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Topic:Lameness

Lameness in horses is a condition characterized by an abnormal gait or stance due to pain or mechanical dysfunction affecting the limbs or spine. It is a common issue in equine practice and can result from a variety of causes, including injury, infection, or degenerative diseases. Lameness can affect a horse's performance and quality of life, making accurate diagnosis and management important for equine health. Diagnostic techniques often include physical examination, imaging, and gait analysis. This page aggregates peer-reviewed research studies and scholarly articles that explore the etiology, diagnostic methods, and management strategies for lameness in horses.
Evaluation of a modified subchondroplasty technique in an equine full-thickness cartilage defect model: a pilot study.
American journal of veterinary research    February 27, 2023   Volume 84, Issue 4 ajvr.22.12.0219 doi: 10.2460/ajvr.22.12.0219
Smanik LE, Selberg KT, Mason GL, Brock M, Stewart HL, Goodrich LR, Kawcak CE.To perform a pilot study with the intent of assessing the feasibility of a modified subchondroplasty (mSCP) technique in a validated preclinical equine model of full-thickness articular cartilage loss and evaluate the short-term patient response to the injected materials. Methods: 3 adult horses. Methods: Two 15-mm-diameter full-thickness cartilage defects were created on the medial trochlear ridge of each femur. Defects were treated with microfracture and then filled by 1 of 4 techniques: (1) autologous fibrin graft (FG) via subchondral injection of fibrin glue (FG), (2) autologous fibrin gra...
Digital lamellar inflammatory signaling in an experimental model of equine preferential weight bearing.
Journal of veterinary internal medicine    February 24, 2023   Volume 37, Issue 2 681-688 doi: 10.1111/jvim.16662
Burns TA, Watts MR, Belknap JK, van Eps AW.Supporting limb laminitis (SLL) is a complication of severe orthopedic disease in horses and is often life-limiting, yet the pathophysiology remains obscure. Objective: To investigate the role of digital lamellar inflammatory signaling in the pathophysiology of SLL using a model of unilateral weight bearing, hypothesizing that there would be evidence of lamellar inflammation in limbs subjected to the model. Methods: Thirteen healthy adult Standardbred horses were used for this study (11 geldings, 2 mares; mean age 6.5 ± 2.5 years; mean body weight 458.3 ± 32.8 kg). Methods: Randomized...
Onchocerca sp. in an imported Zangersheide gelding causing suspensory ligament desmitis.
Journal of veterinary internal medicine    February 23, 2023   Volume 37, Issue 2 735-739 doi: 10.1111/jvim.16653
Brown KA, Johnson AL, Bender SJ, Nolan TJ, Pfisterer B, Slack J, Willis E, Rule EK.A 5-year-old imported Zangersheide gelding was evaluated for SC swellings over both forelimbs and lameness localized to the distal metacarpus. Ultrasound examination of the SC masses was compatible with verminous granulomas. Linear hyperechoic foci were present within the suspensory ligament branches of both forelimbs, suggestive of ligamentous parasitic infiltrates. A diagnosis of onchocerciasis was confirmed on biopsy of a SC mass. The gelding was treated with ivermectin and a tapering course of PO dexamethasone but was eventually euthanized. Necropsy confirmed the presence of SC eosinophili...
Systematic review and meta-analysis of positive long-term effects after intra-articular administration of orthobiologic therapeutics in horses with naturally occurring osteoarthritis.
Frontiers in veterinary science    February 23, 2023   Volume 10 1125695 doi: 10.3389/fvets.2023.1125695
Mayet A, Zablotski Y, Roth SP, Brehm W, Troillet A.Equine veterinarians face challenges in treating horses with osteoarthritic joint pain in routine veterinary practice. All common treatment options aim to reduce the clinical consequences of osteoarthritis (OA) characterized by persistent synovitis and progressive degradation of articular cartilage. A range of joint-associated cell types and extracellular matrices are involved in the not yet entirely understood chronic inflammatory process. Regeneration of articular tissues to re-establish joint hemostasis is the future perspective when fundamental healing of OA is the long-term goal. The use ...
Reattachment of Osteochondritis Dissecans Lesions in the Lateral Femoral Trochlear Ridge With Bioabsorbable Screws in 4 Yearling Standardbreds.
