A Double-Blinded Positive Control Study Comparing the Relative Efficacy of 2.5% Polyacrylamide Hydrogel (PAAG) Against Triamcinolone Acetonide (TA) And Sodium Hyaluronate (HA) in the Management of Middle Carpal Joint Lameness in Racing Thoroughbreds.
Abstract: The purpose of this prospective double-blinded positive control study was to compare the efficacy of 2.5% polyacrylamide hydrogel (2.5% PAAG) in the management of middle carpal joint lameness in Thoroughbreds against treatments of triamcinolone acetonide (TA) or sodium hyaluronate (HA). A total of 31 flat-racing Thoroughbreds with lameness (grade 1-3/5) localized to the carpus by intra-articular analgesia were selected. Following a radiological assessment of the carpi confirming the absence of fragment/fracture, the horses were randomly assigned for intra-articular treatment with either 2 ml of 2.5% PAAG, 12 mg TA or 20 mg HA (followed by two further intravenous treatments of 40 mg, at weekly intervals in the HA group only), by a treating veterinarian. All horses were rested for 48 hours post-treatment and then re-entered an unaltered training regimen. Subsequent examinations at 2, 4, and 6 weeks were performed by a blinded examining veterinarian for all groups, while horses treated with 2.5% PAAG were monitored for 12 weeks for recurrence of lameness. Significantly more joints treated with 2.5% PAAG were lame free (83%) at 6 weeks compared to TA (27%; P = .007) and to HA (40%; P = .04). There was no significant difference between TA and HA groups at any time. All the joints treated within 2.5% PAAG that were lame free at 6 weeks (10/12) were still lame-free at 12 weeks. In conclusion, treatment with 2.5% PAAG led to statistically superior results compared to TA and HA in the management of selected middle carpal joint lameness in flat-racing Thoroughbreds, with therapeutic effects persisting up to 12 weeks.
Copyright © 2021 The Author(s). Published by Elsevier Inc. All rights reserved.
Publication Date: 2021-09-24 PubMed ID: 34802625DOI: 10.1016/j.jevs.2021.103780Google Scholar: Lookup
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- Journal Article
- Randomized Controlled Trial
- Veterinary
- Research Support
- Non-U.S. Gov't
Summary
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The study investigates the efficiency of 2.5% polyacrylamide hydrogel (PAAG) compared to triamcinolone acetonide (TA) and sodium hyaluronate (HA) in the treatment of middle carpal joint lameness in Racing Thoroughbreds. The study reveals that 2.5% PAAG showed better performance and longer-lasting therapeutic effects.
Procedure Overview
- A total of 31 Thoroughbreds with grade 1-3/5 lameness were considered for the study. Lameness was localized to the carpus, confirmed by intra-articular analgesia.
- The horses underwent a radiological evaluation to confirm the absence of any fragments or fractures in the carpi (the horse’s equivalent of the human wrist).
- The horses were then randomly assigned to receive an intra-articular treatment of either 2 ml of 2.5% PAAG, 12 mg TA, or 20 mg HA. Notably, the HA group received two additional intravenous treatments of 40 mg per week.
- All horses, after the procedure, were rested for 48 hours then re-entered into their standard training regimen.
- The treated horses received weekly examinations at 2, 4, and 6 weeks by a blinded examining veterinarian.
- Horses within the 2.5% PAAG group were positioned under further observation till the 12th week for any recurrence of lameness.
Findings of the Study
- The study found that 83% of joints treated with 2.5% PAAG were free of lameness at 6 weeks. This percentage was significantly higher compared to the TA group at 27% and the HA group at 40%.
- No significant difference was noted between the TA and HA groups at any point during the study.
- All the joints treated with 2.5% PAAG that had no lameness at the 6th week (10 out of 12) remained lameness-free at the 12th week.
Conclusions
- The study concluded that the 2.5% PAAG treatment has a superior efficacy in managing middle carpal joint lameness in flat-racing Thoroughbreds compared to TA and HA.
- Besides, the therapeutic effects of the 2.5% PAAG treatment persisted even up to 12 weeks after treatment, demonstrating a longer-lasting effect than the other two treatments.
Cite This Article
APA
de Clifford LT, Lowe JN, McKellar CD, McGowan C, David F.
(2021).
A Double-Blinded Positive Control Study Comparing the Relative Efficacy of 2.5% Polyacrylamide Hydrogel (PAAG) Against Triamcinolone Acetonide (TA) And Sodium Hyaluronate (HA) in the Management of Middle Carpal Joint Lameness in Racing Thoroughbreds.
J Equine Vet Sci, 107, 103780.
https://doi.org/10.1016/j.jevs.2021.103780 Publication
Researcher Affiliations
- Matamata Veterinary Services Limited, Matamata, New Zealand.
- Innovative Medical Solutions Limited, Cambridge, New Zealand.
- AK & K Equine Services, Miners Rest, Victoria, Australia.
- Equine Clinical Science, University of Liverpool, Leahurst, United Kingdom.
- Equine Veterinary Medical Center, Member of Qatar Foundation, Al Rayyan, Doha, Qatar; College of Health & Life Science, Hamad Bin Khalifa University, Member of Qatar Foundation, Education city, Doha, Qatar. Electronic address: fdavid@qf.org.qa.
MeSH Terms
- Acrylic Resins
- Animals
- Carpal Joints / diagnostic imaging
- Female
- Horse Diseases / drug therapy
- Horses
- Hyaluronic Acid / therapeutic use
- Injections, Intra-Articular / veterinary
- Lameness, Animal / drug therapy
- Pregnancy
- Pregnancy-Associated alpha 2-Macroglobulins
- Prospective Studies
- Triamcinolone Acetonide / therapeutic use
Citations
This article has been cited 6 times.- Aykaç B, Dinç M, Nar ÖO, Karasu R, Bayrak HÇ. Comparative efficacy of polyacrylamide hydrogel versus hyaluronic acid and corticosteroids in knee osteoarthritis: A retrospective cohort study. Medicine (Baltimore) 2025 Sep 19;104(38):e44655.
- Walmod PS, Kusk P, Jøhnk N, Ankorina-Stark I, Essex A. An injectable 2.5% cross-linked polyacrylamide hydrogel (2.5 iPAAG) demonstrates no neurotoxicity in human induced pluripotent stem cells-derived iCell(®) GlutaNeurons. Front Toxicol 2025;7:1585430.
- Luque RM, Henderson B, McCorkell TC, Alizadeh AH, Russell KA, Koch TG, Koenig J. Treatment outcomes for equine osteoarthritis with mesenchymal stromal cells and hyaluronic acid. Equine Vet J 2025 Sep;57(5):1245-1254.
- Giarritiello F, De La Motte LR, Drago L. Viscosupplementation and Synovial Fluid Rheology: A Hidden Risk for Bacterial Biofilm Formation in Joint Infections?. Microorganisms 2025 Mar 21;13(4).
- Guerra-Gomes M, Ferreira-Baptista C, Barros J, Alves-Pimenta S, Gomes P, Colaço B. Exploring the Potential of Non-Cellular Orthobiologic Products in Regenerative Therapies for Stifle Joint Diseases in Companion Animals. Animals (Basel) 2025 Feb 18;15(4).
- Riley JW, Chance LM, Barshick MR, Johnson SE. Administration of sodium hyaluronate to adult horses prior to and immediately after exercise does not alter the range of motion in either the tarsus or metacarpophalangeal joints. Transl Anim Sci 2024;8:txae153.
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