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Topic:Intra-Articular Injection
Intra-articular injection in horses involves the administration of therapeutic agents directly into a joint space. This technique is used to manage joint diseases, such as osteoarthritis, by delivering medications like corticosteroids, hyaluronic acid, or biologic therapies directly to the affected area. The procedure aims to reduce inflammation, alleviate pain, and improve joint function. Intra-articular injections are commonly performed under sterile conditions to minimize the risk of infection. This page compiles peer-reviewed research studies and scholarly articles that explore the methods, efficacy, and safety of intra-articular injections in equine medicine, as well as their impact on joint health and performance in horses.
Inter- and intra-rater reliability of linear scoring in warmblood breeding. Reliable phenotypes are essential for successful animal breeding programmes. Subjective phenotypic assessment may lead to under- or overestimation of heritability estimates and thereby affect the power of genome-based analyses. In Warmblood horses, conformation traits are commonly assessed using linear scoring, but its reliability has not been sufficiently quantified. Objective: In this study, we investigated inter- and intra-rater reliability of linear scoring of conformation traits in German warmblood horses. Methods: Professional equine breeding experts (e.g. breeding judges) completed an o...
Intrauterine ozone therapy reduces bacterial load in mares with mixed bacterial endometritis: a longitudinal study. Mixed bacterial endometritis poses a therapeutic challenge in mares due to the coexistence of multiple pathogens with divergent antimicrobial susceptibility profiles. This study evaluated the effects of intrauterine ozone insufflation on uterine bacterial load and endometrial inflammatory response in mares with naturally acquired mixed bacterial endometritis. Fifteen mares with mixed bacterial infection were allocated to two treatment groups: a pathological control group receiving pure medical oxygen insufflation (PC; n = 6) and an ozone-treated group receiving 42 µg/mL ozone for three c...
Intra-articular interleukin-1β induces early synovitis in an ex vivo autologously perfused equine forelimb model. To evaluate an ex vivo model of synovitis induced by IA lipopolysaccharide (LPS) and IL-1β in isolated, perfused equine forelimbs. Unassigned: Forelimbs and blood were collected from 12 clinically unremarkable horses following slaughter at a licensed abattoir. In 8 limbs, 2 of 3 phalangeal joints were injected with LPS (0.5 to 5 ng, 4 limbs) or IL-1β (100 ng, 4 limbs) diluted in 1 mL of distilled water. All limbs were perfused with autologous perfusate for 8 hours. Synovial fluid cytology and synovium sample histology scores for synovitis (0 = no changes and 3 = marked changes) were assessed...
Meta-Analysis and Physiologically-Based Modeling of the Pharmacokinetics and Pharmacodynamics of Dexamethasone in Horses. Dexamethasone (DEX) is widely used in equine practice for its potent anti-inflammatory effects and diverse studies have examined its pharmacology in horses. We integrated all available pharmacokinetic (PK) and pharmacodynamic (PD) data from 12 studies to quantify DEX disposition and endocrine effects in horses. Methods: DEX concentrations in blood, urine and synovial fluid, plus cortisol (CTS) and glucose (GLU) in plasma, following various administration routes (intravenous (IV), intramuscular (IM), intra-articular, oral) were available from original studies or digitized from literature. A mi...
Intra-articular 2.5% polyacrylamide hydrogel alters synovial immune pathways in equine experimental osteoarthritis. To determine differential gene expression in synovial tissues following injection of IA 2.5% polyacrylamide hydrogel (2.5% iPAAG), a biocompatible nondegradable synthetic polymer, to treat osteoarthritis (OA). Unassigned: Osteoarthritis was induced in 1 middle carpal joint of 16, 2- to 5-year-old horses (7 mares and 9 geldings) via surgical osteochondral fragment creation in combination with exercise on a high-speed treadmill; the contralateral limb underwent a sham operation. Horses were exercised 5 days per week, beginning on day 16 postoperatively. The osteochondral fragment joint was injec...
Composition of allogeneic equine orthobiologics and their repeated intra-articular administrations. Orthobiologics such as platelet-rich plasma (PRP) and alpha-2-macroglobulin (A2MG) are increasingly used for equine musculoskeletal injuries. However, their composition and safety with repeated allogeneic intra-articular administration remain poorly investigated. Objective: To characterise orthobiological preparations with or without 1 h incubation at 37°C (PRP, PRP + Inc, A2MG, A2MG + Inc) and evaluate immunological safety following repeated intra-articular administration (autologous and allogeneic) of PRP combined with A2MG + Inc in healthy horses. Methods: In vivo experiments...