Journal of equine veterinary science    February 10, 2023   Volume 123 104242 doi: 10.1016/j.jevs.2023.104242
Bertuglia A, Pallante M, Pillon G, Valle D, Pagliara E, Riccio B.This case series describes an alternative surgical technique to obtain reattachment of osteochondritis dissecans (OCD) lesions in the lateral trochlear ridge of the femur (LTRF) as well as the clinical and radiological outcome of treated cases. Four Standardbred yearlings (6 lesions in total) underwent surgical fixation of large OCD defects in the LTRF under arthroscopic guidance. Reattachment of the OCD lesions was obtained using 3.0/3.7 mm headless bio-compression and absorbable poly-l-lactic acid (PLLA) screws, inserted perpendicularly to the cartilage surface through the lesion. All horse...
Bilateral patellar aplasia in a foal.
Veterinary medicine and science    February 3, 2023   Volume 9, Issue 3 1143-1148 doi: 10.1002/vms3.1083
Ludwig EK, Hallowell K, Womble M, O'Neil E.A 2-day-old Cleveland Bay colt was referred to the Equine Emergency Service of the Farm Animal and Equine Veterinary Medical Center at North Carolina State University's College of Veterinary Medicine for evaluation of decreased nursing behaviour and right hindlimb lameness of 2 days' duration. When assisted to stand, the foal was unable to extend either hindlimb or bear weight on the hindlimbs, the right patella was luxated laterally and unable to be reduced, and the foal assumed a crouched position. Stifle radiographs revealed minimal, heterogeneous, ill-defined ossification of both patellae....
Equine Granulocytic Anaplasmosis.
The Veterinary clinics of North America. Equine practice    February 1, 2023   Volume 39, Issue 1 133-145 doi: 10.1016/j.cveq.2022.11.011
Oliver A, Conrado FO, Nolen-Walston R.Equine granulocytic anaplasmosis is a clinically significant and common disease of equids that has a broader prevalence than was once thought. The most common clinical signs include high fever and edema, with mild to mderate thrombocytopenia and lymphopenia typically noted on complete blood count. Subclinical cases are reported and many are self-limiting. Rare clinical presentations include neurologic disease, vasculitis, dysphagia, rhabdomyolysis, or bicavitary effusion. Most cases resolve rapidly with appropriate antimicrobial intervention.
Identification of a previously unreported site of subchondral bone injury in the dorsodistolateral calcaneus in Thoroughbred racehorses.
Equine veterinary journal    January 30, 2023   doi: 10.1111/evj.13928
Melly V, Ortved KF, Manzi TJ, Richardson DW, Stefanovski D, Wulster KB.Increasing accessibility and advancements in computed tomographic (CT) imaging improve understanding of the contributors to poor performance in the Thoroughbred racehorse. Objective: To characterise an unreported site of tarsal subchondral bone injury (SBI) in Thoroughbred racehorses. Methods: Retrospective, cross-sectional analytical study. Methods: Tarsal CT scans of 108 horses were reviewed for evidence of SBI in the dorsodistolateral calcaneus (DDLC). Signalment, including age, breed, sex, and discipline of horses, was recorded. The association of DDLC SBI with Thoroughbred racehorse compa...
Is Markerless More or Less? Comparing a Smartphone Computer Vision Method for Equine Lameness Assessment to Multi-Camera Motion Capture.
Animals : an open access journal from MDPI    January 24, 2023   Volume 13, Issue 3 390 doi: 10.3390/ani13030390
Lawin FJ, Byström A, Roepstorff C, Rhodin M, Almlöf M, Silva M, Andersen PH, Kjellström H, Hernlund E.Computer vision is a subcategory of artificial intelligence focused on extraction of information from images and video. It provides a compelling new means for objective orthopaedic gait assessment in horses using accessible hardware, such as a smartphone, for markerless motion analysis. This study aimed to explore the lameness assessment capacity of a smartphone single camera (SC) markerless computer vision application by comparing measurements of the vertical motion of the head and pelvis to an optical motion capture multi-camera (MC) system using skin attached reflective markers. Twenty-five...
Prediction of continuous and discrete kinetic parameters in horses from inertial measurement units data using recurrent artificial neural networks.
