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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.
[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...
Surgical arthrodesis of distal tarsal joints in 17 horses clinically affected with osteoarthritis. To evaluate the outcome of 17 horses that underwent surgical arthrodesis of the tarsometatarsal and distal intertarsal joints for treatment of lameness due to osteoarthritis. Methods: Retrospective clinical study using client-owned animals. Methods: Horses with hindlimb lameness were diagnosed with osteoarthritis of the distal tarsal joints following relief of lameness after intra-articular anaesthesia or intra-articular corticosteroid injection. Surgery to stimulate ankylosis was performed on 27 hocks by placing 3 diverging 3.2 mm drill holes approximately 3 cm through the tarsometatarsal and...
Iontophoresis of dexamethosone-phosphate into the equine tibiotarsal joint. In human rehabilitation medicine, dexamethasone-phosphate is theoretically iontophoresed to localized subcutaneous tissue where conversion to dexamethasone occurs. This delivery system has recently been introduced into veterinary medicine for the same purpose. However, the pharmacokinetic justification for parenteral delivery of this prodrug remains undocumented. Utilizing iontophoretic methods that are relevant to both human and veterinary clinical practice, the present investigation compared injection and iontophoresis of dexamethasone-phosphate into the equine tibiotarsal joint, also known ...
Use of pelvic flexure biopsies to predict survival after large colon torsion in horses. To determine if morphologic evaluation of intraoperative biopsies of the large colon could be used to accurately predict outcome in horses with large colon torsion. Methods: Clinical study. Methods: Fifty-four horses with large colon torsion. Methods: A full-thickness biopsy was collected from the pelvic flexure of the ascending colon after correction of naturally occurring colonic torsion. Morphologic changes were evaluated and graded for interstitial tissue to crypt ratio (I:C ratio), percentage loss of superficial and glandular epithelium, and the degree of hemorrhage and edema. These varia...
Determination of synovial fluid and serum concentrations, and morphologic effects of intraarticular ceftiofur sodium in horses. To determine the serum and synovial fluid concentrations of ceftiofur sodium after intraarticular (IA) and intravenous (IV) administration and to evaluate the morphologic changes after intraarticular ceftiofur sodium administration. Methods: Strip plot design for the ceftiofur sodium serum and synovial fluid concentrations and a split plot design for the cytologic and histopathologic evaluation. Methods: Six healthy adult horses without lameness. Methods: Stage 1: Ceftiofur sodium (2.2 mg/kg) was administered IV. Stage 2: 150 mg (3 mL) of ceftiofur sodium (pHavg 6.57) was administered IA into ...
Kinematics of the hind limb in trotting horses after induced lameness of the distal intertarsal and tarsometatarsal joints and intra-articular administration of anesthetic. To identify hind limb and pelvic kinematic variables that change in trotting horses after induced lameness of the distal intertarsal and tarsometatarsal joints and after subsequent intra-articular administration of anesthetic. Methods: 8 clinically normal adult horses. Methods: Kinematic measurements were made before and after transient endotoxin-induced lameness of the distal intertarsal and tarsometatarsal joints and after intra-articular administration of anesthetic. Fourteen displacement and joint angle (metatarsophalangeal [fetlock] and tarsal joints) measurements were made on the right h...
Evaluation of samarium-153 for synovectomy in an osteochondral fragment-induced model of synovitis in horses. To determine the effects of intraarticular administration of Samarium-153 (153Sm) bound to hydroxyapatite microspheres (153SmM) on an osteochondral chip-induced synovitis. Methods: Sixty days after implantation of autogenous osteochondral fragments in the middle carpal and metacarpophalangeal joints, 153SmM was administered into 1 joint of each type. The contralateral joints were used as untreated controls. Methods: Fifteen horses without preexisting joint disease were randomly divided into 2 groups (7 in the carpal group, 8 in the metacarpophalangeal group). Methods: Horses had osteochondral ...
Treatment of progressive ethmoidal haematoma using intralesional injections of formalin in three horses. Three Thoroughbred horses with unilateral progressive ethmoid haematomas were treated using intralesional injections of 10% formalin (4% formaldehyde solution). Injections were performed in the standing sedated horse through the nasal passages under endoscopic guidance and, when the ethmoid haematoma involved the paranasal sinuses, through holes trephined into the affected sinus. Regression of the lesions occurred in all cases after repeated injections. This technique appears to be a safe and effective treatment for progressive ethmoid haematomas in the horse.
Effects of polysulfated glycosaminoglycan and hyaluronan on prostaglandin E2 production by cultured equine synoviocytes. To investigate effects of the anti-arthritic agents hyaluronan and polysulfated glycosaminoglycan (PSGAG) on inflammatory metabolism in cultured equine synoviocytes. Methods: Synoviocytes cultured from samples obtained from the metacarpophalangeal joints of 4 horses. Methods: Equine synoviocytes were grown in monolayer culture. Synoviocytes were stimulated with lipopolysaccharide (LPS) and simultaneously treated with various concentrations of hyaluronan or PSGAG for 48 hours. Three hyaluronan preparations were compared. Prostaglandin E2 (PGE2) concentrations in culture medium were measured, us...
Samarium 153-labeled hydroxyapatite microspheres for radiation synovectomy in the horse: a study of the biokinetics, dosimetry, clinical, and morphologic response in normal metacarpophalangeal and metatarsophalangeal joints. To determine the effects of Samarium-153 bound to hydroxyapatite microspheres (153SmM) when injected into the metacarpophalangeal and metatarsophalangeal joints of horses. Methods: - Horses were injected with 153SmM in metacarpophalangeal and metatarsophalangeal joints with the diagonal contralateral joints used as untreated controls. Methods: Twelve adult horses without pre-existing disease involving the metacarpo/metatarsophalangeal joints. Methods: Horses were divided into three groups: high-dose Samarium-153 (12.5 to 17.0 millicurie [mCi]), intermediate dose (6.5 to 12.0 mCi), and low dose...
