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.
Neuenschwander HM, Moreira JJ, Vendruscolo CP, Fülber J, Seidel SRT, Michelacci YM, Baccarin RYA.The intra-articular use of hyaluronic acid (HA) for the treatment of synovitis and osteoarthritis is still controversial. As a consequence, corticosteroids remain the most frequently employed therapeutic agents, despite their potential systemic and local deleterious effects. This study examined the anti-inflammatory, antioxidant, and chondroprotective activities of low and high molecular weight hyaluronic acid (LMW-HA and HMW-HA) on lipopolysaccharide (LPS)-induced synovitis in horses compared to triamcinolone acetonide (TA). LPS was injected in the metacarpophalangeal joints, which were treat...
Johnston GCA, Wood KA, Jackson KV, Perkins NR, Zedler ST.Intra-articular (IA) hyaluronic acid (HA) is commonly used to treat equine arthritis. Inflammatory response or "joint flare" is a recognized potential side effect. However, the incidence and severity of inflammation following IA HA injection in horses is not well documented. This study compared the effects of two IA HA formulations of different molecular weight (MW) and a saline control on clinical signs and synovial fluid markers of inflammation in normal equine joints. Eight adult horses each had three healthy fetlock joints randomly assigned to treatment with either 1.4 mega Dalton HA, 0.8 ...
Smith R, Parsons J, Dixon J.Desmopathy of the collateral ligaments of the distal interphalangeal joint is a common cause of equine foot lameness and carries a poor prognosis with conservative management. Intralesional injections may improve healing, although accuracy of radiographically guided injections is significantly less than when guided by MRI, which requires special needles. Longitudinal ultrasound-guided injection of the distal collateral ligament has not been evaluated objectively. In this prospective, anatomic study, seven equine cadaver limbs (14 collateral ligaments) were injected with methylene blue dye and ...
Magri C, Schramme M, Febre M, Cauvin E, Labadie F, Saulnier N, François I, Lechartier A, Aebischer D, Moncelet AS, Maddens S.The purpose of this prospective study was to evaluate the effects of single and repeated intra-articular administration of allogeneic, umbilical cord-derived, neonatal mesenchymal stem cells (MSC) in horses with lameness due to osteoarthritis (OA) of a metacarpophalangeal joint (MPJ). Twenty-eight horses were included. Horses were divided into two groups. Horses in group MSC1 received an MSC injection at M0 and a placebo injection at M1 (1 month after M0). Horses in group MSC2 received MSC injections at M0 and at M1. Joint injections were performed with a blinded syringe. Clinical assessment w...
Beaulieu A, Linden AZ, Phillips J, Arroyo LG, Koenig J, Monteith G.In the equine racehorse industry, reduced athletic performance due to joint injury and lameness has been extensively reviewed. Intra-articular injections of glucocorticoids are routinely used to relieve pain and inflammation associated with osteoarthritis. Intra-articular injections of pharmaceutical agents require practice for precise needle placement and to minimize complications. Training on simulators or models is a viable alternative for developing these technical skills. The purpose of this study was to compare the qualitative ultrasonographic characteristics of three-dimensional (3D) pr...
Mereu M, Hawkes C, Cuddy LC, Perez Olmos JF, Pazzola M, McNally TP.To describe a dorsoproximal midline (DPM) standing technique for proximal interphalangeal joint (PIPJ) injection and to compare it to established dorsolateral flexed (DLF), palmaroproximal (PP), and dorsolateral standing (DLS) techniques. Methods: Ex vivo study. Methods: Sixty cadaver equine thoracic limbs. Methods: Limbs were divided into four groups (n = 15 each group), DLF, DPM, PP, and DLS. For each technique, three operators injected radiopaque contrast and methylene blue into the PIPJ in five limbs. The number of attempts required was recorded. Successful injection was confirmed by radio...
