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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.
Complications associated with equine arthroscopy.
The Veterinary clinics of North America. Equine practice    February 11, 2009   Volume 24, Issue 3 573-viii doi: 10.1016/j.cveq.2008.10.009
Goodrich LR, McIlwraith CW.Arthroscopic complications are infrequent but when they occur can cause significant morbidity in the equine patient. This article reviews intraoperative and postoperative complications along with ways to avoid them. Additionally, therapeutic methods of managing these complications also are discussed.
Anti-inflammatory and analgesic effects of intra-articular injection of triamcinolone acetonide, mepivacaine hydrochloride, or both on lipopolysaccharide-induced lameness in horses.
American journal of veterinary research    December 3, 2008   Volume 69, Issue 12 1646-1654 doi: 10.2460/ajvr.69.12.1646
Kay AT, Bolt DM, Ishihara A, Rajala-Schultz PJ, Bertone AL.To assess analgesia, inflammation, potency, and duration of action associated with intra-articular injection of triamcinolone acetonide (TA), mepivacaine hydrochloride, or both in metacarpophalangeal (MCP) joints of horses with experimentally induced acute synovitis. Methods: 18 horses. Methods: Both forelimbs of each horse were injected with lipopolysaccharide (LPS) 3 times. After the first LPS injection, 1 forelimb of each horse was treated with intra-articular injection of mepivacaine (80 mg; n=6), TA (9 mg; 6), or mepivacaine with TA (same doses of each; 6) 12 hours after the initial LPS i...
In vivo effects of intra-articular injection of gelatin hydrogen microspheres containing basic fibroblast growth factor on experimentally induced defects in third metacarpal bones of horses.
American journal of veterinary research    December 3, 2008   Volume 69, Issue 12 1555-1559 doi: 10.2460/ajvr.69.12.1555
Sasaki N, Minami T, Yamada K, Yamada H, Inoue Y, Kobayashi M, Tabata Y.To evaluate the effect of intra-articular injection of gelatin hydrogel microspheres containing basic fibroblast growth factor (bFGF) on experimentally induced defects in third metacarpal bones (MC3s) of horses, in vivo. Methods: 6 healthy adult Thoroughbreds. Methods: Horses were anesthetized, and a hole (diameter, 4.5 mm) was drilled into the medial condyle of both MC3s of each horse. One milliliter (100 microg) of a solution of gelatin hydrogel microspheres (2 mg) containing bFGF was injected into the joint capsule of the right metacarpophalangeal joint of each horse (bFGF joint). One milli...
Intra-articular stabilisation of the equine cricoarytenoid joint.
Equine veterinary journal    May 20, 2008   Volume 40, Issue 6 584-588 doi: 10.2746/042516408X313643
Cheetham J, Witte TH, Rawlinson JJ, Soderholm LV, Mohammed HO, Ducharme NG.The success of laryngoplasty is limited by abduction loss in the early post operative period. Objective: To determine the efficacy of polymethylmethacrylate (PMMA) in stabilising the cricoarytenoid joint (CAJ) and reducing the force on the laryngoplasty suture. Objective: Injection into the cricoarytenoid joint resists the forces produced by physiological laryngeal air flows and pressures thereby reducing the force experienced by the laryngoplasty suture. Methods: Ten cadaver larynges were collected at necropsy and PMMA was injected into one CAJ at selected random. Each larynx was subjected to...
Intralesional injection of platelet-rich plasma followed by controlled exercise for treatment of midbody suspensory ligament desmitis in Standardbred racehorses.
Journal of the American Veterinary Medical Association    May 16, 2008   Volume 232, Issue 10 1515-1520 doi: 10.2460/javma.232.10.1515
Waselau M, Sutter WW, Genovese RL, Bertone AL.To determine outcome of Standardbred racehorses with moderate to severe midbody suspensory ligament desmitis (MSD) treated by means of ultrasound-guided intralesional injection of a single dose of platelet-rich plasma (PRP) followed by a program of gradually increased exercise. Methods: Nonrandomized clinical trial. Methods: 9 Standardbred racehorses. Methods: Following injection of PRP, horses were allowed a controlled, gradual return to exercise. Race records for the year prior to injury and for 3 consecutive years after horses returned to racing were reviewed. For comparison purposes, race ...
