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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.
Osteoarthritis of the talocalcaneal joint in 18 horses. 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 ...
Concentration of methylprednisolone in the centrodistal joint after administration of methylprednisolone acetate in the tarsometatarsal joint. The centrodistal (CD) and tarsometatarsal (TMT) joints are often injected individually with a corticosteroid to resolve lameness caused by osteoarthritis (OA). There are no data available regarding diffusion of methylprednisolone (MP) from the TMT joint to the CD joint. Objective: A therapeutic concentration of MP diffuses into the CD joint after methylprednisolone acetate (MPA) is administered into the TMT joint. Objective: To measure the concentration of MP in the CD joint after MPA was administered into the TMT joint. Methods: MPA was administered into a TMT joint of 16 horses. At different...
Ex vivo investigation of the use of hydrothermal energy to induce chondrocyte necrosis in articular cartilage of the metacarpophalangeal and metatarsophalangeal joints of horses. To evaluate the use of hydrothermal ablation of articular cartilage for arthrodesis in horses through investigation of the effects of joint lavage with physiologic saline (0.9% NaCI) solution (80 degrees C) for various treatment times on chondrocyte viability in the articular cartilage of the metacarpophalangeal and metatarsophalangeal joints of cadaveric horse limbs. Sample Population-7 pairs of metacarpophalangeal and 8 pairs of metatarsophalangeal joints from 8 Thoroughbreds. Methods: The horses were euthanatized for reasons unrelated to musculoskeletal disease. On a random basis, 1 joint o...
Repeated intraarticular injections of triamcinolone acetonide alter cartilage matrix metabolism measured by biomarkers in synovial fluid. Although intraarticular (IA) corticosteroids are frequently used to treat joint disease, the effects of their repeated use on articular cartilage remains controversial. The aim of our study was to determine the effects of a clinically recommended dose of IA triamcinolone acetonide (TA), on synovial fluid (SF) biomarkers of cartilage metabolism. Ten adult horses, free of osteoarthritis (OA) in their radiocarpal joints, were studied. One radiocarpal joint of each horse was randomly chosen for treatment and the contralateral anatomically paired joint acted as the control. Aseptic arthrocentesis w...
Hyaluronan in horses: physiological production rate, plasma and synovial fluid concentrations in control conditions and following sodium hyaluronate administration. Hyaluronic acid (HA) is an endogenous glycosaminoglycan used in the treatment of joint diseases, but medication control is required by horseracing authorities. Therefore, a medication control policy needs to be established. Objective: To establish physiological plasma HA concentrations in post race horses, determine the HA endogenous production rate and document the disposition of HA after i.v. and intra-articular hyaluronic acid administration at recommended therapeutic doses. Methods: Hyaluronan concentrations in plasma were determined using an ELISA specific test; concentrations in synovial...
Medical management of superficial digital flexor tendonitis: a comparative study in 219 horses (1992-2000). There is a lack of long-term follow-up data for outcome of medical treatment of superficial digital flexor (SDF) tendonitis. Objective: To determine whether intralesional injection of hyaluronan, beta aminoproprionitrile fumarate (BAPN) or polysulphated glycosaminoglycans (PSGAG) or systemic administration of PSGAG yielded better results than a controlled exercise programme alone in the management of SDF tendonitis, with a minimum follow-up period of 2 years after resumption of full work; and to determine whether reinjury rate was related to sports discipline and whether fibre alignment score ...
Development and validation of a periarticular injection technique of the sacroiliac joint in horses. Sacroiliac joint osteoarthritis has been recognised as a significant cause of poor performance in competition and racehorses. Reliable diagnostic tools are currently lacking. The diagnosis has been based typically on exclusion of other possible causes of poor performance, back pain and hindlimb lameness. Objective: To develop a safe, reliable and minimally invasive periarticular or intra-articular injection technique of potential use for diagnosis and therapy of sacroiliac joint disease in horses. Methods: Twenty-six horses were used to develop and assess a medial approach to the sacroiliac jo...
Chemical arthrodesis of the distal tarsal joints using sodium monoiodoacetate in 104 horses. To evaluate chemical arthrodesis using sodium monoiodoacetate for treatment of degenerative joint disease of the tarsometatarsal and distal intertarsal joints. Methods: Retrospective clinical study. Methods: Horses were diagnosed with degenerative joint disease of one or more of the tarsometatarsal or distal intertarsal joints based on history, lameness examination, radiographic findings and, in some cases, response to intra-articular anaesthesia or medication. Intra-articular injections of sodium monoiodoacetate were performed using 23 gauge needles in the sedated, standing horse. Positive co...
