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.
Use of ultrasound-guided autologous bone marrow transfer for treatment of suspensory ligament desmitis in 30 race horses (2003-2010). To evaluate the racing performance of horses that underwent ultrasound-guided intralesional injection of autologous bone marrow aspirate for treatment of selected forelimb suspensory ligament (body or branch) core lesions. Methods: Retrospective cohort study of 13 Standardbred and 17 Thoroughbred race horses. Methods: Autologous bone marrow aspirated from the sternebrae was injected, under ultrasound guidance, into suspensory ligament core lesions (body or branch). Racing records were reviewed for a comparison of performance before and after surgery. Results: Of the 13 Standardbreds, 9 (69%) h...
Therapeutic effect of adipose-derived mesenchymal stem cell injection in horses suffering from bone spavin. In this article we demonstrate the efficiency of autologous transplantations of adipose-derived mesenchymal stem cells for equine bone spavin treatment. Horses qualified to the study were divided into three groups: (i) research - treated with intra-articular injections of autologous stem cells, (ii) comparison treated with steroid drugs and (iii) control - untreated. All animals underwent comprehensive clinical examination before and after treatment. Our research confirms the long-term beneficial influence resulting from stem cell therapy in horse bone spavin treatment, in contrast to routine ...
Retrospective evaluation of facilitated pastern ankylosis using intra-articular ethanol injections: 34 cases (2006-2012). While surgical arthrodesis is the treatment of choice for osteoarthritis of the proximal interphalangeal joint, some clients are unable to pursue surgery due to costs. A more economical technique was sought using intra-articular ethyl alcohol injections to facilitate ankylosis. Objective: To describe the technique and outcome of intra-articular ethyl alcohol injections for facilitated ankylosis of proximal interphalangeal joints with osteoarthritis. Methods: As a retrospective case series, the medical records (2006-2012) of clinical cases diagnosed with proximal interphalangeal joint osteoarth...
Response to injection of the navicular bursa with corticosteroid and hyaluronan following high-field magnetic resonance imaging in horses with signs of navicular syndrome: 101 cases (2000-2008). To determine treatment outcome on the basis of pathological changes identified on MRI and lameness duration in horses with navicular syndrome that underwent injection of corticosteroid and hyaluronan into the navicular bursa. Methods: Retrospective case series. Methods: 101 horses with navicular syndrome. Methods: Medical records of horses with signs of navicular syndrome evaluated between January 2000 and December 2008 were reviewed. Data on signalment, use of the horse, history, affected limbs, duration of lameness, findings on lameness examination, radiographic findings, MRI findings, treat...
In vivo effects of a single intra-articular injection of 2% lidocaine or 0.5% bupivacaine on articular cartilage of normal horses. 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...
Pharmacokinetics of methylprednisolone acetate after intra-articular administration and subsequent suppression of endogenous hydrocortisone secretion in exercising horses. To determine the pharmacokinetics of methylprednisolone (MP) and the relationship between MP and hydrocortisone (HYD) concentrations in plasma and urine after intra-articular (IA) administration of 100 or 200 mg of MP acetate (MPA) to horses. Methods: Five 3-year-old Thoroughbred mares. Methods: Horses exercised on a treadmill 3 times/wk during the study. Horses received 100 mg of MPA IA, then 8 weeks later received 200 mg of MPA IA. Plasma and urine samples were obtained at various times for 8 weeks after horses received each dose of MPA; concentrations of MP and HYD were determined. Pharmaco...
The isolated perfused equine distal limb as an ex vivo model for pharmacokinetic studies. Even though intra-articular injections play an important role in the treatment of joint-related lameness in horses, little is known about pharmacokinetic properties of substances used. Therefore, an ex vivo model for pharmacokinetic studies was developed using distal forelimbs of slaughtered horses. The extremity was perfused with gassed Tyrode solution for up to 8 h. Tissue viability was confirmed by measurements of glucose consumption, lactate production, and lactate dehydrogenase activity in the perfusate. Standard criteria for tissue viability had been determined in preliminary experiments...
Evaluation of the inflammatory response in experimentally induced synovitis in the horse: a comparison of recombinant equine interleukin 1 beta and lipopolysaccharide. To compare two transient models of synovitis-osteoarthritis (OA) in horses by characterizing biological changes in synovial fluid and joint tissue. Methods: Twelve skeletally mature mares were utilized in a block design. Synovitis was induced by an intra-articular injection of 100 ng recombinant equine interleukin 1 beta (reIL-1β) or 0.5 ng lipopolysaccharide (LPS) into a middle carpal joint in 1 ml volumes. One ml of saline was injected into the contra-lateral control joint. Lameness evaluations were conducted through post-injection hour (PIH) 8 (at which time arthroscopic removal of syno...