Evaluation of computed tomographic anatomy of the equine metacarpophalangeal joint.
American journal of veterinary research    May 2, 2008   Volume 69, Issue 5 631-638 doi: 10.2460/ajvr.69.5.631
Vanderperren K, Ghaye B, Snaps FR, Saunders JH.To determine the detailed computed tomography (CT) anatomy of the metacarpophalangeal (MCP) joint in healthy horses. Methods: 10 cadaveric forelimbs from 10 adult horses without orthopedic disease. Methods: CT of the MCP joint was performed on 4 forelimbs. In 1 of the limbs, CT was also performed after intra-articular injection of 30 mL of contrast medium (40 mg of iodine/mL). Transverse slices 1-mm thick were obtained, and sagittal and dorsal planes were reformatted with a slice thickness of 2 mm. The CT images were matched with corresponding anatomic slices from 6 additional forelimbs. Resul...
Evaluation of the diffusion of corticosteroids between the distal interphalangeal joint and navicular bursa in horses.
American journal of veterinary research    May 2, 2008   Volume 69, Issue 5 611-616 doi: 10.2460/ajvr.69.5.611
Pauwels FE, Schumacher J, Castro FA, Holder TE, Carroll RC, Sega GA, Rogers CW.To determine whether clinically effective concentrations of methylprednisolone or triamcinolone can be achieved in the navicular bursa after injection of methylprednisolone acetate (MPA) or triamcinolone acetonide (TA) into the distal interphalangeal joint (DIPJ) and whether clinically effective concentrations of these drugs can be achieved in the DIPJ after injecting the navicular bursa with the same doses of MPA or TA. Methods: 32 healthy horses. Methods: Horses in groups 1 through 4 received 40 mg of MPA in the DIPJ, 10 mg of TA in the DIPJ, 40 mg of MPA in the navicular bursa, and 10 mg of...
Cartilage-derived retinoic acid-sensitive protein in equine synovial fluid from healthy and diseased joints.
Equine veterinary journal    February 13, 2008   Volume 40, Issue 6 553-557 doi: 10.2746/042516408X271208
Berg LC, Lenz J, Kjelgaard-Hansen M, Thomsen PD, Jacobsen S.More sensitive and specific diagnostic methods for early detection of changes in the joint cartilage are needed. Cartilage-derived retinoic acid-sensitive protein (CD-RAP) is a potential marker of cartilage synthesis and regeneration. This is the first study on equine CD-RAP. Objective: To evaluate the ability of a commercially available human sandwich ELISA assay to detect equine CD-RAP in synovial fluid from healthy and diseased joints. Methods: Synovial fluid was collected from 28 horses with no signs of joint disease and from 5 with induced inflammatory arthritis. CD-RAP concentrations wer...
Arthroscopic injection of corticosteroids into the fibrous tissue of subchondral cystic lesions of the medial femoral condyle in horses: a retrospective study of 52 cases (2001-2006).
Equine veterinary journal    December 20, 2007   Volume 40, Issue 5 461-467 doi: 10.2746/042516408X258843
Wallis TW, Goodrich LR, McIlwraith CW, Frisbie DD, Hendrickson DA, Trotter GW, Baxter GM, Kawcak CE.There are no published results of subchondral cystic lesions (SCLs) in the medial femoral condyle (MFC) treated with arthroscopic injection of corticosteroids into the lining of the cyst. Objective: 1) To determine the success rate for treatment of SCLs in the MFC with arthroscopic injection of the fibrous tissue of the cyst with corticosteroids. 2) To identify any factors that may predict outcome. Objective: Injection of the fibrous tissue of SCLs of the MFC with corticosteroids utilising arthroscopic guidance yields a similar or higher chance for intended performance than does arthroscopic d...
Retrospective study of the effect of intra-articular treatment of osteoarthritis of the distal tarsal joints in 51 horses.