Intraosseous gentamicin perfusion of the distal metacarpus in standing horses. To report tissue gentamicin concentrations after intraosseous (IO) perfusion in standing horses. Methods: In vivo study. Methods: Twelve horses. Methods: Sedated horses had a cannulated cortical bone screw inserted into the dorsolateral aspect of the treated metacarpus and a tourniquet applied proximally. Gentamicin (2.2 mg/kg) diluted in sterile saline solution (0.1 mL/kg) was infused through the screw. Two horses were euthanatized at each time interval: 0, 2, 6, 12, 24, and 36 hours. Synovial fluid and bone samples were collected distal to the screw from both forelimbs. Gentamicin concentrat...
Use of a three-drill-tract technique for arthrodesis of the distal tarsal joints in horses with distal tarsal osteoarthritis: 54 cases (1990-1999). To assess the long-term clinical outcome of horses with distal tarsal osteoarthritis (OA) in which a 3-drill-tract technique was used to induce arthrodesis of the affected joints, identify any preoperative or operative factors associated with outcome, and describe any complications associated with the technique. Methods: Retrospective study. Methods: 54 horses. Methods: Medical records were reviewed for information on signalment, use, history, physical and lameness examination findings, surgical technique, and postoperative care. Radiographs were examined, and severity of OA was graded. Follow...
Bone gentamicin concentration after intra-articular injection or regional intravenous perfusion in the horse. To compare intra-articular (IA) and bone gentamicin concentrations achieved after intra-articular administration or regional intravenous perfusion (RIP). Methods: Experimental study. Methods: Twelve healthy adult horses. Methods: Horses were assigned to 2 treatment groups (n = 6/group): Group 1, 1 g gentamicin administered simultaneously in both left and right metacarpophalangeal joints and group 2, 1 g gentamicin administered simultaneously in both left and right lateral palmar veins. Serum, synovial fluid, and bone biopsy specimens were collected. Gentamicin concentrations were determined by...
Accuracy of ultrasound-guided intra-articular injection of cervical facet joints in horses: a cadaveric study. Intra-articular facet joint injection is an established diagnostic procedure in human medicine but there are no reports on its reliability in equine practice. Objective: To investigate the accuracy of ultrasound-guided intra-articular injections of the cervical facet joints and to estimate factors influencing the accuracy. Methods: Sixty injections with blue dye were performed on the facet joints between 2nd and 7th cervical vertebra (C2-C7) on horses subjected to euthanasia for nonorthopaedic reasons. The facet joints were subsequently dissected to verify accuracy of deposition. Results: Seve...
Injection of corticosteroids, hyaluronate, and amikacin into the navicular bursa in horses with signs of navicular area pain unresponsive to other treatments: 25 cases (1999-2002). To determine history, clinical and radiographic abnormalities, and outcome in horses with signs of navicular area pain unresponsive to corrective shoeing and systemic nonsteroidal anti-inflammatory drug administration that were treated with an injection of corticosteroids, sodium hyaluronate, and amikacin into the navicular bursa. Methods: Retrospective study. Methods: 25 horses. Methods: Data collected from the medical records included signalment, history, horse use, severity and duration of lameness, shoeing regimen, results of diagnostic anesthesia, radiographic abnormalities, and outcome. ...
Intralesional administration of formalin for treatment of epidermal inclusion cysts in five horses. Five horses with unilateral epidermal inclusion cysts located in the nasal diverticula were sedated and treated with intralesional injection of neutral-buffered 10% formalin (volume range, 2 to 4.5 mL). After aspiration of the cyst, formalin was injected intralesionally until leakage of fluid around the needle was observed. After several weeks, desiccation of the cyst was evident; it was excised 2 weeks after treatment in 3 horses, digitally removed by the owner of 1 horse, and never removed in 1 horse, because the owner declined further treatment after resolution of the original swelling of t...
