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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.
Acute synovitis and intra-articular methylprednisolone acetate in ponies. To determine how acute synovitis, with and without intra-articular methylprednisolone acetate (MPA), affect synthesis of proteoglycan, total protein, and collagen in articular cartilage and total protein synthesis in synovial membrane. Methods: Synovitis was induced in 10 ponies by the injection of 0.5 ng lipopolysaccharide (LPS) into the left radiocarpal and midcarpal joints every 2 days for a total of four treatments. Synovitis was documented by clinical examination and synovial fluid analyses. Two days before euthanasia, MPA (0.1 mg/kg) was injected with the last dose of LPS into both the l...
The effects of intra-articular methylprednisolone and exercise on the mechanical properties of articular cartilage in the horse. Intra-articular corticosteroids are widely used as anti-inflammatory agents for symptomatic management of arthritis, but their administration with concurrent exercise remains controversial. Biochemical and morphologic analysis of treated cartilage has revealed conflicting results, but previous biomechanical assessment has not been undertaken. Objective: To compare the biomechanical properties of intra-articular methylprednisolone acetate (MPA) and diluent treated cartilage in treadmill exercised horses. Methods: Eight 2-year-old female horses had MPA or diluent administered into contralateral ...
Transendoscopic chemical ablation of progressive ethmoidal hematomas in standing horses. To examine the response of horses with progressive ethmoidal hematoma (PEH) to intralesional injection of 4% formaldehyde solution. Methods: Nasal passages of horses affected with PEH were examined endoscopically at different intervals to determine the effects of intralesional injection of formaldehyde solution. Methods: 21 horses with PEH. Methods: PEHs were injected transendoscopically with 4% formaldehyde solution. Horses were examined endoscopically and retreated at different intervals until the PEH was eliminated or was so small that reinjection was not possible. Results: Lesions diminish...
Lateral approach for arthrocentesis of the distal interphalangeal joint in horses. To determine anatomic landmarks for a lateral approach for arthrocentesis of the proximopalmarolateral aspect of the distal interphalangeal (DIP) joint in horses and the likelihood of entering synovial structures other than the DIP joint through this approach. Methods: Prospective study. Methods: Paired forelimbs of 8 cadavers and 12 horses. Methods: Anatomic preparations were used to determine anatomic landmarks. Positive-contrast arthrography was used to determine which structures were entered. Results: Landmarks for the lateral approach included a depression in the proximal border of the la...
Effects of osteochondral fragmentation and intra-articular triamcinolone acetonide treatment on subchondral bone in the equine carpus. To determine the effects of osteochondral fragmentation and intra-articular corticosteroid treatment on dynamics of bone remodelling and fragility, 12 horses each had a unilateral, 8 mm osteochondral fragment created in the distal aspect of one radiocarpal bone. Six of the horses were treated in the fragmented joint, and the other 6 were treated in the nonfragmented joint with 12 mg of triamcinolone acetonide (TA) 14 and 28 days after surgery. All horses were exercised on a high-speed treadmill starting 15 days, and ending 72 days after surgery. Horses treated with TA in the fragmented joints ...
Cell trafficking, mediator release, and articular metabolism in acute inflammation of innervated or denervated isolated equine joints. To describe the acute cellular response, inflammatory mediator release, and effect on chondrocyte metabolism of interleukin 1 beta (IL-1 beta) in isolated innervated or denervated equine metacarpophalangeal joints. Methods: One metacarpophalangeal joint of 24 adult horses. Methods: The metacarpophalangeal joint was isolated for 6 hours in a pump-perfused, auto-oxygenated, innervated or denervated metacarpophalangeal joint preparation. Isolated joints were assigned to 4 groups: control, control-denervated, inflamed, and inflamed-denervated, and inflammation was induced by intra-articular inject...
Survey of diplomates of the American College of Veterinary Surgeons regarding postoperative intra-abdominal adhesion formation in horses undergoing abdominal surgery. To obtain information from specialists in equine surgery as to prevalence of, predisposing factors for, and methods to prevent postoperative adhesion formation in horses undergoing abdominal surgery. Methods: Survey. Methods: Surveys were mailed to 196 diplomates of the American College of Veterinary Surgeons involved in equine practice. Results: 60 (31%) surveys were returned. Most respondents (55/60) routinely informed clients of the risk of postoperative adhesion formation in horses with small intestinal lesions. When asked after which procedures they routinely used measures to prevent adhe...
Effects of triamcinolone acetonide on an in vivo equine osteochondral fragment exercise model. The objective of this study was to determine the effects of intra-articularly administered triamcinolone acetonide (TA) in exercised equine athletes with carpal osteochondral fragmentation. Eighteen horses were randomly assigned to each of 3 groups. An osteochondral chip fragment was created in one randomly chosen intercarpal joint of each horse. Both intercarpal joints in the placebo control group (CNT) horses were injected with intra-articular administration (IA) of polyionic fluid. Both joints in the TA control group (TA CNT) horses were treated with 12 mg of TA in the intercarpal joint wit...