The Veterinary record    November 6, 2007   Volume 161, Issue 18 611-616 doi: 10.1136/vr.161.18.611
Labens R, Mellor DJ, Voûte LC.Osteoarthritis of the distal tarsal joints, affecting the centrodistal and tarsometatarsal joints, is a common cause of hindlimb lameness in horses. This paper describes the outcome of the intra-articular treatment of 51 horses with the condition with either methylprednisolone acetate (mpa) or triamcinolone acetonide (tr), either with or without hyaluronic acid (ha). The outcome was assessed in terms of the changes in the horses' grade of lameness. Follow-up information was obtained from the owners by means of a telephone questionnaire. Horses treated once with mpa or tr, either with or withou...
An evidence-based approach to selected joint therapies in horses.
The Veterinary clinics of North America. Equine practice    July 10, 2007   Volume 23, Issue 2 443-460 doi: 10.1016/j.cveq.2007.04.007
Richardson DW, Loinaz R.There is an enormous volume of published material about most of the agents used to treat or prevent arthritis in horses. Unfortunately, most of the claims made by nearly all purveyors of arthritis medications in such media are largely unsubstantiated. In addition, the quality of the available information is highly inconsistent, making evidence-based recommendations difficult. This article concentrates on injectable polysulfated glycosaminoglycan, injectable hyaluronan, and the common oral "nutraceuticals".
Effects of intra-articular botulinum toxin type A in an equine model of acute synovitis: a pilot study.
American journal of physical medicine & rehabilitation    July 5, 2007   Volume 86, Issue 10 777-783 doi: 10.1097/PHM.0b013e3181157718
DePuy T, Howard R, Keegan K, Wilson D, Kramer J, Cook JL, Childers MK.To test the hypothesis that botulinum toxin type A (BoNT-A) can attenuate lameness associated with acute synovitis in an equine model. Methods: Four horses 2-6 yrs of age with clinically normal carpi were studied for 15 days. Kinematic gait analysis and clinical measures of lameness were conducted before and after experimental interventions. Horses were randomly assigned to either placebo (saline) or treatment (BoNT-A) groups. On day 0 of the intervention, 50 units of BoNT-A or an equivalent volume of saline (0.09%) was given into the middle carpal joints. On day 14, acute synovitis was induce...
Multivariable analysis of factors influencing outcome of 2 treatment protocols in 128 cases of horses responding positively to intra-articular analgesia of the distal interphalangeal joint.
Equine veterinary journal    March 24, 2007   Volume 39, Issue 2 150-156 doi: 10.2746/042516407x170094
Kristiansen KK, Kold SE.There is limited knowledge available of factors influencing response to treatments of the DIP-joint in horses with lameness responding to diagnostic analgesia of the DIP-joint. For this reason a multivariable statistical analysis was performed. Objective: Horses with lameness reduced by > or = 75% 10 min after intra-articular analgesia of the DIP-joint, can be treated successfully by intra-articular medication of the joint. Multiple factors influence the response to treatment. Methods: The study was performed retrospectively based on clinical records of horses treated with either polysulpha...
Ultrasound-guided coxofemoral arthrocentesis in horses.
Equine veterinary journal    January 19, 2007   Volume 39, Issue 1 79-83 doi: 10.2746/042516407x153093
David F, Rougier M, Alexander K, Morisset S.Coxofemoral joint pain is probably underestimated due to difficulties in identifying hip pain. The deep location of the joint and proximity of the sciatic nerve make arthrocentesis based on external landmarks a difficult and potentially risky procedure in mature horses. Objective: To describe an ultrasound-guided injection technique of the coxofemoral joint in standing horses and to evaluate its accuracy and potential difficulties/complications. Methods: Nine mature horses had both pelvic areas prepared for sterile ultrasound examination (3.5 MHz curvilinear probe). Coxofemoral joints were loc...
Severe acute inflammatory reaction (SAIR) of the fetlock joint after intraarticular hyaluronate injection in a horse.
Veterinary and comparative orthopaedics and traumatology : V.C.O.T    December 5, 2006   Volume 19, Issue 4 236-238 
Kuemmerle JM, Uhlig H, Kofler J.Hyaluronate (HA) was administered by intra-articular injection to a 13-year-old Haflinger mare for treatment of metacarpophalangeal osteoarthritis. Ten hours after the injection, a severe inflammatory reaction developed in the treated joint. While awaiting results of synovial fluid analysis, treatment for iatrogenic infectious arthritis was initiated, but the analysis did not confirm sepsis. Clinical signs improved significantly following systemic non-steroidal anti-inflammatory medication and the horse was discharged three days later. Following an intravenous hyaluronate injection, four days ...
