength of the tendon without peritendinous granulation tissue and...
Tyrnenopoulou PC, Rizos ED, Kritsepi-Konstantinou M, Papadopoulou PL, Patsikas MN, Papazoglou LG, Aggeli A, Diakakis NE.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...
Listoni AJ, Arruda I, Maia L, Barberini DJ, Martins I, Vasconcellos FC, Landim-Alvarenga FC.Nanotechnology techniques have a prominent role in the current technical and scientific scene. The layer-by-layer (LbL) deposition allows obtaining nanostructures with sophisticated multilayer, using a simple, but versatile technique. This procedure, which is used to coat and functionalize surfaces with nanometer- thick films, has applications in bioengineering, medicine, chemistry, materials and chemical engineering among other areas. Chitosan is a biomaterial, coming from the chitin, a very abundant polymer in nature, which has been recently tested as scaffolds. In this experiment we test th...
Hilbert BJ, Rowley G, Antonas KN, McGill CA, Reynoldson JA, Hawkins CD.Sodium hyaluronate was injected into normal horse joints and joints that had undergone an arthrotomy and experimental cartilage damage. The elimination half-life for hyaluronic acid in normal joints was found to be approximately 96 h. The injection caused a non-significant increase (42%) in synovial fluid protein concentration and a fall in the intrinsic viscosity of the fluid. In the arthrotomy group the synovial fluid hyaluronic acid concentration fell after surgery but it was unaffected by the injection of sodium hyaluronate. An initial rise in the intrinsic viscosity of the synovial fluid ...
Viitanen M, Bird J, Makela O, Schramme M, Smith R, Tulamo RM, May S.The purpose of this study was to investigate biochemical changes in synovial fluid in navicular disease, and to establish if synovial fluid from the distal interphalangeal joint (DIP) could be used diagnostically to assess alterations in the synovial fluid of the navicular bursa. Cartilage oligomeric matrix protein (COMP), total glycosaminoglycans (GAG), hyaluronan (HA), metalloproteinases 2 and -9 (MMP-2 and MMP-9) and total protein (TP) levels were determined in synovial fluids obtained from 18 navicular bursae and 35 DIP -joints from animals suffering from navicular disease, and the same sy...
Auer J.Degenerative joint disease is the most frequently diagnosed problem of the carpus. Horses afflicted with this disease should not be injected with corticosteroids, but should be rested for several months. Swimming exercise and intra-articular injections of hyaluronic acid during this time help to restore the integrity of the involved joints. Chip fractures of the various carpal bones and the distal radius are commonly diagnosed as the cause of the lameness. Not all horses with carpal fractures are candidates for surgery. It is important that the severity of the problem be realized and that the ...
Höglund N, Rossi H, Javela HM, Oikari S, Nieminen P, Mustonen AM, Airas N, Kärjä V, Mykkänen A.Equine asthma (EA) is a chronic lower airway inflammation that leads to structural and functional changes. Hyaluronic acid (HA) has crucial functions in the extracellular matrix homeostasis and inflammatory mediator activity. HA concentration in the lungs increases in several human airway diseases. However, its associations with naturally occurring EA and airway remodelling have not been previously studied. Our aim was to investigate the association of equine neutrophilic airway inflammation (NAI) severity, airway remodelling, and HA concentration in horses with naturally occurring EA. We hypo...
Bianchera A, Borghetti P, Ravanetti F, Bertocchi L, De Angelis E, Bettini R.Hyaluronic acid (HA) is a key component of synovial fluid as it plays a crucial role in joint physiology. Its biological activity is influenced by molecular weight, local concentration, and persistence in joints. High-molecular-weight HA has a consolidated history of clinical use, whereas little is known about the metabolic effect of low-molecular-weight hyaluronate on cartilage differentiation. This study explores the potential of HA-based nanoparticles (NPs) on chondrocytes differentiation in vitro. Starting from 25 kDa and 250 kDa sodium hyaluronate solutions, two types of NPs were prepared...
Arnade H, Ivie IE, Gordon J, Peroni JF.To evaluate the feasibility of short-term 3-D tissue culture in maintaining the structure and function of equine synovial explants and demonstrate that day 4 explant characteristics were not significantly different from day 0. We hypothesized that a 4-day culture period in 3-D explant culture would not significantly disrupt synovial tissue health and function compared to baseline measurements. Unassigned: Synovial explants (n = 24/horse) from healthy carpal joints of 5 horses were cultured in 12-well plates using tissue-stabilizing agar rings. Explants were evaluated in triplicate or quadrupli...
Luque RM, Henderson B, McCorkell TC, Alizadeh AH, Russell KA, Koch TG, Koenig J.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€...
Rinnovati R, Spadari A, Malpighi A, Meistro F, Ralletti MV, Marcucci E, Tarasconi MA, Chiatto RL, Tommasa SD.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...
Hobbs KJ, Ludwig EK, Martin EM, Bayless R, Bauck AG, Freeman DE, Gonzalez LM.To determine if blood and peritoneal fluid levels of syndecan-1, heparan sulfate, and hyaluronan are elevated in horses with small intestinal disease compared to healthy counterparts. Unassigned: 61 horses were categorized into control (n = 20), inflammatory (11), and strangulating (30) groups. Paired peritoneal fluid and blood samples were obtained from each group from December 2016 through December 2024 and analyzed via equine-validated ELISAs for syndecan-1, heparan sulfate, and hyaluronan concentrations. Patient survival to discharge was recorded for all groups. Immunofluorescence staining...
Bungărdean D, Pall E, Daradics Z, Popescu M, Tripon MA, Lupșan AF, Crecan CM, Morar IA, Nicolescu A, Bora FD, Marcus I.Musculoskeletal disorders are a major cause of lameness in horses, often necessitating innovative regenerative strategies to restore joint function and improve quality of life. This study investigated the effects of platelet-rich plasma (PRP), ozonized PRP, hyaluronic acid, paracetamol, and polyacrylamide hydrogel (NOLTREX) on the behavior of mesenchymal stem cells (MSCs) derived from equine synovial fluid. Synovial fluid samples were collected under strict cytological criteria to ensure viability, followed by in vitro expansion and phenotypic characterization of MSCs. Cultures were supplement...
Vishwanath K, McClure SR, Bonassar LJ.Intra-articular injections of hyaluronic acid (HA) are the cornerstone of osteoarthritis (OA) treatments. However, the mechanism of action and efficacy of HA viscosupplementation are debated. As such, there has been recent interest in developing synthetic viscosupplements. Recently, a synthetic 4 wt% polyacrylamide (pAAm) hydrogel was shown to effectively lubricate and bind to the surface of cartilage in vitro. However, its ability to localize to cartilage and alter the tribological properties of the tissue in a live articulating large animal joint is not known. The goal of this study was to...