Clinical Outcomes Following Intra-Articular Administration of Autologous Muscle-Derived Mesenchymal Stem Cells in Horses with Chronic Osteoarthritis: A Prospective Open-Label Study. Mesenchymal stromal/stem cells (MSCs) are increasingly investigated as intra-articular therapies for equine osteoarthritis (OA), although most studies have focused on allogeneic or combination-based approaches. Evidence supporting the use of autologous MSCs as a stand-alone treatment remains limited. The present study evaluated the safety and clinical evolution following intra-articular administration of autologous muscle-derived MSCs (mdMSCs) in horses with naturally occurring chronic OA. Thirteen horses with confirmed clinical disease were included. Each affected joint received a single inje...
Clinical and Biochemical Effects of Intra-Articular Autologous Conditioned Serum and Triamcinolone in an Equine Model of Synovitis. Synovitis is a key contributor to the development of OA, and early modulation of the synovial environment may help limit downstream cartilage damage. This study compared the clinical and biochemical effects of intra-articular triamcinolone acetonide (TA) and autologous conditioned serum (ACS) in an equine model of IL-1β-induced synovitis. Six healthy adult horses were used in a crossover design involving five groups: PBS (negative control), IL-1β (positive control), IL-1β + ACS, IL-1β + TA, and an exploratory ACS-alone group administered post hoc to isolate its effects without IL-1β inter...
Ertugliflozin decreases the insulin spike in non-insulin dysregulated standardbred horses following intra-articular triamcinolone administration. Horses with equine metabolic syndrome (EMS) are at an increased risk of laminitis following corticosteroid use. Ertugliflozin reduces hyperinsulinemia in horses with EMS, and therefore may be a management option to reduce the insulin spike seen post corticosteroid use. It was hypothesised that oral ertugliflozin, administered before and after intra-articular (IA) triamcinolone acetonide (TA), will significantly lower the insulin response in comparison to placebo. A randomised, blinded, placebo-controlled, crossover design was performed on eight adult standardbred geldings with no history of la...
Toll-like receptor 3-activated allogeneic umbilical cord blood-derived mesenchymal stromal cells as an adjunct for the treatment of synovial sepsis in 3 horses. To describe the case presentation, treatment, and outcome of horses treated with Toll-like receptor 3 (TLR-3)-activated allogeneic umbilical cord blood-derived mesenchymal stromal cells (CB-MSCs). Unassigned: 3 horses presenting with chronic or antimicrobial-resistant (AMR) septic synovitis. Unassigned: All horses presented with clinical signs associated with septic synovitis including marked grade 4/5 lameness, joint effusion, heat/swelling of the limb, and synovial fluid parameters consistent with sepsis. Case 1 presented 3 weeks following the onset of clinical signs. Cases 2 and 3 developed...
Intra-articular hydrogel therapeutics exhibit anti-inflammatory effects on cytokine-stimulated equine cartilage and synovial membrane explants. To investigate whether IA hydrogel therapeutics alter the inflammatory and/or degradative responses of articular cartilage (AC) and synovial membrane (SM) to cytokine stimulation. Unassigned: AC and SM tissue explants were stimulated with interleukin-1β (IL-1β) or tumor necrosis factor-α (TNF-α) and simultaneously treated with triamcinolone acetonide, hyaluronic acid, collagen-elastin hydrogel microparticles (CEHM), or 2.5% polyacrylamide hydrogel (2.5% iPAAG) at 3 doses. Synovial membrane (n = 9 explants, 3 horses) was stimulated/treated for 18 hours, whereas AC (12 explants, 6 horses) wa...
Long term safety and efficacy of a functionalized nanogel with endothelin-1 and bradykinin receptor antagonist peptides for treatment of osteoarthritis of the metacarpophalangeal and distal interphalangeal joints in horses: a descriptive clinical pilot study. Intra-articular drug delivery systems (DDS) are emerging as promising therapies for osteoarthritis (OA), yet their efficacy in spontaneous clinical cases remains largely untested. This uncontrolled, descriptive pilot study was designed to provide a proof of concept for the feasibility, safety, and preliminary clinical effects of intra-articular administration in sport horses with naturally occurring OA. The study involved a peptide-functionalized nanogel composed of chitosan and hyaluronic acid, delivering endothelin type A (BQ-123) and bradykinin B1 (R-954) receptor antagonists, which have pr...