Subdural injection of contrast medium during cervical myelography. Three patients (1 dog, 2 horses) are described where myelography was complicated, purportedly by injection of contrast medium into the meninges superficial to the subarachnoid space. Contrast medium injected in this location in a cadaver tended to accumulate dorsally within the vertebral canal, deep to the dura mater but superficial to the subarachnoid space. The ventral margin of the pooled contrast medium had a wavy or undulating margin and the dorsal margin was smooth. Pooled contrast medium was believed to be sequestered within the structurally weak dural border cell layer between the dura...
Evaluation of cartilage lesions on the medial femoral condyle as a cause of lameness in horses: 11 cases (1988-1994). To evaluate clinical findings and response to treatment in horses in which cartilage lesions on the medial femoral condyle were a cause of lameness. Methods: Retrospective case series. Methods: Medical records of 11 horses that had cartilage lesions on the medial femoral condyle detected during arthroscopy of the stifle. Methods: Signalment, history, lameness examination, response to intra-articular anesthesia, radiographs of the stifle, observations during diagnostic arthroscopy, and treatment were extracted from the medical record of each horse. Follow-up examinations and outcome were availa...
Intra-articular anesthesia of the distal interphalangeal joint alleviates lameness associated with the navicular bursa in horses. To determine if intra-articular anesthesia of the distal interphalangeal joint could alleviate lameness associated with the navicular bursa in horses. Methods: Experimental investigation. Methods: Six clinically normal horses. Methods: Lameness was induced in each horse by injecting either the left or right front navicular bursa with 5 mg of amphotericin-B. Forty-eight hours later each horse was videotaped walking and trotting before, and 5, 30, and 60 minutes after injecting the distal interphalangeal joint of the treated limb with 5 mL of 2% mepivacaine hydrochloride. All video recordings we...
The role of computed tomography in evaluation of subchondral osseous lesions in seven horses with chronic synovitis. Seven horses with severe, persistent lameness of sudden onset were evaluated with scintigraphy and/or computed tomography. The lameness was localised to the front fetlock joint in 2 horses and to the tibiotarsal joint in 5 horses. Five of the horses had a history of intra-articular injections of the involved joint prior to presentation. All horses had effusion of the affected joint and were positive to flexion tests. Intraarticular anaesthesia eliminated or improved the lameness in 4 cases and a nerve conduction block proximal to the affected joint improved the lameness in another. Cytology ex...
Palmaroproximal approach for arthrocentesis of the proximal interphalangeal joint in horses. A technique was developed for arthrocentesis of the palmaroproximal pouch of the pastern joint. The landmark for percutaneous puncture is a 'V' shaped depression formed by the palmar aspect of the proximal phalanx (P1) dorsally, an eminence associated with the attachment of the collateral ligaments to P1 and the middle phalanx distally and the insertion of the lateral branch of the superficial digital flexor tendon palmarodistally. Comparison of arthrocentesis between the palmaroproximal approach and the traditional dorsal approach in 8 cadavers and 8 horses demonstrated that the palmaroproxim...
Advances in equine arthroscopy. Surgical procedures completed under arthroscopic guidance have become commonplace in many equine practices and have largely replaced surgery using arthrotomy incisions. With a limited amount of equipment, numerous diagnostic and surgical procedures can be completed. Surgeons need to become familiar with regional and intraarticular (intrasynovial) anatomy to ensure that proper surgical approaches are used, access to the lesion will be realized, and potential complications will be minimized. Specialized motorized instruments and surgical lasers are now available and may be useful in the treatmen...
Immunohistochemical analysis of an equine model of synovitis-induced arthritis. To use lipopolysaccharide (LPS) to create synovitis in the midcarpal joint of ponies, and to assess the morphologic, histochemical, and immunohistochemical effects of synovitis on articular cartilage of the third carpal bone. Methods: 2- to 3-year-old ponies, 6 control (group 1) and 6 treated (group 2). Methods: Synovitis was induced in 1 midcarpal joint of group-2 ponies by intra-articular injections of LPS (0.02 micrograms/kg of body weight), morphine (0.1 mg/kg), and saline solution (group 2a) and a morphine and saline solution alone in the contralateral midcarpal joint (group 2b). Articula...