Scientific reports    January 13, 2023   Volume 13, Issue 1 740 doi: 10.1038/s41598-023-27899-4
Parmentier JIM, Bosch S, van der Zwaag BJ, Weishaupt MA, Gmel AI, Havinga PJM, van Weeren PR, Braganca FMS.Vertical ground reaction force (GRFz) measurements are the best tool for assessing horses' weight-bearing lameness. However, collection of these data is often impractical for clinical use. This study evaluates GRFz predicted using data from body-mounted IMUs and long short-term memory recurrent neural networks (LSTM-RNN). Twenty-four clinically sound horses, equipped with IMUs on the upper-body (UB) and each limb, walked and trotted on a GRFz measuring treadmill (TiF). Both systems were time-synchronised. Data from randomly selected 16, 4, and 4 horses formed training, validation, and test dat...
Ultrasonographic comparison of the intermediate patellar ligament in warmbloods versus quarter horses. Cannon JK, Ellis KL.Striations are present on ultrasonography of the intermediate (middle) patellar ligament in the transverse plane, which can be confused with tears. Comparison to the contralateral limb is often performed to help differentiate anatomic variation from pathologic change. The purposes of this prospective, observational study were to describe the striation patterns in Warmbloods and Quarter Horses, determine if these patterns are bilaterally symmetrical, and compare striation characteristics between Warmbloods and Quarter Horses. The intermediate patellar ligaments of six Warmblood horses and six Q...
Synopsis of the pharmacokinetics, pharmacodynamics, applications, and safety of firocoxib in horses.
Veterinary and animal science    January 11, 2023   Volume 19 100286 doi: 10.1016/j.vas.2023.100286
Fadel C, Giorgi M.According to in vitro and in vivo investigations, firocoxib (FX), a second-generation coxib, is a highly selective COX-2 inhibitor in horses. With a COX-1/COX-2 IC50 ratio of 643 in horses, FX spares the COX-1 inhibitory effects. It is approved for the treatment of musculoskeletal problems and lameness in horses and dogs with osteoarthritis (OA). For the treatment of OA in horses, both an injectable formulation for IV administration at a dose of 0.09 mg/kg for five days and an oral paste formulation at a dose of 0.1 mg/kg for 14 days are licensed. Numerous analytical methods were reported in...
Heart rate variability during high-speed treadmill exercise and recovery in Thoroughbred racehorses presented for poor performance.
Equine veterinary journal    January 10, 2023   Volume 55, Issue 5 727-737 doi: 10.1111/evj.13908
Hammond A, Sage W, Hezzell M, Smith S, Franklin S, Allen K.Heart rate variability (HRV) analysis measures the inter-beat interval variation of successive cardiac cycles. Measurement of these indices has been used to assess cardiac autonomic modulation and for arrhythmia identification in exercising horses. Objective: To report HRV indices during submaximal exercise, strenuous exercise and recovery, and explore relationships with clinical conditions (arrhythmias, lameness, equine gastric ulcer syndrome [EGUS], lower airway inflammation and upper respiratory tract obstructions [URTOs]) in Thoroughbred racehorses. Methods: Retrospective, observational cr...
Percutaneous full endoscopic foraminotomy for treatment of cervical spinal nerve compression in horses using a uniportal approach: Feasibility study.
Equine veterinary journal    January 10, 2023   Volume 55, Issue 5 788-797 doi: 10.1111/evj.13919
Swagemakers JH, Van Daele P, Mageed M.Cervical spinal nerve insult can be a sequel of osteoarthropathy in horses due to enlargement of the articular processes (AP). Objective: To describe the percutaneous endoscopic cervical foraminotomy procedure in horses. Methods: Ex vivo experimental study and clinical case report. Methods: The technique was performed in three equine cadavers and in two clinical cases with history of forelimb lameness located in the caudal cervical region. Briefly, the horse was positioned in lateral recumbency, with the affected AP joint uppermost. Under fluoroscopic guidance, the endoscopic instruments (Ø 6...
Effect of age at training initiation on hoof morphology and lameness in juvenile American Quarter Horses.
Equine veterinary journal    January 9, 2023   Volume 55, Issue 5 765-776 doi: 10.1111/evj.13913
Kawahisa-Piquini G, Bass LD, Pezzanite LM, Moorman VJ.Lameness, discipline, training intensity, environmental variability, and shoeing are all factors demonstrated to affect hoof loading and therefore act as adaptive stimuli to alter hoof morphology. Objective: To evaluate the effect of age at training initiation on hoof morphology and lameness incidence and determine if specific hoof morphology measurements correlate with lameness in juvenile American Quarter Horses. Methods: Prospective cohort study. Methods: American Quarter Horses (n = 42; 29 two-year-olds, 13 three-year-olds) entering training were monitored for hoof morphology and lamenes...