Warnock WR, Marsh CA, Hand DR.The purpose of this study was to report long-term outcome following arthroscopic debridement of articular cartilage lesions of the distal interphalangeal joint, diagnosed with high-field magnetic resonance imaging. Diagnosis was based on the results of diagnostic anesthesia, magnetic resonance imaging (MRI), and arthroscopy. Ten horses underwent arthroscopic evaluation for cartilage injury and received various intra-articular therapies after surgery. Three of ten horses had lesions that were surgically inaccessible. Four horses became sound and returned to their preoperative level of athletici...
Radtke A, Fortier LA, Regan S, Kraus S, Delco ML.Equine diagnostic anaesthesia can be a useful tool in challenging lameness examinations. However, anaesthetics diffuse over time leading to nonspecific desensitisation of periarticular structures. Nerves that convey sensation from the distal limb to the central nervous system pass in close proximity to the caudal stifle joint capsule. Therefore, diffusion of intra-articular (IA) anaesthetics could cause inadvertent desensitisation of the distal limb resulting in a false diagnosis of stifle lameness. Objective: To determine if IA stifle anaesthesia can alleviate lameness originating in the dist...
Colbath AC, Dow SW, Hopkins LS, Phillips JN, McIlwraith CW, Goodrich LR.Allogeneic bone marrow-derived mesenchymal stem cells (BMDMSCs) could provide multiple advantages over autologous BMDMSCs, including creating an 'off-the-shelf' treatment together with the ability to control for donor variation. Objective: The objective of the study was to compare the clinical and synovial fluid response of the normal equine joint to autologous and pooled-allogeneic BMDMSCs while controlling for individual variation and joint variations in response to intra-articular injections. We hypothesised that, by controlling for individual animal and joint variation, we could identify d...
Stewart RC, Nelson BB, Kawcak CE, Freedman JD, Snyder BD, Goodrich LR, Grinstaff MW.Early detection of osteoarthritis (OA) remains a diagnostic challenge owing to insensitive diagnostic techniques currently available. Herein a new semiquantitative scoring system, based upon contrast-enhanced computed tomographic (CECT) imaging, is described for further refinement of early OA disease staging. Trochlear ridge cartilage defects were surgically created in the femoropatellar joint of an adult horse (ACUC approved protocols). Seven weeks post-surgery, CECT imaging was performed on a clinical scanner after intra-articular injection of a cationic iodinated contrast agent, CA4+, into ...
Ekstrand C, Bondesson U, Giving E, Hedeland M, Ingvast-Larsson C, Jacobsen S, Löfgren M, Moen L, Rhodin M, Saetra T, Ranheim B.Dexamethasone is used for the intra-articular route of administration in management of aseptic arthritis in horses. Despite its widespread use there is very little quantitative data of the disposition and response to dexamethasone. The aim of this study was to investigate and describe the synovial fluid and plasma dexamethasone concentration over time and to explore the relation between synovial fluid concentration and response using clinical endpoints as response biomarkers after IA injection of dexamethasone disodium salt solution in an equine model of synovitis. Results: Inflammation was in...
McCoy AM, Smith RL, Herrera S, Kawcak CE, McIlwraith CW, Goodrich LR.To report the outcome of horses engaged in Western performance disciplines after stifle arthroscopy and identify prognostic factors for return to performance. Methods: Retrospective case series. Methods: Eighty-two Western performance horses undergoing stifle arthroscopy. Methods: Medical records were reviewed for horses involved in athletic performance/training for various Western performance disciplines and undergoing arthroscopy for lameness localized to the stifle. Follow-up was obtained ≥2 years postoperatively by telephone interviews with the owners. Preoperative and intraoperative f...
Niemelä TM, Tulamo RM, Carmona JU, López C.Inflammatory and degenerative activity inside the joint can be studied in vivo by analysis of synovial fluid biomarkers. In addition to pro-inflammatory mediators, several anabolic and anti-inflammatory substances are produced during the disease process. They counteract the catabolic effects of the pro-inflammatory cytokines and thus diminish the cartilage damage. The response of synovial fluid biomarkers after intra-articular hyaluronan injection, alone or in combination with other substances, has been examined only in a few equine studies. The effects of hyaluronan on some pro-inflammatory m...