Changes in MMP-2 and -9 activity and MMP-8 reactivity after amphotericin B induced synovitis and treatment with bufexamac.
Journal of veterinary medicine. A, Physiology, pathology, clinical medicine    August 12, 2006   Volume 53, Issue 6 311-318 doi: 10.1111/j.1439-0442.2006.00837.x
Marttinen PH, Raulo SM, Suominen MM, Tulamo RM.The objective here was to evaluate the acute effects of induced arthritis on synovial fluid (SF) levels of matrix metalloproteinases (MMP) -2, -8 and -9 in horses. To evaluate MMP-2 and -9 activities and the effect of non-steroidal anti-inflammatory drug (NSAID) bufexamac during remission from acute arthritis. Aseptic arthritis was induced in 24 Standardbred horses using 20 mg of amphotericin B as a single intra-articular (IA) injection in the right intercarpal joint. After 1 week and 2 weeks, horses were treated intra-articularly with 10, 20, or 40 mg of bufexamac suspension or with sterile s...
Use of intra-articular administration of ethyl alcohol for arthrodesis of the tarsometatarsal joint in healthy horses.
American journal of veterinary research    May 3, 2006   Volume 67, Issue 5 850-857 doi: 10.2460/ajvr.67.5.850
Shoemaker RW, Allen AL, Richardson CE, Wilson DG.To evaluate the efficacy and safety of intra-articular administration of ethyl alcohol for arthrodesis of tarsometatarsal joints in horses. Methods: 8 healthy female horses without lameness or radiographic evidence of tarsal joint osteoarthritis. Methods: In each horse, 1 tarsometatarsal joint was treated with 4 mL of 70% ethyl alcohol and the opposite joint was treated with 4 mL of 95% ethyl alcohol. Lameness examinations were performed daily for 2 weeks, followed by monthly evaluations for the duration of the 12-month study. Radiographic evaluations of both tarsi were performed 1 month after...
Pharmacokinetics of methylprednisolone acetate after intra-articular administration and its effect on endogenous hydrocortisone and cortisone secretion in horses.
American journal of veterinary research    April 4, 2006   Volume 67, Issue 4 654-662 doi: 10.2460/ajvr.67.4.654
Soma LR, Uboh CE, Luo Y, Guan F, Moate PJ, Boston RC.To determine the pharmacokinetics of methylprednisolone (MP) and develop a pharmacokinetic-pharmacodynamic model of the related changes in plasma concentrations of endogenous hydrocortisone (HYD) and cortisone (COR) following intra-articular administration of methylprednisolone acetate (MPA) in horses. Methods: 6 Thoroughbreds. Methods: In each horse, 200 mg of MPA was injected intrasynovially into a carpal joint, and plasma MP, HYD, and COR concentrations were determined via liquid chromatography-mass spectrometry. Results: A 5-compartment pharmacokinetic-pharmacodynamic model was used to des...
Comparison of amikacin concentrations in normal and inflamed joints of horses following intra-articular administration.
Equine veterinary journal    March 16, 2006   Volume 38, Issue 2 189-191 doi: 10.2746/042516406776563233
Taintor J, Schumacher J, DeGraves F.No abstract available
Gentamicin concentrations in synovial fluid and joint tissues during intravenous administration or continuous intra-articular infusion of the tarsocrural joint of clinically normal horses.
American journal of veterinary research    March 2, 2006   Volume 67, Issue 3 409-416 doi: 10.2460/ajvr.67.3.409
Lescun TB, Ward MP, Adams SB.To compare gentamicin concentrations achieved in synovial fluid and joint tissues during IV administration and continuous intra-articular (IA) infusion of the tarsocrural joint in horses. Methods: 18 horses with clinically normal tarsocrural joints. Methods: Horses were assigned to 3 groups (6 horses/group) and administered gentamicin (6.6 mg/kg, IV, q 24 h for 4 days; group 1), a continuous IA infusion of gentamicin into the tarsocrural joint (50 mg/h for 73 hours; group 2), or both treatments (group 3). Serum, synovial fluid, and joint tissue samples were collected for measurement of gentami...