Prevalence and clinical significance of increasing head height asymmetry as a measure of forelimb lameness in horses when trotting in a straight line after palmar digital nerve block.
Equine veterinary journal    January 5, 2023   doi: 10.1111/evj.13921
Kolding SA, Sørensen JN, Kramer J, McCracken MJ, Reed SK, Keegan KG.Some horses increase in forelimb lameness, measured as vertical head height asymmetry, or differences in maximums and minimums of head heights (HDmax, HDmin), after a palmar digital nerve (PDN) block. The prevalence of this finding, or what it means clinically, has not been reported in peer-reviewed literature. Objective: To estimate the prevalence of increasing head height asymmetry after a PDN block and determine if this is associated with cause of forelimb lameness. Methods: Retrospective case series. Methods: Head height asymmetry, normalised to expected vertical head displacement, from in...
Equine blood flow restriction training: Safety validation.
Equine veterinary journal    January 4, 2023   Volume 55, Issue 5 872-883 doi: 10.1111/evj.13904
Johnson SA, Frisbie DD, Griffenhagen GM, King MR.Blood flow restriction (BFR) has become a key rehabilitative tool for human orthopaedic conditions. With modernised technology and evolution of clinical application, patient-specific delivery of occlusion percentages is now considered the standard of care in human patients due to improved therapeutic outcomes and minimised safety risks. Safety validation and limb occlusion pressure (LOP) data for horses, however, are lacking. Objective: (1) To determine if BFR exposure resulted in forelimb biomechanical gait dysfunction as safety validation and (2) to investigate inter-horse and inter-limb LOP...
A one-health lens offers new perspectives on the importance of endocrine disorders in the equine athlete.
Journal of the American Veterinary Medical Association    January 2, 2023   Volume 261, Issue 2 153-164 doi: 10.2460/javma.22.11.0485
Manfredi JM, Jacob S, Norton E.Endocrine disorders are associated with joint pain and tendon injury in humans, but the effects in the horse are only starting to be understood. Similar patterns of clinical signs and injury appear to affect horses and humans for both orthopedic and endocrine disorders, supporting the use of a one-health approach to tackle these issues. In this Currents in One Health, we will discuss common equine endocrinopathies, current testing recommendations, dietary management, genetic predispositions, and endocrine disorders' effects on performance. Our aim is to use a one-health lens to describe curren...
Treponema spp. spirochetes and keratinopathogenic fungi isolated from keratomas in donkeys.
Veterinary pathology    December 24, 2022   Volume 60, Issue 2 190-198 doi: 10.1177/03009858221144730
Paraschou G, Cook JM, Priestnall SL, Evans NJ, Staton GJ, Paterson GK, Winkler B, Whitbread TJ.Keratoma is an aberrant keratin mass thought to originate from epidermal horn-producing cells interposed between the stratum medium of the hoof wall and the underlying third phalanx. The cause is unknown, although the presence of keratomas is frequently associated with chronic irritation, focal infection, or trauma. A total of 167 donkeys with keratomas were presented in this study. The diagnosis of a keratoma was based on clinical signs, radiography, and histopathologic examination. Surgical excision was attempted on all donkeys with lameness unless euthanasia was advised. Histopathologic exa...
Validation of inertial measurement units to detect and predict horse behaviour while stabled.
Equine veterinary journal    December 20, 2022   doi: 10.1111/evj.13909
Anderson K, Morrice-West AV, Walmsley EA, Fisher AD, Whitton RC, Hitchens PL.Musculoskeletal injuries are observed in Thoroughbred racehorses and may become catastrophic. Currently, there are limited methods for early detection of such injuries. Most injuries develop gradually due to accumulated damage, providing the opportunity for early detection. Horses experiencing pain or lameness may exhibit changes in behaviour so the development of an objective, real-time system monitoring horse behaviour may enable detection of bone injuries before catastrophic failure. Objective: To determine whether intensive observational methods of assessing horse behaviour can be replaced...
Plasma Amino Acid Concentration in Obese Horses with/without Insulin Dysregulation and Laminitis.