Effects of intra-articular sodium pentosan polysulfate and glucosamine on the cytology, total protein concentration and viscosity of synovial fluid in horses. 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...
Pharmacokinetics of dexamethasone following intra-articular, intravenous, intramuscular, and oral administration in horses and its effects on endogenous hydrocortisone. This study investigated and compared the pharmacokinetics of intra-articular (IA) administration of dexamethasone sodium phosphate (DSP) into three equine joints, femoropatellar (IAS), radiocarpal (IAC), and metacarpophalangeal (IAF), and the intramuscular (IM), oral (PO) and intravenous (IV) administrations. No significant differences in the pharmacokinetic estimates between the three joints were observed with the exception of maximum concentration (Cmax ) and time to maximum concentration (Tmax ). Median (range) Cmax for the IAC, IAF, and IAS were 16.9 (14.6-35.4), 23.4 (13.5-73.0), and 46.9...
Comparison of four techniques of arthrocentesis of the lateral compartment of the femorotibial joint of the horse. Clinical experiences indicate that centesis of the lateral compartment of the femorotibial joint is often unsuccessful. Objective: To determine the accuracy of 2 published and 2 unpublished techniques of centesis of the lateral compartment of the femorotibial joint. Objective: It was hypothesised that a drug can be administered into the lateral compartment of the femorotibial joint via a diverticulum of this joint that surrounds the medial aspect of the long digital extensor tendon and that this technique is more accurate than described techniques of centesis of this compartment. Methods: Twen...
Influence of exercise on the distribution of technetium Tc 99m medronate following intra-articular injection in horses. To determine the effects of exercise on the distribution and pharmacokinetics of technetium Tc 99m medronate ((99m)Tc-MDP) following intra-articular (IA) injection in horses. Methods: 5 horses. Methods: 1 antebrachiocarpal joint (ACJ)/horse was assigned to the exercised group (n = 5), and the contralateral ACJ was evaluated in the nonexercised group (5) after a minimum washout period of 7 days. Following IA injection of (99m)Tc-MDP (148 MBq), blood and scintigraphic images of the carpus were obtained at 5, 10, 15, 20, 25, 30, 45, 60, 90, 120, 240, 360, 480, 600, 720, and 1,440 minutes. Plasma ...
Comparison of ultrasound-guided vs. ‘blind’ techniques for intra-synovial injections of the shoulder area in horses: scapulohumeral joint, bicipital and infraspinatus bursae. Diagnosis and treatment of pathologies involving synovial structures in the shoulder region are technically difficult. Ultrasound-guided (UG) injection techniques have been shown to be highly accurate, safe and reliable for various structures in human and equine patients. Objective: To develop easy-to-use and reliable UG injection techniques for the infraspinatus bursa (IB), bicipital bursa (BB) and scapulohumeral joint (SHJ) and to compare them with conventional 'blind' methods. Methods: Eight pairs of equine shoulders were positioned on a computed-tomography (CT) table with left and right sh...
Inflammation and immune response of intra-articular serotype 2 adeno-associated virus or adenovirus vectors in a large animal model. Intra-articular gene therapy has potential for the treatment of osteoarthritis and rheumatoid arthritis. To quantify in vitro relative gene transduction, equine chondrocytes and synovial cells were treated with adenovirus vectors (Ad), serotype 2 adeno-associated virus vectors (rAAV2), or self-complementary (sc) AAV2 vectors carrying green fluorescent protein (GFP). Using 6 horses, bilateral metacarpophalangeal joints were injected with Ad, rAAV2, or scAAV2 vectors carrying GFP genes to assess the in vivo joint inflammation and neutralizing antibody (NAb) titer in serum and joint fluid. In vit...
Alcohol-facilitated ankylosis of the distal intertarsal and tarsometatarsal joints in horses with osteoarthritis. To assess the safety and efficacy of alcohol-facilitated ankylosis of the distal intertarsal (DIT) and tarsometatarsal (TMT) joints in horses with osteoarthritis (bone spavin). Methods: Prospective clinical trial. Methods: 21 horses with DIT or TMT joint-associated hind limb lameness and 5 nonlame horses. Methods: 11 horses (group 1) underwent lameness, force-plate, and radiographic examinations; following intra-articular analgesia, lameness and force-plate examinations were repeated. Nonlame horses were used for force-plate data acquisition only. Following localization of lameness to the DIT ...