Radiological appearance of air introduced during equine regional limb anaesthesia. Twelve horses were injected intra-articularly into the metacarpophalangeal joint and extra-articularly in the region of the lateral palmar digital nerve with 1 ml air and local anaesthetic to simulate gas accidentally introduced during regional anaesthesia. Half the horses underwent limited exercise after which all horses were radiographed at 15 and 45 min and then every 24 h until all evidence of gas had disappeared. Intra-articular gas appeared as gas capped radiolucencies (GCR) in the proximal aspect of the joint. Extra-articular gas appeared as linear radiolucencies (LR) which initially te...
Influence of methylprednisolone acetate on osteochondral healing in exercised tarsocrural joints of horses. To evaluate joint function and healing of surgically created full-thickness articular cartilage defects in exercised horses after intra-articular administration of methylprednisolone acetate (MPA; 120 mg) and sterile saline solution in the contralateral limb. Methods: Experimental investigation. Methods: 12 healthy, sound, radiographically normal horses with induced full-thickness osteochondral lesions on the medial and lateral trochlear ridges of the tali. Methods: Two 8.4-mm-diameter full-thickness articular cartilage lesions were created in each tarsocrural joint (12 horses [24 tarsocrural ...
Intra-articular morphine and saline injections induce release of large molecular weight proteoglycans into equine synovial fluid. Both morphine and physiologic saline injected intra-articularly into healthy equine tarsocrural joints induced a release of large molecular size proteoglycan (PG) subunits into the synovial fluid (SF) analysed 24 h postinjection. High-performance liquid chromatography (HPLC) with a size-exclusion column was used to assess the high molecular weight proteoglycans in equine synovial fluid (SF). The PG peaks of SF samples eluated separately from SF hyaluronate and other molecular components of the SF in the HPLC chromatographies indicating no interaction between hyaluronate and PG in the SF. Indiv...
Joint pressure influences synovial tissue blood flow as determined by colored microspheres. We measured regional blood flow in synovial tissue of the antebrachiocarpal, midcarpal, and metacarpophalangeal joints of six normal adult anesthetized horses by using 15-microns-diameter polystyrene colored microspheres. The midcarpal fibrous capsule and synovial membrane blood flows (SMBF) were compared, and the effect of increased intra-articular pressure (30 and 60 mmHg) on midcarpal SMBF was investigated. Dorsal, medial palmar, and lateral palmar midcarpal SMBF measured 108 +/- 36, 61 +/- 12, and 50 +/- 11 microliters.min-1.g-1, respectively. Antebrachiocarpal, dorsal, and palmar metacarp...
Plasma, urine, and synovial fluid disposition of methylprednisolone acetate and isoflupredone acetate after intra-articular administration in horses. OBJECTIVE--To document plasma, urine, and synovial fluid disposition of 2 common intra-articularly administered steroid preparations, methylprednisolone acetate (MPA) and isoflupredone acetate (IPA). DESIGN--Descriptive investigation. SAMPLE POPULATION--100 mg of MPA or 4 mg of IPA was administered to 2 groups of 4 healthy sound radiographically normal female horses. PROCEDURE--Blood samples were collected at time 0 (before) and 2, 4, 6, 8, 10, 12, 24, 36, 48, 72, and 96 hours after administration of the designated steroid. Complete urine collection for measurement of designated steroid was ac...
Ultrasound-guided intrafollicular treatment in mares. A technique for intrafollicular treatment with a transvaginal ultrasound-guided injection needle was developed using equine chorionic gonadotropin (eCG) as the test substance. An injection was made into one growing follicle of a wave when the follicles were 20 to 23 mm. The treated follicles were injected with 1000 iu of eCG in 0.2 ml saline solution and control follicles were injected with 0.2 ml of the saline vehicle (10 mares per group, 1 follicle per mare). The injection system used an inner 25-gauge needle and an outer 20-gauge needle inserted together through the needle-guide channel of ...
Intra-articular pressure, elastance, and range of motion in flexion of the equine metacarpophalangeal joint. A study was done to determine whether intra-articular pressure is increased in equine metacarpophalangeal joints with increasing degrees of synovial distention, and to correlate elastance of the soft tissue forming the dorsal pouch of the metacarpophalangeal joint to maximal range of motion in flexion. Sixty seven metacarpophalangeal joints in 36 horses were categorized by palpation and visual inspection of the palmar pouch into 1 of 4 increasing grades of distention. Intra-articular pressures were then measured, using 2 pressure transducers attached to 22 gauge needles, from the dorsal and pa...
Effect of tumor necrosis factor antibody on synovial fluid cytokine activities in equine antebrachiocarpal joints injected with endotoxin. Six horses received intra-articular injections of a mixture of 1 micrograms of endotoxin/5 mg of equine tumor necrosis factor (eqTNF) monoclonal antibody in 1 antebrachiocarpal joint and an equal volume (2 ml) of 1 micrograms of endotoxin/5 mg of control antibody in the opposite joint. Synovial fluid sample collection (1 ml) was accomplished by use of an indwelling, intra-articular catheter at postinjection hours (PIH) 0, 1, 1.5, 2, 5, and 8, and by arthrocentesis at PIH 24. Joint fluid samples were analyzed for nucleated cell count, protein concentration, and TNF, interleukin 6 (IL-6), IL-1, ...