Bessonnat A, Picotte K, Lavoie JP.Locally administered corticosteroids are commonly used to treat joint diseases in sport and racehorses. As they are also the most potent drugs for the treatment of equine asthma, we hypothesised that the intra-articular corticosteroids used to treat joint diseases also improve the lung function in horses with severe asthma, thus potentially delaying the diagnosis of this common lung condition. Objective: To compare the effects of intra-articular (IA) and intramuscular (IM) triamcinolone acetonide (TA) on lung function in horses with severe asthma. Methods: Randomised and controlled experiment ...
Bertoni L, Branly T, Jacquet S, Desancé M, Desquilbet L, Rivory P, Hartmann DJ, Denoix JM, Audigié F, Galéra P, Demoor M.Osteoarthritis is a significant and costly cause of pain for both humans and horses. The horse has been identified as a suitable model for human osteoarthritis. Regenerative therapy with allogeneic mesenchymal stem cells (MSCs) is a promising treatment, but the safety of this procedure continues to be debated. The aim of this study is to evaluate the safety of intra-articular injections of allogeneic MSCs on healthy joints by comparing two different dosages and two different tissue sources, namely, bone marrow and umbilical cord blood, with a placebo treatment on the same individuals. We also ...
Broeckx SY, Martens AM, Bertone AL, Van Brantegem L, Duchateau L, Van Hecke L, Dumoulin M, Oosterlinck M, Chiers K, Hussein H, Pille F, Spaas JH.There is a need to improve therapies for osteoarthritis in horses. Objective: To assess the efficacy of equine allogeneic chondrogenic-induced mesenchymal stem cells combined with equine allogeneic plasma as a novel therapy for osteoarthritis in horses. Methods: Randomised, double-blinded, placebo-controlled experiment. Methods: In 12 healthy horses, osteoarthritis was induced in the metacarpophalangeal joint using an osteochondral fragment-groove model. Five weeks after surgery, horses were randomly assigned to either an intra-articular injection with chondrogenic-induced mesenchymal stem cel...
Canonici P, Beccati F, Canonici F, Pepe M.To develop a reliable method for injection of the tarsometatarsal (TMT) joint of horses through a medial approach and to characterize anatomy of the synovial recesses of the TMT joint with CT. Methods: 13 pairs of fresh cadaveric equine tarsi. Methods: TMT joints were assessed with radiography and CT. Twelve pairs of TMT joints were assigned to an experienced veterinarian (8 joints) or veterinary student (16 joints) for injection with contrast medium through a medial or a lateral approach. Every TMT joint was then reexamined radiographically and with CT to assess diffusion of contrast medium. ...
Hoaglund EL, Seabaugh KA, Selberg KT, Hess A, Bass L.Centrodistal joint injection is an important component of lameness evaluation and treatment. Successful injection is poor for the medial approach. The dorsolateral approach is an alternative but has not been validated with contrast medium. Radiograph-guidance has not been studied to determine its necessity or benefit for either approach. Objective: To determine if the dorsolateral approach to the centrodistal joint is more successful than the medial approach. To determine if radiograph-guidance is beneficial. Methods: Prospective, randomised study. Methods: Three operators injected 98 centrodi...
Silva GB, De La Côrte FD, Brass KE, Palma HE, Gallio M, Cantarelli C, Bertolin K, Krause A, Wergutz J, Fontanari Krause LM, Antoniazzi AQ.Chondrocyte health is altered when exposed to local anesthetics, raising concerns as to the long-term effects of local anesthetics intra-articularly for diagnosis and analgesia. To investigate the drug with the lowest toxic potential, the effect of ropivacaine and mepivacaine on chondrocytes was evaluated. Articular cartilage from normal metacarpophalangeal joints of five equine cadaver specimens was used to establish chondrocyte cultures. Following seven days, chondrocytes were exposed to standard culture medium (DMEM), ropivacaine 7.5 mg/ml (ROP7.5), ropivacaine 10 mg/ml (ROP10), mepivacaine...