Scintigraphic evaluation of intra-arterial and intravenous regional limb perfusion of allogeneic bone marrow-derived mesenchymal stem cells in the normal equine distal limb using (99m) Tc-HMPAO. Mesenchymal stem cells (MSCs) are commonly injected intralesionally for treatment of soft tissue injuries in the horse. Alternative routes of administration would be beneficial for treatment of lesions that cannot be accessed directly or to limit needle-induced iatrogenic damage to the surrounding tissue. Objective: The purpose of our study was to evaluate MSC distribution after intra-arterial (IA) and intravenous (IV) regional limb perfusions (RLP) using scintigraphy. We hypothesised that MSCs would persist in the distal limb after tourniquet removal and that both techniques would lead to dif...
The effect of intralesional injection of bone marrow derived mesenchymal stem cells and bone marrow supernatant on collagen fibril size in a surgical model of equine superficial digital flexor tendonitis. Collagen fibril size is decreased in repair tissue following tendon injury compared to normal tendon matrix in horses. Mesenchymal stem cells have been suggested to promote regeneration of tendon matrix rather than fibrotic repair following injury, although this concept remains unproven. Objective: To explore the hypothesis that implantation of autologous mesenchymal stem cells derived from bone marrow into a surgically created central core defect in the superficial digital flexor tendon (SDFT) of horses would induce the formation of a matrix with greater ultrastructural similarities to tendon...
Use of ethanol in the treatment of distal tarsal joint osteoarthritis: 24 cases. REASONS FOR PERFORMING THIS STUDY: Intra-articular ethanol has been described to promote distal tarsal joint ankylosis. Its use and results in clinical cases affected by osteoarthritis (OA) have not been reported. Objective: To describe and evaluate the results of treatment of distal tarsal joint OA by facilitated ankylosis stimulated by intra-articular ethanol injection. Methods: Twenty-four horses met the inclusion criteria of tarsometatarsal and centrodistal joint OA diagnosed by a positive response to intra-articular analgesia, radiographic evaluation and recurrence of lameness ≤ 4 month...
Oral rosmarinic acid-enhanced Mentha spicata modulates synovial fluid biomarkers of inflammation in horses challenged with intra-articular LPS. 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 ...
Pharmacokinetics of intra-articular, intravenous, and intramuscular administration of triamcinolone acetonide and its effect on endogenous plasma hydrocortisone and cortisone concentrations in horses. To compare pharmacokinetics of triamcinolone acetonide (TA) following i.v., intra-articular (i.a.), and i.m. administration and determine its effect on plasma concentrations of hydrocortisone and cortisone. Methods: 6 Thoroughbreds. Methods: TA (0.04 mg/kg) was administered i.v., i.m., or i.a., and plasma TA, hydrocortisone, and cortisone concentrations were determined. Results: I.v. administration of TA was fitted to a 2-compartment model. Median distribution half-life was 0.50 hours (range, 0.24 to 0.67 hours); elimination half-life was 6.1 hours (range, 5.0 to 6.4 hours). Transfer half-life...
Cell-based therapies for equine joint disease. Joint disease is a major cause of wastage in performance horses. Arthritis can be challenging to treat because articular cartilage has little or no capacity for repair, therapeutic options are limited and are largely targeted at ameliorating clinical signs of joint disease. Cell-based therapies have potential to overcome the intrinsic constraints to articular cartilage repair. This article focuses on cell-based therapies for treatment of equine joint disease. Results from experimental model and human clinical studies are presented along with available data from equine studies.
Evaluation of intra-articular mesenchymal stem cells to augment healing of microfractured chondral defects. This study evaluated intra-articular injection of bone marrow-derived mesenchymal stem cells (BMSCs) to augment healing with microfracture compared with microfracture alone. Methods: Ten horses (aged 2.5 to 5 years) had 1-cm2 defects arthroscopically created on both medial femoral condyles of the stifle joint (analogous to the human knee). Defects were debrided to subchondral bone followed by microfracture. One month later, 1 randomly selected medial femorotibial joint in each horse received an intra-articular injection of either 20 × 10(6) BMSCs with 22 mg of hyaluronan or 22 mg of hyalurona...
