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.
Butler J, Rydell NW, Balazs EA.Twelve horses with traumatic arthritis were treated with intraarticular injection of hyaluronic acid mixed with cortisone and the results compared with 6 horses treated only with cortisone. There was a significantly better improvement in the group injected with a mixture of hyaluronic acid and cortisone. Further studies have given the same results in traumatic arthritis in horses if hyaluronic acid alone is injected. After injection of hyaluronic acid a large number of granulated monocytes appeared in the synovial fluid, but no inflammatory signs were observed. It is possible that this macroph...
Degenerative joint disease is one of the main causes of equine early retirement from pleasure riding or a performance career. The disease is initially triggered by an abnormal loading of normal cartilage or a normal loading of abnormal cartilage. This primary insult is accompanied with joint inflammation, which leads to further progressive degeneration of the articular cartilage and changes in the surrounding tissues. Therefore, in search for an effective treatment, 75 adult horses with early signs of degenerative fetlock joint disease were enrolled in a randomized, multicenter, double-blinded...
Seabaugh K, Rao S, Koenig JB, Pezzanite L, Dow S, Koch TG, Russell KA, Mehrpouyan S, Alizadeh AH, Goodrich LR.Synovitis is present before and during osteoarthritis in horses and can result in performance-limiting lameness. Twenty-four horses with lameness localized to the metacarpo-/metatarsophalangeal joint or a single joint of the carpus were enrolled in this study. We evaluated the response of intra-articular injection with 10 million activated (aMSC) or non-activated (naMSC) allogeneic equine umbilical cord blood-derived mesenchymal stromal cells (MSCs). Subjective and objective lameness was assessed on Days 0, 1, 21, and 42. The treatment injection was randomly assigned and performed following th...
Korac L, Golestani N, MacNicol J, Souccar-Young J, Witherspoon S, Wildish A, Topfer S, Pearson W.The purpose was to determine local (articular) and systemic effects of intra-articular interleukin-1 in horses supplemented with a dietary PUFA supplement [STRUCTURE-Joint (ST-J)]. Sixteen (16) healthy, mature, light breed horses were randomly assigned to diets containing 0 or 120 mL (n = 8 per group) of ST-J for 30 d. On days 0 (prior to beginning supplementation) and 27, recombinant equine interleukin-1β (reIL-1 β) (75 ng) was injected into the left or right intercarpal joint to induce mild, transient synovitis. Synovial fluid was obtained by aseptic arthrocentesis at postinjection hou...
Story MR, King M, Nout-Lomas YS, Barrett MF, Kawcak C, Frisbie D, McIlwraith CW, Haussler KK.To develop and define a model of acute neck pain in an equine cervical articular process joint (APJ) using recombinant equine IL-1β (reIL-1β). Unassigned: 12 horses in this experimental study received a randomly assigned, unilateral intra-articular injection of 50 ng (n = 6) or 100 ng (n = 6) of reIL-1β and saline (contralateral side as control) into the C5-to-C6 APJ. Blinded ultrasonographic, clinical, and biomechanical parameters were evaluated between 4 hours and 14 days. Unassigned: There was a significant increase in APJ effusion on ultrasonographic examination that peaked at 24 hours ...
Whitaker B, Barnhard JA, Webb KR, Levine D, Green MM, Vieira MR.This study assessed the safety and tolerability of concurrent intra-articular (IA) injection of 2.5% polyacrylamide hydrogel (2.5% iPAAG) and betamethasone sodium phosphate and betamethasone acetate esters (BME) in the metacarpophalangeal joints (MCPJs) of healthy horses. Methods: 10 healthy therapeutic riding horses were enrolled in this open-label safety study from August 1 to September 14, 2023. Inclusion criteria required normal physical examinations, insulin level, hematology, biochemistry, soundness at all gaits, and negative forelimb flexion tests. Screening occurred from days -14 to -0...