Histology of two rice bodies isolated from the stifle of an adult draught horse stallion.
Journal of veterinary science    January 26, 2006   Volume 7, Issue 1 83-85 doi: 10.4142/jvs.2006.7.1.83
Schneider N, Heimann M, Lejeune JP, Verwilghen DR, Deby-Dupont GP, Serteyn DA.In the human and equine species, different kinds of free floating intra-articular particles are related to certain disorders. Osteochondral fragments formed during osteochondrosis dissecans are the most common finding in the equine species, whereas in humans rice bodies due to rheumatoid arthritis are more frequent. Herein we report a third type of floating body inside the stifle of an adult draught horse stallion, in macroscopic appearance similar to articular rice bodies known in humans. As revealed by histologic examination, the two particles consist of polypoid degenerated structures deriv...
Medical treatment of osteoarthritis in the horse – a review.
Veterinary journal (London, England : 1997)    January 24, 2006   Volume 171, Issue 1 51-69 doi: 10.1016/j.tvjl.2004.07.008
Goodrich LR, Nixon AJ.The medical treatment of osteoarthritis (OA) in the horse is one of the most utilized therapeutic regimens in the equine practice. It is important to understand the anatomy of synovial joints and the pathophysiology of the disease process to treat OA adequately. Once a thorough understanding of the disease process is comprehended the proper combination of systemic nonsteroidal anti-inflammatory drugs (NSAIDs), intraarticular steroids, viscosupplementation and chondroprotectants can be used to treat the disease and inhibit further progression of degenerative changes to the cartilage surface. Th...
Serum amyloid A isoforms in serum and synovial fluid in horses with lipopolysaccharide-induced arthritis.
Veterinary immunology and immunopathology    December 5, 2005   Volume 110, Issue 3-4 325-330 doi: 10.1016/j.vetimm.2005.10.012
Jacobsen S, Niewold TA, Halling-Thomsen M, Nanni S, Olsen E, Lindegaard C, Andersen PH.The aim of the study was to determine the intraarticular serum amyloid A (SAA) response pattern in horses with inflammatory arthritis. Inflammatory arthritis was induced by injection of lipopolysaccharide (LPS) into the radiocarpal joint of four horses. Serum and synovial fluid (SF) samples were collected before and at 4, 8, 12, 24, 48, 72, 96, and 144 h after injection. Concentrations of SAA were measured by immunoturbidometry, and expression of SAA isoforms was visualized by denaturing isoelectric focusing and Western blotting. The LPS injection caused systemic and local clinical signs of in...
Musculoskeletal problems associated with lameness and poor performance among horses used for barrel racing: 118 cases (2000-2003).
Journal of the American Veterinary Medical Association    November 30, 2005   Volume 227, Issue 10 1646-1650 doi: 10.2460/javma.2005.227.1646
Dabareiner RM, Cohen ND, Carter GK, Nunn S, Moyer W.To identify types of musculoskeletal problems associated with lameness or poor performance in horses used for barrel racing. Methods: Retrospective case series. Methods: 118 horses. Methods: Medical records were reviewed for information on signalment, history, physical and lameness examination findings, diagnostic tests performed, diagnosis, and treatment. Results: Most horses were examined because of lameness (n = 72 [61%]) rather than poor performance (46 [39%]), but owner complaint was not significantly associated with age or body weight of the horse. The most common performance change was ...
Intra-articular injections for joint disease in horses.
The Veterinary clinics of North America. Equine practice    November 22, 2005   Volume 21, Issue 3 559-v doi: 10.1016/j.cveq.2005.07.003
Caron JP.Lameness remains an important source of reduced performance in many types of horses. Pain referable to joints is among the most common causes, and intra-articular injections remain a common and important means of addressing lameness referable to joints in horses.
Intraoperative pain responses following intraovarian versus mesovarian injection of lidocaine in mares undergoing laparoscopic ovariectomy.