Radiation synovectomy with holmium-166 ferric hydroxide macroaggregate in equine metacarpophalangeal and metatarsophalangeal joints. To evaluate the effects of radiation synovectomy (RSYN) with holmium-166 ferric hydroxide macroaggregate (Ho-166 FHMA) on synovium and synovial fluid in normal metacarpo- and metatarsophalangeal joints of horses and to determine intraarticular distribution of radioactivity after Ho-166 FHMA treatment. Methods: Either Ho-166 FHMA or nonradioactive Ho-165 FHMA was injected into metacarpo- or metatarsophalangeal joints. Methods: Six adult mixed-breed horses without any clinical evidence of metacarpo- or metatarsophalangeal joint disease. Methods: Joints were injected with a single high dose of Ho...
Effect of foot balance on the intra-articular pressure in the distal interphalangeal joint in vitro. Increased joint pressure has been implicated in the progression of osteoarthritis. Objective: That intra-articular pressure in the distal interphalangeal joint (DIP) is significantly higher in legs loaded with heel up (HU), low heel (TU), lateral side up (LU) and medial side up (MU) imbalance compared to the balanced position. Methods: Twelve elbow down limbs were compressed in a hydraulic loading jig and DIP pressure measured. Results: Elevating the heels by 5 degrees significantly increased DIP pressure. After 5 ml of contrast was injected into the joint, heel elevation caused a greater incr...
Intraosseous regional perfusion for treatment of septic physitis in a two-week-old foal. A 2-week-old Morgan filly examined because of lameness of 5 days' duration was found, on the basis of clinical and radiographic findings, to have septic physitis of the distal end of the radius. The foal was treated by means of intraosseous regional perfusion with penicillin and amikacin and systemic administration of antimicrobials. Intraosseous regional perfusion was performed 3 times. The foal was anesthetized for the first episode of intraosseous regional perfusion, but was only sedated for the subsequent 2 episodes. Antimicrobials were administered systemically for 22 days. Foals with sep...
[Direct endoscopic approach improves prognosis of septic-synovitis in the horse]. The medical records of 71 horses with sepic arthritis, bursitis, or tenosynovitis, treated between 1996 and 2001 at Dierenkliniek Enmeloord, were reviewed. A total number of 81 joints, tendon sheaths and bursae were treated (21 tarsi, 17 digital tendon sheaths, 14 metacarpo/metatarso-phalangeal joints, 12 stifles, 6 carpi, 4 coffin joints, 2 navicular bursae, 1 elbow joint, 1 proximal-interphalangeal joint, 1 tarsal sheath, 1 bursa calcanei subtendineum). The aetiology in 42 cases was a penetrating wound (group 1), in 4 cases an intra-articular injection, and in 2 cases arthroscopic surgery (g...
The effect of intra-articular methylprednisolone acetate and exercise on equine carpal subchondral and cancellous bone microhardness. Dorsal carpal osteochondral injury is a major cause of lameness in horses undergoing high intensity training. Intra-articular corticosteroid treatment is used commonly to manage exercise-associated articular pain, but its use remains highly controversial in the equine athlete. This project, therefore, aimed to compare the mechanical properties of intra-articular MPA and diluent-treated middle carpal subchondral and cancellous bone in horses undergoing a short-term treadmill exercise programme. It was hypothesised that subchondral and cancellous bone mechanical properties are influenced by intr...
Clinical effects of betamethasone and hyaluronan, and of defocalized carbon dioxide laser treatment on traumatic arthritis in the fetlock joints of horses. The clinical effects of intra-articular betamethasone together with hyaluronan (betaM/HA) and treatment with a defocalized carbon dioxide laser on acute traumatic arthritis of the fetlock joint were assessed. The horses in these studies were selected using a thorough lameness examination, including intra-articular anaesthesia abolishing the lameness. This investigation comprised an observer-blind study, including 10 sport horses (10 joints), and a prospective study, including 180 sport horses (333 joints). In both studies, the material was divided into two groups treated with either betaM/HA o...
Use of opioids for pain and anesthetic management in horses. REGIONAL ADMINISTRATION: There is limited, but convincing, evidence that epidural administration of morphine and some other mu-agonist opioids consistently relieves regional pain in horses. In addition, this effect is not accompanied by notable undesirable effects. On the other hand, a clinically important analgesic action has not been demonstrated for similarly administered kappa-agonist opioids. There has been little objective data presented to support the analgesic effectiveness of intra-articularly administered opioids in horses. However, the evidence of local opioid receptors legitimately...