Di Salvo A, Chiaradia E, Della Rocca G, Giorgi M, Mancini F, Marenzoni ML, Conti MB, Nannarone S.Intra-articular administration of analgesics is performed to ensure good perioperative pain management avoiding undesirable systemic effects. To evaluate the effect of intra-articular injection of tramadol on postoperative pain after arthroscopy in horses and to determine whether tramadol had a local effect. Before the in vivo study, an in vitro test was performed aiming to evaluate the viability of equine chondrocytes after exposure to various concentrations of tramadol. The concentration identified as most appropriate was used to treat the horses' joints. Twelve horses affected by osteochond...
Grady ST, Britton L, Hinrichs K, Nixon AJ, Watts AE.Mesenchymal stem cells (MSCs) improve the osteoarthritis condition, but the fate of MSCs after intra-articular injection is unclear. We used fluorescent nanoparticles (quantum dots [QDs]) to track equine MSCs (QD-labelled MSCs [QD-MSCs]) in vivo after intra-articular injection into normal and osteoarthritic joints. One week after injection of QD-MSCs, unlabelled MSCs, or vehicle, we determined the presence of QD-MSCs in synovium and articular cartilage histologically. In vitro, we evaluated the persistence of QDs in MSCs and whether QDs affected proliferation, immunophenotype, or differentiati...
Smith LCR, Wylie CE, Palmer L, Ramzan PHL.There are few observational studies regarding the potentially serious complication of synovial sepsis following intrasynovial medication in general equine practice. Quantification of risk is fundamental to fully inform decision-making and owner consent prior to undertaking procedures. Objective: To describe the occurrence of synovial sepsis following intrasynovial injections in a large ambulatory equine practice between 2006-2011. Methods: Retrospective cohort study. Methods: Medication records were cross-referenced against synovial cytology submissions and hospital admissions for synovial sep...
Fischer BM, McMullen RJ, Reese S, Brehm W.Despite appropriate medical therapy, many horses with equine recurrent uveitis continue to suffer from recurrent bouts of inflammation. Surgical intervention via the pars plana vitrectomy or suprachoroidal cyclosporine implant placement may control and/or prevent recurrences, however, these procedures may be contraindicated, unavailable, or declined by an owner. Thus, an effective adjunctive treatment option may help to improve the clinical outcomes in those situations. There are several anecdotal reports on the use of intravitreal gentamicin injections, but to date, no data evaluating the com...
McIlwraith CW, Lattermann C.The use of intra-articular corticosteroids for traumatic arthritis and osteoarthritis (OA) is common in the horse. The beneficial and deleterious effects of the principal corticosteroids used betamethasone esters (Celestone [Soluspan], methylprednisolone acetate [Depo Medrol], and triamcinolone acetonide [TA] [Vetalog or Kenalog]) have been defined for the horse. While TA has both disease-modifying as well as symptom-modifying effects, methyl prednisolone acetate has deleterious effects on the articular cartilage. Studies in traumatically injured joints show the same rationale (suppression of ...
Yamasaki A, Omura T, Murata D, Kobayashi M, Sunaga T, Kusano K, Ueno Y, Kuramoto T, Hobo S, Misumi K.Synovium-derived mesenchymal stromal cells (SM-MSCs) from seven Thoroughbreds with naturally occurring intra-articular fracture proliferated to over ten million cells by the second passage. Using three experimental Thoroughbreds, columnar osteochondral defects were made arthroscopically at the bilateral distal radius. Five million allogenic SM-MSCs were implanted into the right defect, and another five million were injected into the right radio-carpal joint (implantation site). No SM-MSCs were implanted into the left defect or the same joint (control site). At 3 and 6 weeks after surgery, ten ...
