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Equine veterinary journal2019; 51(6); 795-801; doi: 10.1111/evj.13095

Comparing the clinical success rate of the dorsolateral approach to the medial approach for injection of the centrodistal joint in the horse.

Abstract: 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 centrodistal joints in total, each horse served as its own control. In Phase 1, injections were performed by standard technique. In the Phase 2, operators were allowed to use radiography to assist needle placement. Contrast deposition was evaluated by a single radiologist. Results: Without radiographic assistance, 10/25 (40%) joints were successfully injected using either the medial or dorsolateral approach. With radiographic assistance, 19/24 (79%) joints were successfully injected using the medial approach, 11/24 (46%) joints were successfully injected using the dorsolateral approach. Conclusions: The population consisted of aged horses representing a variety of breeds with existing osteoarthritis, and multiple operators were recruited. Conclusions: The dorsolateral approach was equivalent to the medial approach when traditional injection techniques were used. Radiograph-guidance improved success of the medial approach, but not the dorsolateral approach. Many injections performed from the dorsolateral approach (32/49; 65%) resulted in extensive perivascular subcutaneous contrast deposition after infiltration into the tarsal canal. Further research is needed to improve injection success of the centrodistal joint when using the dorsolateral approach.
© 2019 EVJ Ltd.
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Publication Date: 2019-03-28 PubMed ID: 30854693DOI: 10.1111/evj.13095Google Scholar: Lookup
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  • Journal Article
  • Randomized Controlled Trial
  • Veterinary

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

Researchers conducted a study to compare the success rate of two different approaches, medial and dorsolateral, for injecting the centrodistal joint in horses, and to evaluate the benefits of using radiograph-guidance during this procedure.

Objective of the Research

  • The study aimed to determine which approach, medial or dorsolateral, was more successful for injecting the centrodistal joint in horses.
  • It also sought to understand the benefits of using radiographic guidance during injections.

Research Methodology

  • The study was a prospective, randomized study involving the injection of 98 centrodistal joints in total.
  • Each horse involved in the experiment served as its own control.
  • In Phase 1, injections were performed using a standard technique. In Phase 2, the researchers used radiography to assist in the placement of the needle.
  • The deposition of the contrast agent was evaluated by a radiologist.

Research Findings

  • Without the assistance of radiography, only 40% of the joints were successfully injected, irrespective of the approach (medial or dorsolateral).
  • With radiographic assistance, successful injections were significantly higher for the medial approach (79%) as compared to the dorsolateral approach (46%).
  • The study population included aged horses of various breeds and with existing osteoarthritis, and multiple operators were involved in the injections.
  • Without radiographic guidance, both the dorsalateral and medial approaches to injection were equivalent in success rate.
  • There was a high incidence (65%) of extensive perivascular subcutaneous contrast deposition after injections from the dorsolateral approach.

Conclusions and Implications

  • Radiograph-guidance significantly improved the success rate for the medial approach to injecting the centrodistal joint but did not have the same effect for the dorsolateral approach.
  • Given the high rate of contrast deposition after dorsolateral injections, the researchers stated that further research is needed to improve the success rate of the dorsolateral approach to centrodistal joint injections.

Cite This Article

APA
Hoaglund EL, Seabaugh KA, Selberg KT, Hess A, Bass L. (2019). Comparing the clinical success rate of the dorsolateral approach to the medial approach for injection of the centrodistal joint in the horse. Equine Vet J, 51(6), 795-801. https://doi.org/10.1111/evj.13095

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 51
Issue: 6
Pages: 795-801

Researcher Affiliations

Hoaglund, E L
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, USA.
Seabaugh, K A
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, USA.
  • Orthopaedic Research Center, Colorado State University, Fort Collins, USA.
Selberg, K T
  • Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, USA.
Hess, A
  • Department of Statistics, Colorado State University, Fort Collins, USA.
Bass, L
  • Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, USA.

MeSH Terms

  • Animals
  • Contrast Media / administration & dosage
  • Horse Diseases / diagnosis
  • Horses
  • Injections, Intra-Articular / veterinary
  • Iohexol / administration & dosage
  • Lameness, Animal / diagnosis
  • Prospective Studies
  • Tarsus, Animal

Grant Funding

  • Zoetis Services LLC

References

This article includes 16 references
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Citations

This article has been cited 1 times.
  1. Al-Sobayil F, Sadan MA, El-Shafaey EA, Allouch J. Intra-articular injection in the hind limb joints of dromedary camels (Camelus dromedarius) using anatomical and arthrographic-guided landmarks. Vet World 2021 Aug;14(8):2055-2063.
    doi: 10.14202/vetworld.2021.2055-2063pubmed: 34566321google scholar: lookup
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