Treatment with ertugliflozin mitigates the hyperinsulinemic response to intra-articular triamcinolone acetonide. Intra-articular (IA) corticosteroids can cause hyperinsulinemia, which can subsequently increase the risk of laminitis, particularly in horses with insulin dysregulation (ID). Sodium glucose cotransporter 2 inhibitors (SGLT2i), a drug class that is being utilised more commonly in horses with insulin dysregulation, could potentially be used to control post-IA corticosteroid hyperinsulinemia. Objective: To determine whether treatment with the SGLT2i drug ertugliflozin decreases hyperinsulinemia following intra-articular corticosteroid administration in metabolically normal horses. Methods: Prosp...
Repeatability and reproducibility of intraocular pressure measurements in horses using rebound and applanation tonometry. Intraocular pressure (IOP) assessment is a fundamental component of ophthalmic examinations in both veterinary and human medicine. Due to variations in IOP across species and potential differences among examiners, knowledge of normal IOP values obtained using different tonometers is essential. Unassigned: This study aimed to compare the repeatability and reproducibility of IOP values in horses obtained by three different examiners using rebound (Tonovet) and applanation (Tonopen Avia) tonometers. Unassigned: Thirty healthy criollo horses were examined. IOP was measured by three veterinarians w...
Functional and biochemical inflammatory responses to low-dose intra-articular recombinant equine IL-1β: a pilot study. Low-dose intra-articular injection of recombinant equine interleukin-1β (reIL-1β) may offer a useful model for studying early onset or subclinical joint inflammation in horses. This pilot study aimed to determine the lowest intra-articular dose of reIL-1β required to produce biochemical evidence of synovitis, and to correlate synovitis biomarkers with functional, upper-body asymmetry parameters. Saline (control) and 50, and 75 ng reIL-1β were injected into the left or right intercarpal joint of three ( = 3) horses in a three-way crossover design. Synovial fluid was collected by aseptic art...
Effects of intrauterine ozone insufflation in eleven subfertile mares: a case series. Equine persistent breeding-induced endometritis can lead to chronic uterine inflammation and fibrosis, reducing fertility. Intrauterine ozone (O₃) has recently been proposed as a potential treatment for mares unresponsive to conventional therapies. This case series describes O₃ treatment in eleven mares barren for at least one year despite multiple inseminations attempts. During the first oestrous cycle, low-volume uterine lavage and endometrial biopsy were performed, followed by 3 consecutive days of intrauterine O₂-O₃ gas insufflation. In the subsequent cycle, both procedures were re...
Intra-articular methylprednisolone acetate does not induce hyperinsulinemia or hyperglycemia in metabolically normal horses. The goal of this project was to examine the metabolic effects of IA methylprednisolone acetate (MPA) following injection into multiple low-motion joints. Unassigned: Six 3-year-old geldings without pituitary pars intermedia dysfunction or insulin dysregulation were randomly injected with 20 mg of IA MPA/joint (80 mg total; bilateral distal hock joints) or an equal volume of saline. Serial blood samples were collected for resting ACTH, cortisol, insulin, and glucose, as well as insulin and glucose following repeated low-dose oral sugar tests. Treatments were crossed over after a 6-week washout,...
Effects of clodronate disodium on markers of inflammation and cartilage metabolism in juvenile horses challenged with intra-articular lipopolysaccharide. Perceived chondroprotective and anti-inflammatory benefits of bisphosphonates in the juvenile horse has led to extra-label use without supportive data regarding intra-articular effects on cartilage metabolism and inflammation. Thirty-two yearling Quarter Horses were stratified into 4 treatment groups by age (500 ± 13 d), BW (336 ± 26 kg), sex (n = 16 female; n = 16 male) and initial bone optical density for a 140-d study. The study consisted of two exercise phases: Phase 1 (d 0-84) emulated sales preparation and Phase 2 (d 99-140) mimicked early exercise training. Horses we...
PPARγ Agonism Modulates Synovial Macrophage and Cartilage Responses in an Equine Model of Synovial Inflammation-Implications for Joint Therapy. Synovitis resolution is critical for joint homeostasis and prevents the progression of osteoarthritis (OA). Treatments like NSAIDs and intra-articular corticosteroids relieve symptoms by blocking pro-inflammatory mediators, but also impair the production of pro-resolving mediators, contributing to the likelihood of chronic synovitis. PPARγ signaling is an essential mechanism of synovitis resolution, which is decreased in OA tissues. To evaluate the potential of PPARγ agonists to promote pro-resolving pathways, equine macrophages cultured in autologous, normal, or inflamed synovial fluid ( = ...