Hunt CL, Leatherwood JL, Coverdale JA, Sigler DL, Vogelsang MM, Arnold CE.Osteoarthritis (OA) is a prevalent and economically costly source of lameness in the athletic horse. Previous studies investigating OA pathology have focused on localized trauma to the articular cartilage of a joint, largely ignoring the systemic immune status of the animal. In this study, yearling Quarter Horses were used to evaluate systemic cytokine gene expression and circulating leukocytes following a localized intra-articular inflammatory insult of the endotoxin, lipopolysaccharide (LPS). Treatments for the 35-d experiment included an intra-articular injection of 0.25 ng (n = 7) or 0.50 ...
Rowland AL, Xu JJ, Joswig AJ, Gregory CA, Antczak DF, Cummings KJ, Watts AE.We recently demonstrated that intracellular xenogen-contaminated autologous MSCs (FBS) and non-xenogen-contaminated allogeneic (ALLO) MSCs caused an adverse clinical response after repeated intra-articular injection in horses, whereas autologous (AUTO) MSCs did not. Our current objective was to use clinical data from the previous study to compare MSC stemness against adverse response indicated by synovial total nucleated cell count (TNCC) following intra-articular MSC injection. Stemness, quantified by a trilineage differentiation (TLD) score; immunomodulation, quantified by mixed lymphocyte ...
Düsterdieck-Zellmer KF.Systemic administration of tiludronate or clodronate decreases lameness in some horses suffering from navicular syndrome within 2-6 months of treatment. In horses that fail to respond to the first treatment, a follow-up treatment may still improve the lameness. Horses with a lameness duration of less than 6 months have better odds of experiencing improvement in lameness. Bisphosphonate (BP) treatment can result in renal damage, and it is recommended to assess renal function prior to and after treatment. Horses with pre-existing renal compromise should not be treated with BP, as this may promot...
Knych HK, Mama KR, Moore CE, Hill AE, McKEMIE DS.The use of intra-articular (IA) local anaesthetics has proven to be an effective means to treat post-operative pain. The effects of local anaesthetics on equine chondrocytes are mixed with some studies reporting chondrodestruction and others no adverse effects. A liposomal formulation of bupivacaine is used in people and dogs by intra- and peri-articular administration to provide up to 72 h of analgesia. The potential uses, side effects including chondrotoxicity, and likelihood of abuse (long-term analgesic effects) has not been evaluated in horses. Objective: Describe bupivacaine concentrati...
Hendesi H, Stewart S, Gibison ML, Guehring H, Richardson DW, Dodge GR.Posttraumatic osteoarthritis is a disabling condition impacting the mostly young and active population. In the present study, we investigated the impact of intra-articular sprifermin, a recombinant truncated fibroblast growth factor 18, on the outcome of microfracture treatment, a widely used surgical technique to enhance cartilage healing at the site of injury. For this study, we created a cartilage defect and performed microfracture treatment in fetlock joints of 18 horses, treated joints with one of three doses of sprifermin (10, 30, or 100 μg) or with saline, hyaluronan, and evaluated a...
Kramer J, Keegan KG, Wilson DA, Smith BK, Wilson DJ.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...
Van Hoogmoed L, Snyder JR, Pascoe JR, Olander H.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...
Moreira JJ, Moraes AP, Brossi PM, Machado TS, Michelacci YM, Massoco CO, Baccarin RY.This experimental controlled study was performed to evaluate the composition of autologous processed plasma (APP), and the effects of APP intra-articular injection into healthy equine metacarpophalangeal joints. The effects on joints were analysed with a short-phase protocol and a prolonged-phase protocol using saline-injected joints as controls. For the short protocol, horses received one intra-articular APP injection. Synovial fluid samples were collected prior to the injection and 3, 6, 24, 48, and 16 h after treatment. For the prolonged protocol, the joints received three weekly injections...