Animals : an open access journal from MDPI    December 18, 2022   Volume 12, Issue 24 3580 doi: 10.3390/ani12243580
Stoeckle SD, Timmermann D, Merle R, Gehlen H.Laminitic horses commonly suffer from an endocrine disease such as equine metabolic syndrome. Hyperinsulinemia is considered a key factor in the pathogenesis of laminitis. Since insulin also affects protein turnover in the body, the resting plasma amino acid concentrations of obese horses that were presented for a combined glucose insulin test (CGIT) were determined. In total, 25 obese horses and two lean horses with recurrent laminitis underwent a CGIT. Of these, five were not insulin dysregulated (obese), 14 were insulin dysregulated (ID), and eight were insulin-dysregulated and laminitic (I...
Adaptations in equine axial movement and muscle activity occur during induced fore- and hindlimb lameness: A kinematic and electromyographic evaluation during in-hand trot.
Equine veterinary journal    December 14, 2022   doi: 10.1111/evj.13906
Spoormakers TJP, St George L, Smit IH, Hobbs SJ, Brommer H, Clayton HM, Roy SH, Richards J, Serra Bragança FM.The inter-relationship between equine thoracolumbar motion and muscle activation during normal locomotion and lameness is poorly understood. Objective: To compare thoracolumbar and pelvic kinematics and longissimus dorsi (longissimus) activity of trotting horses between baseline and induced forelimb (iFL) and hindlimb (iHL) lameness. Methods: Controlled experimental cross-over study. Methods: Three-dimensional kinematic data from the thoracolumbar vertebrae and pelvis, and bilateral surface electromyography (sEMG) data from longissimus at T14 and L1, were collected synchronously from clinicall...
Pharmacokinetics and pharmacodynamics of intra-articular isoflupredone following administration to horses with lipopolysaccharide-induced synovitis.
BMC veterinary research    December 13, 2022   Volume 18, Issue 1 436 doi: 10.1186/s12917-022-03537-5
Knych HK, Weiner D, Harrison L, McKemie DS.Intra-articular corticosteroids, such as isoflupredone acetate, are commonly used in the treatment of joint inflammation, especially in performance horses. Following administration in a non-inflamed joints blood concentrations of isoflupredone were low and detectable for only a short period of time post-administration compared to synovial fluid concentrations. For some drugs, inflammation can affect pharmacokinetics, therefore, the goal of the current study was to describe the pharmacokinetics of isoflupredone acetate following intra-articular administration using a model of acute synovitis. S...
Investigation of Thresholds for Asymmetry Indices to Represent the Visual Assessment of Single Limb Lameness by Expert Veterinarians on Horses Trotting in a Straight Line.
Animals : an open access journal from MDPI    December 11, 2022   Volume 12, Issue 24 3498 doi: 10.3390/ani12243498
Macaire C, Hanne-Poujade S, De Azevedo E, Denoix JM, Coudry V, Jacquet S, Bertoni L, Tallaj A, Audigié F, Hatrisse C, Hébert C, Martin P, Marin F....Defining whether a gait asymmetry should be considered as lameness is challenging. Gait analysis systems now provide relatively accurate objective data, but their interpretation remains complex. Thresholds for discriminating between horses that are visually assessed as being lame or sound, as well as thresholds for locating the lame limb with precise sensitivity and specificity are essential for accurate interpretation of asymmetry measures. The goal of this study was to establish the thresholds of asymmetry indices having the best sensitivity and specificity to represent the visual single-lim...
Investigation of MicroRNA Biomarkers in Equine Distal Interphalangeal Joint Osteoarthritis.
International journal of molecular sciences    December 8, 2022   Volume 23, Issue 24 15526 doi: 10.3390/ijms232415526
Baker ME, Lee S, Clinton M, Hackl M, Castanheira C, Peffers MJ, Taylor SE.Osteoarthritis of the equine distal interphalangeal joint is a common cause of lameness. MicroRNAs from biofluids are promising biomarkers and therapeutic candidates. Synovial fluid samples from horses with mild and severe equine distal interphalangeal joint osteoarthritis were submitted for small RNA sequencing. The results demonstrated that miR-92a was downregulated in equine synovial fluid from horses with severe osteoarthritis and there was a significant increase in COMP, COL1A2, RUNX2 and SOX9 following miR-92a mimic treatment of equine chondrocytes in monolayer culture. This is the first...
Agmatine Administration Effects on Equine Gastric Ulceration and Lameness.