Effect of glucocorticoids on serum osteocalcin concentration in horses. The effects of dexamethasone (0.2 mg/kg of body weight; IV, IM, and PO) and methylprednisolone acetate (120 mg given intra-articularly) on serum osteocalcin and cortisol concentrations were studied in 6 horses. Serum osteocalcin and cortisol concentrations were serially monitored after each treatment. A significant (P < 0.05) decrease in serum osteocalcin and cortisol concentrations was observed from 12 to 24 and 2 to 48 hours, respectively, after IV and IM administrations of dexamethasone. Serum osteocalcin and cortisol concentrations were significantly decreased from 6 to 48 and 3 to 72 h...
Determination of triamcinolone acetonide in equine serum and urine by liquid chromatography-atmospheric pressure ionization mass spectrometry. Urine and serum samples collected from four standard-bred mares after 30-mg intraarticular administrations of triamcinolone acetonide were analyzed using combined high-performance liquid chromatography-atmospheric pressure ionization mass spectrometry. Maximum triamcinolone acetonide concentrations of 32.3, 14.8, 24.3, and 29.4 ng/mL in the urine and 2.7, 1.9, 2.3, and 2.5 ng/mL in the serum samples were observed. The peak concentrations of the drug were detected approximately 22 h (urine) and 12 h (serum) after administration. The drug elimination profiles for both urine and serum are present...
Use of sodium monoiodoacetate to fuse the distal hock joints in horses. Intra-articular injection of sodium monoiodoacetate (MIA) was investigated as an agent for chemical arthrodesis of the distal hock joints in the horse. Five horses diagnosed with either spavin (three horses), a small tarsal bone fracture or a failed surgical arthrodesis, had 150 mg of MIA injected into the tarsometatarsal (TMT) joint of the affected hock(s). Eight joints were treated in the five horses. Follow-up evaluation by clinical and radiological examination took place over 9 to 14 months. Two of the five horses were sound at the conclusion of the study and one horse, although lame after...
Experimentally-induced synovitis as a model for acute synovitis in the horse. The use of extremely small dosages of intra-articular E. coli lipopolysaccharide (LPS) endotoxin can create a model of synovitis that mimics acute synovitis in horses. Dosages of 5000 ng, 25 ng, 0.5 ng, 0.25 ng, 0.17 ng and 0.125 ng per joint were injected into various joints of a total of 6 horses. The dose response of LPS on clinical signs and synovial fluid parameters was evaluated at baseline and 12, 24, 36 and 48 h after LPS injection. Peripheral venous blood analysis was performed at baseline and at 0, 4, and 12 h after LPS injection. Dosages greater than 0.5 ng/joint resulted in clinica...
Comparison of the cranial and a new lateral approach to the femoropatellar joint for aspiration and injection in horses. The genual joint in horses is complex, making synovial fluid aspiration and injection of the femoropatellar joint difficult. Horses commonly have signs of resentment to needle penetration at this site. We compared the safety and efficacy of a new technique, using a lateral approach to the femoropatellar joint, with that of the standard cranial approach in 12 horses. A significantly greater amount of fluid was obtained with the lateral approach (2.0 +/- 0.5 ml, mean +/- SEM) than with the cranial approach (0.9 +/- 0.2 ml). Significant differences were not observed in color, nucleated cell count...
Effect of betamethasone and exercise on equine carpal joints with osteochondral fragments. Osteochondral fragments were created arthroscopically on the distal aspect of both radial carpal bones in 12 horses. On day 14 after surgery, one middle carpal joint of each horse was injected with 2.5 mL Betavet Soluspan (3.9 mg betamethasone sodium phosphate and 12 mg betamethasone acetate per milliliter) and the contralateral joint was injected with 2.5 mL saline as a control. Intra-articular treatments were repeated on day 35. On day 17, six horses began exercising 5 days per week on a high-speed treadmill. The other six horses were kept in box stalls throughout the study as nonexercised c...
The anatomic features of the normal tarsus of the live horse as perceived by the sense of sight. A description is given of 75 features present in the normal tarsus of the standing horse which are apparent due to visible skin contours overlying them. Depending on whether or not the pelvic limb is supporting full weight or resting, some contours alter their configuration. Therefore the contour of each underlying feature is described separately for each stance of the limb. It is considered that visual inspection and identification of the apparent superficial features of the normal equine tarsus form the basis of orientation and clinical inspection. Furthermore, these features provide referen...