Piat P, Richard H, Beauchamp G, Laverty S.To assess the effects of an intra-articular (IA) lidocaine or bupivacaine injection on synovial fluid (SF) biomarkers of cartilage metabolism. Methods: Experimental. Methods: Horses (n = 6). Methods: The study had 2 components, each with an identical design: the first arm assessed the effects of bupivacaine (0.5%) IA in the intercarpal joints and, after a 2-week washout period, the second was conducted to evaluate the effects of IA lidocaine (2%) in the tarsocrural joints. The mares were randomly assigned to receive the test local anesthetic in the target joint or the placebo (0.9% NaCl) in th...
Rowland AL, Xu JJ, Joswig AJ, Gregory CA, Antczak DF, Cummings KJ, Watts AE.We recently demonstrated that intracellular xenogen-contaminated autologous MSCs (FBS) and non-xenogen-contaminated allogeneic (ALLO) MSCs caused an adverse clinical response after repeated intra-articular injection in horses, whereas autologous (AUTO) MSCs did not. Our current objective was to use clinical data from the previous study to compare MSC stemness against adverse response indicated by synovial total nucleated cell count (TNCC) following intra-articular MSC injection. Stemness, quantified by a trilineage differentiation (TLD) score; immunomodulation, quantified by mixed lymphocyte ...
Lapointe JM, Laverty S, Lavoie JP.Case histories, results of synovial fluid analyses, treatment regimens and outcome are described for 15 adult Standardbred horses with confirmed post-injection septic arthritis. Joint sepsis followed injection of corticosteroids, hyaluronic acid, polysulphated glycosaminoglycan, or local anaesthetic. The median interval from injection to appearance of clinical signs was 2.5 days, and median interval from injection to referral was 9 days. The median initial synovial leucocyte count on admission was 57 x 10(9)/litre, but there was a wide range of values (18-258 x 10(9)/litre). The median synovia...
Lavach JD, Sullins KE, Roberts SM, Severin GA, Wheeler C, Lueker DC.Twenty-six horses and five mules with periocular sarcoids were treated with intralesional injections of a purified bacillus of Calmette and Guerin (BCG) cell walls in oil suspension. All sarcoids were cured and the horses and mules remained free from recurrence of sarcoid during the two-year follow-up period.
Cousty M, David Stack J, Tricaud C, David F.To evaluate the effect of arthroscopic lavage and repeated intra-articular administration of antibiotic in adult horses and foals with septic arthritis. Methods: Retrospective clinical study. Methods: Adult horses and foals with septic arthritis (n = 62). Methods: Age, sex, cause of septic synovitis, joint involved, hospitalization time, and outcome were recorded. Arthroscopic lavage was performed at day 0 (D 0). Synovial fluid was collected every 48 hours prior to intra-articular administration of antibiotic, and until hospital discharge. Synovial nucleated cell count, total protein, and ...
Whitcomb MB, Vaughan B, Katzman S, Hersman J.Intrasynovial access to the equine coxofemoral joint (CFJ) is inherently challenging. Blind injection techniques rely upon inconsistently palpable landmarks, and ultrasound guidance requires expertise for needle placement into the coxofemoral articulation. Aspiration is recommended to confirm intrasynovial placement and avoid sciatic nerve anesthesia. The aim of this observational, descriptive, retrospective study was to evaluate the feasibility for an alternative ultrasound-guided approach in horses with cranioventral distention of the CFJ identified during pelvic ultrasound. Thirteen horses ...
Leatherwood JL, Gehl KL, Coverdale JA, Arnold CE, Dabareiner RA, Walter KN, Lamprecht ED.Fourteen yearling Quarter horses (351 to 470 kg) were utilized in a randomized complete block design to evaluate potential of glucosamine hydrochloride (HCl) to mitigate intra-articular inflammation following a single inflammatory insult. Horses were blocked by BW, age, and sex, and randomly assigned to treatments for a 98-d experiment. Treatments consisted of a control diet (CON; = 7) fed 1% BW per d (as-fed) of concentrate only or a treatment diet ( = 7) of concentrate top dressed with 30 mg/kg BW glucosamine HCl (99.6% purity; GLU30) offered at 12 h intervals. Horses were maintained in indi...
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...