Perrone G, Giampaoli C, Smirnoff AL, Ochoa A, Pareja R, De Simone E.Osteoarthritis (OA) is the most common pathology in sport horses, presenting a chronic and recurrent course. Traditional anti-inflammatory treatments provide only temporary clinical improvement and pain relief; however, they have been associated with metabolic disorders in articular cartilage in the medium term. In this study, we generated a llama polyclonal antibody against equine TNF-α, which was used for intra-articular treatment in horses with OA. Treatment effects were assessed through clinical examination and the determination of inflammatory parameters (MMP-2, MMP-9, LDH, and GAGs) in ...
Adler DMT, Nielsen AT, Olsen C, Verwilghen D, Damborg P, Olsen RH.To investigate the in vitro efficacy of antibiotics (amikacin, ceftiofur, and gentamicin) in combination with local anesthetics (LAs; bupivacaine hydrochloride, lidocaine hydrochloride, and mepivacaine hydrochloride), a combination commonly performed for IA injectate and regional limb perfusion (RLP) in horses. Unassigned: 17 equine clinical isolates were tested by the checkerboard method for their minimum inhibitory concentration (MIC) against a combination of concentrations of LAs and antibiotics from August 2020 through December 2023. Unassigned: For the majority of combinations, the antibi...
Yu R, Jusko WJ.This study assesses the pharmacokinetics (PK) of published methylprednisolone (MPL) data in horses following intra-articular (IA) administration of MPL acetate (MPA) and the associated adrenal suppression. The concentrations of MPL/MPA in synovial fluid, blood, and urine, as well as hydrocortisone (HC) in plasma, were digitized from multiple sources in the literature. A minimal physiologically based pharmacokinetic model and a linked indirect response model with a circadian rhythm baseline were applied. Concentrations of MPA in joints followed a triexponential decay, converting to MPL. The cle...
Luque RM, Henderson B, McCorkell TC, Alizadeh AH, Russell KA, Koch TG, Koenig J.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€...
Beck AA, Paz LB, Frank MI, Pereira RCF, De La Côrte FD.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...
Shokry M, Ali LB, El-Sharkawy M.Showjumping athletic horses are frequently affected by back pain, which in turn influences their performance and equestrian activities. Unassigned: The aim of the present study was to determine the etiological factors predisposing to back problems in show jumping horses and how to diagnose, and manage them. Unassigned: A total of 75 cases (45 geldings and 30 mares, aged between 8 and 23 years and weighing 420-550 Kg) with histories suggestive of back problems and low competitive ability as show jumping were used in this study. The evaluation of data was based on the inputs of case history, cli...
Moore GE, Leatherwood JL, Glass KG, Arnold CE, Paris BL, Carter MM, George JM, Fontenot AB, Martinez RE, Franklin MA, Norton SA, Bradbery AN....The objective was to evaluate dietary fermentation product (SCFP) on joint inflammation and cartilage metabolism in exercising yearlings challenged with intra-articular lipopolysaccharide (LPS), hypothesizing dietary SCFP (TruEquineC, Diamond V Mills, Inc.) would ameliorate joint inflammation and increase cartilage metabolism. Thirty Quarter Horse yearlings were stratified by bodyweight (BW), age, sex, and randomly assigned to dietary treatments (n = 10/treatment): control (0), 46, or 92 mg/kg BW/d SCFP. Treatments were top-dressed to 1% BW/d concentrate void of added microbials. Horses ...
Rinnovati R, Spadari A, Malpighi A, Meistro F, Ralletti MV, Marcucci E, Tarasconi MA, Chiatto RL, Tommasa SD.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...
Pluim M, Frippiat T.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...
Berni P, Del Bue M, Conti V, Andreoli V, Ramoni R, Angelone M, Squassino GP, Bari E, Torre ML, Rinaldi M, Dotti S, Rossi R, Yusuf I, Mauri P....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...
Munoz Moran JA.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 ...
Khaliji E, Marycz K, Horna M, Morgan JM, Galuppo LD, Vapniarsky N, Cassano JM.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...
Kooy S, Constant J, Cole R, Boone L.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...