Journal of clinical medicine    December 8, 2022   Volume 11, Issue 24 doi: 10.3390/jcm11247283
Taguchi T, Morales Yniguez FJ, Takawira C, Andrews FM, Lopez MJ.Osteoarthritis (OA) accounts for up to 60% of equine lameness. Agmatine, a decarboxylated arginine, may be a viable option for OA management, based on reports of its analgesic properties. Six adult thoroughbred horses, with lameness attributable to thoracic limb OA, received either daily oral phenylbutazone (6.6 mg/kg), agmatine sulfate (25 mg/kg) or a control for 30 days, with 21-day washout periods between treatments. Subjective lameness, thoracic limb ground reaction forces (GRF), plasma agmatine and agmatine metabolite levels were evaluated using an established rubric, a force platform, an...
A Case Series of 11 Horses Diagnosed with Bone Spavin Treated with High Intensity Laser Therapy (HILT).
Journal of equine veterinary science    December 2, 2022   Volume 120 104188 doi: 10.1016/j.jevs.2022.104188
Zielińska P, Śniegucka K, Kiełbowicz Z.The aim of this work was to characterize and describe the effect of High Intensity Laser Therapy (HILT) used in the treatment of chronic osteoarthritis in horses. Over a 2 year period, 11 horses with diagnosed bone spavin were treated with HILT as a monotherapy. The horses chosen for this report presented hind limb lameness, were positive in a spavin flexion test and showed improvement after intra-articular anesthesia of the tarsometatarsal joint. Additionally, all the horses presented radiological signs of tarsus osteoarthritis and had not been treated for bone spavin for a minimum of 6 month...
Residual effects of intra-articular betamethasone and triamcinolone acetonide in an equine acute synovitis model.
Equine veterinary journal    December 1, 2022   Volume 55, Issue 5 905-915 doi: 10.1111/evj.13899
Partridge E, Adam E, Wood C, Parker J, Johnson M, Horohov D, Page A.Intra-articular (IA) corticosteroids are regularly used in equine athletes for the control of joint inflammation. Objective: The goal of this study was to use an acute synovitis inflammation model to determine the residual effects of IA betamethasone and triamcinolone acetonide on various inflammatory parameters and lameness. Methods: Crossover randomised trial. Methods: Five mixed-breed, 2-year-old horses were randomly allocated to an IA treatment of the radiocarpal joint with 9 mg of either betamethasone or triamcinolone acetonide. Two weeks following treatment, horses were injected with 1Â...
Modified toggle pin technique combined with prosthetic capsular reconstruction for surgical stabilization of coxofemoral luxation in a Shetland pony.
Veterinary surgery : VS    November 21, 2022   Volume 52, Issue 2 221-228 doi: 10.1111/vsu.13915
Müller EMT, Ehrle A, Pozzi A, Lasarzik de Ascurra J, Lischer CJ, Kümmerle JM.To describe open reduction and surgical stabilization of a coxofemoral luxation in a pony using a modified toggle pin technique and prosthetic joint capsule reconstruction without osteotomy of the greater trochanter. Methods: A 2-year-old Shetland pony with a bodyweight of 167 kg. Methods: Case report. Methods: Radiographic examination confirmed craniodorsal luxation of the left coxofemoral joint. An open reduction with the aid of a pulley system was performed. A toggle pin was inserted through a bone tunnel extending from the level of the femoral shaft through the femoral head and the cente...
Effects of intra-articular injection of an acellular equine liquid amniotic allograft in healthy equine joints.
Veterinary surgery : VS    November 21, 2022   Volume 52, Issue 1 62-68 doi: 10.1111/vsu.13918
Wolkowski DD, McCarthy RD, Schoonover MJ, Taylor JD, Eastman TG.Evaluate effects of acellular equine liquid amnion allograft (ELAA) injected into healthy equine joints. Methods: Randomized, blinded, controlled experiment. Methods: Eight healthy adult horses. Methods: One intercarpal joint (ICJ) of each horse was randomly assigned to be injected with 1.5 ml of ELAA (treatment) while the contralateral ICJ was injected with 1.5 ml of 0.9% NaCl (control). Subjective lameness evaluation, force plate analysis, and synovial fluid analysis, including interleukin-1 receptor antagonist (IL-1ra) analysis, were performed before (day 0) and at days 1, 3, 5, and 10. S...
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