Current joint therapy usage in equine practice: a survey of veterinarians 2009. Medications are frequently employed to treat intra-articular (IA) problems in the performance horse. Actual usage of the different IA medications in horses is not available. Objective: To determine the most common usage of these medications, members of the American Association of Equine Practitioners (AAEP) were surveyed. Methods: An email link to an online survey was electronically sent to 6305 AAEP members and the responses tabulated and analysed with a logistic regression model. Results: A total of 831 survey responses were submitted and tabulated. Eighty per cent of the respondents indicat...
Implantation of bone marrow-derived mesenchymal stem cells demonstrates improved outcome in horses with overstrain injury of the superficial digital flexor tendon. Mesenchymal stem (progenitor; stromal) cell (MSC) therapy has gained popularity for the treatment of equine tendon injuries but without reports of long-term follow-up. Objective: To evaluate the safety and reinjury rate of racehorses after intralesional MSC injection in a large study of naturally occurring superficial digital flexor tendinopathy and to compare these data with those published for other treatments. Methods: Safety was assessed clinically, ultrasonographically, scintigraphically and histologically in a cohort of treated cases: 141 client-owned treated racehorses followed-up for a...
Computed tomographic anatomy of the equine stifle joint. 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...
Intra-articular injection of morphine to the horse: establishment of an in vitro-in vivo relationship. In the area of parenteral depots, a strong need exists for the development of suitable in vitro drug release models that might enable establishment of in vitro-in vivo relations (IVIVRs). Objective: The objective of this study was to investigate the possibility of establishing an IVIVR between morphine disappearance from the joint cavity and in vitro release data obtained employing the rotating dialysis cell model. Methods: In vitro release experiments were conducted using the rotating dialysis cell model. For establishment of an IVIVR, data from a previous study on pharmacokinetics of intra-a...
Comparison of medial and lateral ultrasound-guided approaches for periarticular injection of the thoracolumbar intervertebral facet joints in horses. To compare ultrasound-guided lateral and medial approaches for periarticular injections of the thoracolumbar intervertebral facet joints (IFJ). Methods: Experimental cadaveric study. Methods: Adult equine cadavers (n=4). Methods: IFJ (T12-T13 to L5-L6) were identified by ultrasound (transducer perpendicular to the spine axis) and insertion of a 13 cm, 18 g spinal needle monitored until bone contact using medial (right side) and lateral (left side) approaches. Number of needle insertions at each site, needle repositioning, and insertion depth were recorded. On bone contact 2 mL latex was ...
Comparison of three methods of injecting the proximal interphalangeal joint in horses. The efficacy of three methods of injecting the equine proximal interphalangeal (pastern) joint was compared using cadaver limbs. Five veterinary students without prior experience attempted to inject an aqueous radiographic contrast medium into the joint using five limbs for each technique. The number of attempts was recorded and successful injection of the joint was confirmed by the presence of intra-articular contrast on radiographic examination. Levels of accuracy for the dorsal, dorsolateral and palmaroproximal approaches were 32, 48 and 36 per cent, respectively. There was inadvertent inje...
Evaluation of ethyl alcohol for use in a minimally invasive technique for equine proximal interphalangeal joint arthrodesis. To determine whether intra-articular 70% ethyl alcohol alone (IAEA) or in combination with 2 percutaneously placed transarticular lag screws (EA-TLS) would result in arthrodesis of the equine proximal interphalangeal (PIP) joint. Methods: Experimental. Methods: Healthy horses (n=6), aged 1.5-3 years, free of lameness, diagonally paired front and hind PIP joints. Methods: Six milliliters 70% ethyl alcohol was injected into randomly selected diagonally paired front and hind PIP joints. Thirty days later, 2 parallel 5.5 mm cortical screws were inserted in lag fashion across the hind PIP joints an...
Evaluation of gastric pressures as an indirect method for measurement of intraabdominal pressures in the horse. To develop an indirect method for measurement of intraabdominal pressures in the standing horse using measurement of gastric pressures as a less invasive technique, and to compare this method with direct intraabdominal pressures obtained from the peritoneal cavity. Methods: Prospective, experimental study. Methods: University-based equine research facility. Methods: Ten healthy adult horses, 7 geldings and 3 mares. Methods: Gastric pressures were measured using a nasogastric tube with a U-tube manometry technique, while intraperitoneal pressures were measured with a peritoneal cannula. Measure...