Nerve block and intra-articular anaesthesia of the forelimb in the sound horse. Nerve blocks and intra-articular anaesthesia are used extensively as routine methods in lameness evaluation. The method is based on the assumption that the technique itself does not change the movement pattern. The aim of this study was to carry out a quantitative kinematic study to confirm or reject the hypothesis that high palmar digital nerve block (HPDN) and intra-articular fetlock joint anaesthesia (IAF) influence significantly the movement pattern of the horse. Seven Standardbred horses trotting at 4.5 m/s were recorded at 240 Hz on a treadmill before and after anaesthesia by use of a Pr...
Effects of intra-articular injections of bufexamac suspension on amphotericin B-induced aseptic arthritis in horses. To evaluate effects of intra-articular (i.a.) injections of bufexamac on amphotericin B-induced aseptic arthritis in horses. Methods: 24 Standardbred horses. Methods: Aseptic arthritis was induced in the right intercarpal joint by i.a. injection of amphotericin B (20 mg). One week later (day 0), horses were randomly assigned to four 6-horse treatment groups and treated with i.a. injection of 10, 20, or 40 mg of bufexamac suspension (20 mg/ml) or 2.0 ml of sterile saline (0.9% NaCl) solution (control). The treatment was repeated once after 7 days. Clinical lameness examinations and synovial flu...
Intra- and inter-stallion variation in sperm morphology and their relationship with fertility. Dismount semen samples were collected from Thoroughbred stallions during the breeding season to determine the magnitude and significance of the variation in sperm morphology within (intra-) and among (inter-) stallions. The degree of intra-stallion variation in sperm morphology during the breeding season was substantial (coefficient of variation: 20%; range 8-56%), but did not affect the day-to-day fertility of sperm samples taken from the same stallion (intra-stallion). This variability did not affect the pregnancy rate of the mares with which each stallion was mated. The degree of interstall...
Modes of local drug delivery to the musculoskeletal system. A number of methods for the local delivery of drugs to musculoskeletal tissues in the horse are now available. Further research is required to document the disposition of drugs delivered by such methods and to correlate this information with efficacy. Perhaps the greatest potential area for the methods discussed is the treatment of synovial and bone infections. To be able to provide high and sustained therapeutic concentrations of antimicrobials to the site of infection should increase the chances of success in such cases. These methods of drug delivery need to be used in conjunction with othe...
Comparison of intra-articular injection of 2 ml of 0.9% NaCl solution with rest alone for treatment of horses with traumatic arthritis. To compare effects of intra-articular injection of 2 ml of 0.9% NaCl solution with rest alone for treatment of horses with traumatic arthritis. Methods: 38 Standardbred horses with moderate to severe lameness that resulted from traumatic arthritis. Methods: Horses were stratified on the basis of number of affected joints. In each stratum, horses were allocated randomly to treatment groups (intraarticular injection of 2 ml of 0.9% NaCl solution vs rest only). Treatment was for a period of 3 weeks. Horses were inspected weekly with a final examination 2 to 4 weeks after completion of treatment. ...
Effects of 6alpha-methylprednisolone acetate on an equine osteochondral fragment exercise model. To determine effects of intra-articularly administered 6alpha-methylprednisolone acetate (MPA) in exercised horses with carpal osteochondral fragmentation. Methods: 18 horses: 3 groups of 6 each. Methods: An osteochondral (chip) fragment was created in 1 randomly chosen middle carpal joint of each horse. Polyionic fluid (PF) was injected into both middle carpal joints of horses in the control group. In horses of the MPA-control group, MPA was injected into the middle carpal joint without an osteochondral fragment; a similar volume of PF was injected into the contralateral middle carpal joint. ...
Intra-articular pressure, elastance and range of motion in healthy and injured racehorse metacarpophalangeal joints. The objective of this study was to determine if intraarticular pressure, elastance of the soft tissue forming the dorsal pouch, and range of motion in flexion measurements are significantly different in Thoroughbred metacarpophalangeal joints with clinical evidence of idiopathic synovitis, primary synovitis, synovitis/capsulitis, or osteoarthritis relative to clinically normal joints. Forty-two metacarpophalangeal joints, in 25 active or retired Thoroughbred racehorses, were categorised by palpation and visual inspection of the palmar pouch into one of 4 increasing grades of distention. Intra-...
Local hemodynamics, permeability, and oxygen metabolism during acute inflammation of innervated or denervated isolated equine joints. To determine oxygen metabolism, permeability, and blood flow in isolated joints in response to interleukin 1beta (IL-1beta) and contribution of innervation. Methods: One metacarpophalangeal (MCP) joint of 24 adult horses. Methods: The MCP joint was isolated for 6 hours in a pump-perfused, auto-oxygenated, innervated or denervated preparation. Isolated joints were assigned to the following 4 groups: control, control-denervated, inflamed, and inflamed-denervated, and inflammation was induced by intra-articular injection of IL-1beta. Circuit arterial and venous pressures, flows, and blood gas ten...
Experimental model of synovitis/capsulitis in the equine metacarpophalangeal joint. To develop and define a model of acute synovitis/capsulitis in the equine metacarpophalangeal joint (fetlock) to study clinical effects of diagnostic or therapeutic procedures. Methods: 5 adult Standardbreds. Methods: Polyvinyl alcohol foam particles were injected into the left front fetlock of horses; the right front fetlock was used as a control. Horses were examined clinically and for lameness on a regular basis. Blood samples were taken to measure routine variables. Synovial fluid samples were collected from both fetlocks, and macroscopic, microscopic, and biochemical variables were measur...