Kwan C, Bell R, Koenig T, Bischofberger A, Horadagoda N, Perkins NR, Jeffcott LB, Dart AJ.Evaluate synovial fluid cytology, total protein concentration and viscosity after intra-articular administration of combined pentosan polysulfate and glucosamine in horses. Methods: Ten adult Standardbred horses had each carpal joint (n = 20) randomly assigned to one of two treatments: control (5 mL saline) or treated (pentosan polysulfate and glucosamine). All horses received an intra-articular injection every 7 days for 3 weeks and synovial fluid samples were collected on days 1 (baseline), 2, 3, 7, 8, 9, 14, 15, 16 and 21. Synovial fluid variables measured included total protein concentrati...
Byron CR, Trahan RA.Osteoarthritis (OA) is a ubiquitous disease affecting many horses. The disease causes chronic pain and decreased performance for patients and great cost to owners for diagnosis and treatment. The most common treatments include systemic non-steroidal anti-inflammatory drugs and intra-articular injection of corticosteroids. There is excellent support for the palliative pain relief these treatments provide; however, they do not arrest progression and may in some instances hasten advancement of disease. Orthobiologic treatments have been investigated as potential OA treatments that may not only am...
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...
Mattson S, Bouré L, Pearce S, Hurtig M, Burger J, Black W.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...
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...
Wagner AE, McIlwraith CW, Martin GS.Orgotein was injected into the right intercarpal joint of each of 8 horses; the corresponding left joint was left alone (not injected) or was given an injection of normal saline solution. Injection with orgotein caused a transient, marked inflammatory response, evidenced by clinical signs and by increased leukocytes and total protein in the synovia (synovial fluid). Leukocyte numbers and total protein concentration were increased (P less than 0.010) in the orgotein-injected joints within 24 hours. However, saline solution alone also elicited a marked inflammatory response, manifested by increa...
Pearson W, Fletcher RS, Kott LS.A biological extract of high-rosmarinic acid mint (HRAM) has previously demonstrated inhibitory effects on lipopolysaccharide (LPS)-induced prostaglandin E(2) (PGE(2)), nitric oxide (NO) and glycosaminoglycan (GAG) release in vitro. This study was undertaken to determine whether HRAM added to feed produces similar effects in horses challenged with intra-articular LPS. Eight horses received HRAM (0 or 28.1 ± 1.3 g/day; n = 4 per group) in their feed for 24 days in a blinded manner. On day 21, all horses received an intra-articular injection of LPS (0.3 ng) into their left or right intercarpal ...
McIlwraith CW, Van Sickle DC.Arthritis was experimentally induced in the intercarpal joints of a series of mature ponies by the intraarticular injections of 400 microgram of the polyene antibiotic filipin in 1 ml of dimethyl sulfoxide. Twelve consecutive weekly injections were administered and the ponies were euthanatized 4 weeks after the last injection of filipin was made. The ponies were exercised for 1 hour each day throughout the experiment. Articular cartilage specimens from 4 sites in each intercarpal joint were examined histologically and histo-chemically. For the histochemical examination, safranin O-fast green, ...
Gillespie CC, Adams SB, Moore GE.To determine common methods for intra-articular injections and variables associated with the risk of septic arthritis following intra-articular injection in the horse. Methods: Cross-sectional survey. Methods: Equine veterinarians. Methods: A link to an online survey was distributed to equine practitioners in 2014. Responses for descriptive data were tabulated. Data on infection rates obtained from medical records were analyzed. Variables associated with the risk of septic arthritis were determined using χ or Fisher's exact tests and logistic regression. Results: Common current methods for in...
Murray RC, DeBowes RM, Gaughan EM, Zhu CF, Athanasiou KA.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 ...
Steel CM, Pannirselvam RR, Anderson GA.The aims of this study were to determine the risk of septic arthritis after intra-articular medication (IAM) and to identify potential risk factors for this complication. Methods: A retrospective and prospective descriptive study of prevalence, and matched case-control study for risk factors. Results: Of 16,624 joints injected in 1103 horses at 6695 horse-visits, septic arthritis occurred as a complication in 13 joints (13 horses). The risk of septic arthritis following IAM was 7.8 cases per 10,000 injections or 1 case per 1279 injections. Veterinarian and type of corticosteroid were identifie...