Journal of the American Veterinary Medical Association    August 25, 2005   Volume 227, Issue 4 593-596 doi: 10.2460/javma.2005.227.593
Farstvedt EG, Hendrickson DA.To compare intraoperative pain responses following intraovarian versus mesovarian injection of lidocaine in mares undergoing laparoscopic ovariectomy. Methods: Randomized controlled trial. Methods: 15 mares between 4 and 20 years old. Methods: Standard bilateral laparoscopic ovariectomy was performed. Prior to manipulation of the ovary, 2% lidocaine (10 mL) was injected into the ovary and saline (0.9% NaCI) solution (10 mL) was injected into the mesovarium on 1 side, with saline solution (10 mL) injected into the ovary and 2% lidocaine (10 mL) injected into the mesovarium on the other side. Pr...
Comminuted fracture of the distal sesamoid bone and distal rupture of the deep digital flexor tendon. Hoegaerts M, Pille F, De Clercq T, Fulton IC, Saunders JH.A 10-year-old show jumper was evaluated for an acute severe lameness (grade 4 of 5) of the right foreleg. During weight bearing, the toe of the affected limb rotated dorsally suggesting rupture of the deep digital flexor tendon (DDFT). Upon radiographic examination of the hoof, a severe erosion at the flexor surface and a parasagittal fracture of the distal sesamoid bone were found. Ultrasonographic examination confirmed rupture of the DDFT. These findings were confirmed on post-mortem examination. Prior to the acute lameness, the horse was treated with corticosteroid injections into the podot...
The synovial response to exogenous phospholipid (synovial surfactant) injected into the equine radiocarpal joint compared with that to prilocaine, hyaluronan and propylene glycol.
New Zealand veterinary journal    July 21, 2005   Volume 47, Issue 4 128-132 doi: 10.1080/00480169.1999.36129
Ethell MT, Hodgson DR, Hills BA.To determine the effects of the intra-articular injection of surface-active phospholipid in a propylene glycol carrier on synovial fluid composition and joint function of horses, and to compare these effects with those observed after the intra-articular administration of prilocaine, hyaluronan and propylene glycol alone. Methods: Twenty-four horses were randomly allocated to four treatment groups: Group 1 100 mg of surface-active phospholipid in 1 ml of propylene glycol; Group 2 1 ml of propylene glycol; Group 3 10 ml of prilocaine; Group 4 2 ml of hyaluronan. Left radiocarpal joints were inje...
Comparison of two techniques for injection of the podotrochlear bursa in horses.
Journal of the American Veterinary Medical Association    May 11, 2005   Volume 226, Issue 9 1524-1528 doi: 10.2460/javma.2005.226.1524
Piccot-Crézollet C, Cauvin ER, Lepage OM.To compare accuracy of 2 methods for injection of the podotrochlear bursa in horses. Methods: Observational study. Methods: 17 French Standardbreds. Methods: In each horse, contrast medium was injected into the podotrochlear bursa of 1 foot by use of a distal palmar approach with the needle inserted parallel to the sole (DPPS) and into the podotrochlear bursa of the other foot by use of a distal palmar approach to the navicular position (DPNP). Podotrochlear bursa injection was evaluated by means of radiographic examination in all horses and postmortem examination in 6. Results: Contrast mediu...
Osteoarthritis of the talocalcaneal joint in 18 horses.
Equine veterinary journal    March 23, 2005   Volume 37, Issue 2 166-171 doi: 10.2746/0425164054223813
Smith RK, Dyson SJ, Schramme MC, Head MJ, Payne RJ, Platt D, Walmsley J.Talocalcaneal osteoarthritis (TO) is an uncommon cause of moderate to severe hindlimb lameness, on which only isolated case reports have been published to date. Objective: To review the clinical features of TO and determine optimal methods for diagnosis, management and prognosis. Methods: The case records from 4 referral centres of 18 horses showing hindlimb lameness considered, as a result of clinical investigation, to be caused by TO, were reviewed. Results: TO affected mature sports and pleasure horses (age 7-16 years) and caused moderate to severe lameness, usually of sudden onset with no ...
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