Inflammatory response following intra-articular injection of decellularized porcine amnion/chorion in horses. The objective of the study was to evaluate effects of intra-articular decellularized porcine amnion/chorion suspension (dPACLS) in horses. Methods: Controlled, randomized, prospective study. Methods: A total of 10 adult horses. Methods: One randomly selected radiocarpal joint (RCJ) was injected with a high dose (HD) of 50 mg (n = 5) or low dose (LD) of 5 mg of dPACLS (n = 5). The contralateral RCJ received saline as control. Systemic serum amyloid A (SAA), synovial fluid analysis (including SAA) and subjective lameness evaluation were performed prior to injection (time 0) and 24, 4...
Synovial Fluid Biomarker Profile After Intra-Articular Administration of Neosaxitoxin in Horses: A Feasibility Study. Osteoarthritis (OA) is an inflammatory joint disease and the leading cause of musculoskeletal disability affecting human and veterinary patients. New therapeutics halting inflammation while preserving joint homeostasis remain a critical need. Voltage-gated sodium (NaV) channels regulate the pro-inflammatory response of macrophages in the synovium, the central driver of joint homeostasis. Neosaxitoxin (NeoSTX) is a phycotoxin that blocks NaV channels, conferring a unique potential to regulate joint inflammation. This study evaluated the safety of intra-articular administration of NeoSTX in hors...
Platelet-derived mitochondrial preparation did not alter early inflammatory markers in a bilateral lipopolysaccharide-induced model of equine synovitis. To evaluate IA autologous platelet-derived mitochondrial preparation versus vehicle control in a bilateral lipopolysaccharide (LPS)-induced model of equine synovitis. Unassigned: 2 ng of LPS was injected into bilateral intercarpal joints of 6 horses over 3 months. Autologous mitochondria, isolated with a commercial kit, were injected into one joint, while the contralateral joint received a vehicle control, a within-subject controlled experimental design. Mitochondrial organelle appearance was visualized on transmission electron microscopy. Outcome measures included synovial fluid and whole-blo...
Safety study of leucoreduced allogeneic pooled freeze-dried platelet-rich plasma in healthy equine joints. Clinical use of blood-derived intra-articular therapies, such as platelet-rich plasma (PRP), have increased in equine athletes due to their proposed disease-modifying effects. Need for a shelf-stable, allogeneic PRP product with known composition for standardized treatment exists. The objective of this study was to compare systemic and local effects of a single intra-articular injection of equine leucoreduced allogeneic pooled freeze-dried PRP (alloPRP) to a placebo control (saline) in normal, healthy equine joints. Unassigned: Twelve healthy horses were randomly assigned to either control (sa...
Clinical evaluation of freeze-dried secretome (lyosecretome) for osteoarthritis: a controlled trial in dogs and preliminary safety assessment in horses. Most in vivo studies on MSC-secretome for osteoarthritis (OA) have relied on animal models, using products lacking pharmaceutical quality, not formulated for clinical use, and insufficiently characterized, limiting knowledge of its effectiveness. This study reports veterinary clinical trials on dogs and horses with spontaneous OA: in dogs (26 subjects), the trial is randomized, double-blinded, and controlled; in horses, 5 clinical cases were treated for safety assessment. Treatment consisted of hyaluronic acid with either lyosecretome - a freeze-dried, injectable MSC-secretome obtained through...
PRP and hyaluronic acid reduce synovitis in horses after arthroscopic OCD removal in Andalusian horses. 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 ...
Evaluation of an intra-articular carboxymethylcellulose crosslinked hydrogel in horses with osteoarthritis. 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...
Survey of veterinarians’ usage and satisfaction with intra-articular polyacrylamide gel in horses. Polyacrylamide gel is increasingly used in equine veterinary medicine for osteoarthritis and other joint disorders. This study aimed to document the indications, treatment protocols, rehabilitation plans, outcomes, and satisfaction with intra-articular polyacrylamide gel in horses, as reported by equine veterinarians. An online questionnaire was distributed to practitioners through the European and American Colleges of Veterinary Sports Medicine and Rehabilitation mailing lists, social media, and direct contact. Of 197 respondents, 160 completed the survey, forming the basis for the descriptiv...
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€...
Lameness improvement in horses with distal tarsal pain after intra-articular injection of botulinum neurotoxin type A. To evaluate the effect of IA injections of botulinum toxin type A (BoNT-A) in horses with chronic, naturally occurring distal tarsal osteoarthritis. Unassigned: 9 horses were selected after physical and radiographic assessments. Horses also underwent an objective lameness examination and were included if they had a hindlimb impact lameness (Pmin ≥ 3 mm), which positively responded (≥ 50%) to the tarsometatarsal and centrodistal joints' anesthetic block. Horses randomly received an intra-articular injection of BoNT-A or an equivalent volume of saline solution. Horses were reevaluated at pos...