Ortved K, Wagner B, Calcedo R, Wilson J, Schaefer D, Nixon A.Intraarticular (IA) administration of viral vectors expressing a therapeutic transgene is an attractive treatment modality for osteoarthritis (OA) as the joint can be treated as a contained unit. Humoral and cell-mediated immune responses in vivo can limit vector effectiveness. Transduction of articular tissues has been investigated; however, the immune response to IA vectors remains largely unknown. We hypothesized that IA rAAV2 and rAAV5 overexpressing insulin-like growth factor-I (IGF-I) would result in long-term IGF-I formation but would also induce neutralizing antibodies (NAb) and anti-c...
Firth EC, Wensing T, Seuren F.The effects of intra-articular injection of small amounts of E. coli lipopolysaccharide (LPS) into the intercarpal joint of 5 ponies were studied. The LPS induced predictable changes all of which were analogous to acute bacterial infection, except that the development of signs occurred sooner after the LPS injection, and subsided within 36 hours. Fever was monophasic and peaked at 5-7 hours. The ponies exhibited depression, reduced or absent appetite, increased pulse and respiration rates, and lameness. The lameness became evident between 1 and 2 hours after injection, at which time warmth, ar...
Fischer BM, McMullen RJ, Reese S, Brehm W.Despite appropriate medical therapy, many horses with equine recurrent uveitis continue to suffer from recurrent bouts of inflammation. Surgical intervention via the pars plana vitrectomy or suprachoroidal cyclosporine implant placement may control and/or prevent recurrences, however, these procedures may be contraindicated, unavailable, or declined by an owner. Thus, an effective adjunctive treatment option may help to improve the clinical outcomes in those situations. There are several anecdotal reports on the use of intravitreal gentamicin injections, but to date, no data evaluating the com...
DePhillipo NN, Hendesi H, Aman ZS, Lind DRG, Smith J, Dodge GR.To evaluate the efficacy of fibroblast growth factor-18 (FGF-18) augmentation for improving articular cartilage healing following surgical repair in preclinical () animal models. A systematic review was performed evaluating the efficacy of FGF-18 augmentation with cartilage surgery compared with cartilage surgery without FGF-18 augmentation in living animal models. Eligible intervention groups were FGF-18 treatment in conjunction with orthopedic procedures, including microfracture, osteochondral auto/allograft transplantation, and cellular-based repair. Outcome variables were: International Ca...
Vekens EV, Bergman EH, Vanderperren K, Raes EV, Puchalski SM, Bree HJ, Saunders JH.To provide a detailed computed tomography (CT) reference of the anatomically normal equine stifle joint. Sample-16 hind limbs from 8 equine cadavers; no horses had evidence of orthopedic disease of the stifle joints. Methods: CT of the stifle joint was performed on 8 hind limbs. In all limbs, CT was also performed after intra-articular injection of 60 mL of contrast material (150 mg of iodine/mL) in the lateral and medial compartments of the femorotibial joint and 80 mL of contrast material in the femoropatellar joint (CT arthrography). Reformatted CT images in the transverse, parasagittal, an...
Love CC, Varner DD, Thompson JA.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...
Beaulieu A, Linden AZ, Phillips J, Arroyo LG, Koenig J, Monteith G.In the equine racehorse industry, reduced athletic performance due to joint injury and lameness has been extensively reviewed. Intra-articular injections of glucocorticoids are routinely used to relieve pain and inflammation associated with osteoarthritis. Intra-articular injections of pharmaceutical agents require practice for precise needle placement and to minimize complications. Training on simulators or models is a viable alternative for developing these technical skills. The purpose of this study was to compare the qualitative ultrasonographic characteristics of three-dimensional (3D) pr...