Effects of continuous intra-articular infusion of gentamicin on synovial membrane and articular cartilage in the tarsocrural joint of horses. To determine the effects of a continuous intra-articular infusion of gentamicin on the synovial membrane and articular cartilage in the tarsocrural joint of horses. Methods: 6 healthy adult horses. Methods: A balloon infusion system attached to a catheter placed in the plantarolateral pouch of both tarsocrural joints in each horse was used for continuous gentamicin solution (GM) or balanced electrolyte solution (BES) delivery for 5 days. Cartilage and synovial membrane specimens were collected on day 5 from 3 horses and on day 14 from the remaining 3 horses. Both infused joints from each horse...
Diffusion of mepivacaine between adjacent synovial structures in the horse. Part 2: tarsus and stifle. This paper tests the hypothesis that the local analgesic agent mepivacaine diffuses between adjacent equine synovial structures in the hindlimb and with greater frequency than latex, gelatine dye or contrast media. We report the incidence of diffusion of mepivacaine between the tarsometatarsal, centrodistal and tarsocrural joints, and the 3 synovial compartments of the stifle in 33 fresh equine cadavers. The tarsometatarsal joint and one synovial compartment of the stifle in the left limb and the centrodistal joint and a different synovial compartment of the stifle in the right limbs were inje...
Effects of intra-articular injections of bufexamac suspension in healthy horses. To evaluate the effects of intra-articular (IA) injections of bufexamac in horses, focusing particularly on the effects of bufexamac on articular cartilage. Methods: 20 Standardbreds. Methods: Horses were randomly allocated into 4 groups consisting of 5 horses each, and 20, 60, or 100 mg of bufexamac or 1 ml of sterile saline (0.9% NaCl) solution (control) was injected into 1 intercarpal joint at weekly intervals for 6 treatments (days 0, 7, 14, 21, 28, and 35). Clinical signs and results of hematologic, serum biochemical, and synovial fluid (SF) analyses and radiography were used to evaluate ...
Use of synovial fluid markers of cartilage synthesis and turnover to study effects of repeated intra-articular administration of methylprednisolone acetate on articular cartilage in vivo. In vivo the effects of intra-articular (IA) corticosteroids on articular cartilage remain controversial. This study was designed to examine this issue using synovial fluid (SF) markers of cartilage metabolism. Paired radiocarpal joints, without clinical or radiographic signs of joint disease, were studied in 10 adult horses. Aseptic arthrocentesis was performed weekly for 13 weeks. IA injections of methylprednisolone acetate (MPA) into the treatment joint and the vehicle into the control joint were performed at weeks 3, 5 and 7. We used radioimmunoassays on SF samples which measure a keratan s...
Treatment of sepsis in the small tarsal joints of 11 horses with gentamicin-impregnated polymethylmethacrylate beads. Gentamicin-impregnated polymethylmethacrylate beads were used to treat infective arthritis in the small tarsal joints of 11 severely lame horses. Under general anaesthesia, between five and 10 beads were placed into a 7 to 8 mm tract drilled across the affected joint and, in all except one horse, they were left in place for 14 days. Two of the horses were euthanased for reasons other than persistent tarsal joint sepsis, but the other nine survived and seven of them returned to their previous level of athletic performance.
Intra-articular pressure profiles of the cadaveric equine fetlock joint in motion. The study of the influence of motion and initial intra-articular pressure (IAP) on intra-articular pressure profiles in equine cadaver metatarsophalangeal (MTP) joints was undertaken as a prelude to in vivo studies. Eleven equine cadaver MTP joints were submitted to 2 motion frequencies of 5 and 10 cycles/min of flexion and extension, simulating the condition of lower and higher (double) rates of passive motion. These frequencies were applied and pressure profiles generated with initial normal intra-articular pressure (-5 mmHg) and subsequently 30 mmHg intra-articular pressure obtained by inje...
The effect of implanting gentamicin-impregnated polymethylmethacrylate beads in the tarsocrural joint of the horse. To determine the effect of intra-articular gentamicin-impregnated polymethylmethacrylate (PMMA) beads inserted in the equine tarsocrural joint on the synovial fluid, synovial lining, and cartilage, and to determine the peak and sustainable gentamicin concentrations in synovial fluid and plasma. Methods: Pharmacokinetic, cytologic, and histologic study of the effect of gentamicin-impregnated PMMA on normal equine tarsocrural joints. Methods: Five healthy adult horses. Methods: Gentamicin-impregnated PMMA bead strands (3 strands each of 40 beads, with each strand containing 100 mg gentamicin) we...
