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Effects of extracorporeal shock wave therapy and polysulfated glycosaminoglycan treatment on subchondral bone, serum biomarkers, and synovial fluid biomarkers in horses with induced osteoarthritis.
Abstract: To evaluate effects of extracorporeal shock wave therapy (ESWT) and polysulfated glycosaminoglycan treatment (PSGAGT) on subchondral bone (SCB), serum biomarkers, and synovial fluid biomarkers in horses with induced osteoarthritis. Methods: 24 healthy 2- to 3-year-old horses. Methods: An osteochondral fragment was created on the distal aspect of the radial carpal bone in 1 middle carpal joint of each horse. Horses were randomly allocated to receive local application of ESWT (days 14 and 28; n = 8), PSGAGT (IM, q 4 d for 28 days; 8), or a sham ESWT probe (placebo; days 14 and 28; 8). Serum biomarkers were measured every 7 days, and synovial fluid biomarkers were measured every 14 days. Bone density was measured by use of computed tomography on days 0 and 70, and microdamage and bone formation variables were compared among groups at the end of the study (day 70). Results: There was no significant effect of ESWT or PSGAGT on any bone variable. Serum osteocalcin concentration was significantly greater in horses that received ESWT, compared with placebo-treated horses, and serum concentration of the C-terminal telopeptide of type I collagen was significantly higher in horses that received ESWT, compared with placebo- and PSGAG-treated horses. Concentrations of the synovial fluid epitope CS846 were significantly higher in joints with osteoarthritis treated with ESWT CONCLUSIONS AND CLINICAL RELEVANCE: Treatment of osteoarthritis with ESWT had no effect on SCB but did induce increases in serum biomarkers indicative of bone remodeling. Treatment of osteoarthritis with PSGAG had no effect on SCB or biomarkers.
Publication Date: 2011-06-02 PubMed ID: 21627523DOI: 10.2460/ajvr.72.6.772Google Scholar: Lookup The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- Journal Article
- Randomized Controlled Trial
Summary
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This research evaluates the impacts of extracorporeal shock wave therapy and polysulfated glycosaminoglycan treatment on the subchondral bone, serum biomarkers and synovial fluid biomarkers in horses suffering from introduced osteoarthritis.
Research Methods
The research involved a scientific experiment carried out on 24 healthy horses aged between 2 to 3 years. Methods employed included:
- Creating an osteochondral fragment on the distal aspect of the radial carpal bone in one middle carpal joint of each participating horse.
- Randomly assigning horses to receive either local application of extracorporeal shock wave therapy (ESWT), polysulfated glycosaminoglycan treatment (PSGAGT), or a placebo.
- Conducting serum biomarkers measurements every 7 days, and synovial fluid biomarkers measurements every 14 days.
- Measuring bone density using computed tomography on day 0 and day 70, with a comparison of microdamage and bone formation variables conducted among groups at the end of the study.
Results
The results from this research showed:
- No significant effect of either ESWT or PSGAGT on any bone variable.
- A significantly higher serum osteocalcin concentration in horses that received ESWT compared to those that received a placebo treatment.
- A significantly higher serum concentration of the C-terminal telopeptide of type I collagen in horses that received ESWT compared with horses that were given a placebo treatment or the PSGAGT.
- A significant increase in the concentration of the synovial fluid epitope CS846 in joints with osteoarthritis that were treated with ESWT.
Conclusions and Clinical Relevance
The research concluded that:
- ESWT treatment of osteoarthritis had no impact on the subchondral bone (SCB), however, it did lead to increases in serum biomarkers indicating bone remodeling.
- On the other hand, treating osteoarthritis with PSGAGT had no effect on either subchondral bone or biomarkers.
Therefore, while ESWT seems to bring about changes in serum biomarkers, neither of the examined treatment options (ESWT and PSGAGT) showed an impact on subchondral bone, suggesting they may not be effective in altering bone metrics in horses with artificially induced osteoarthritis.
Cite This Article
APA
Kawcak CE, Frisbie DD, McIlwraith CW.
(2011).
Effects of extracorporeal shock wave therapy and polysulfated glycosaminoglycan treatment on subchondral bone, serum biomarkers, and synovial fluid biomarkers in horses with induced osteoarthritis.
Am J Vet Res, 72(6), 772-779.
https://doi.org/10.2460/ajvr.72.6.772 Publication
Researcher Affiliations
- Gail Holmes Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA. ckawcak@colostate.edu
MeSH Terms
- Animals
- Biomarkers / metabolism
- Carpus, Animal / injuries
- Carpus, Animal / pathology
- Cartilage, Articular / pathology
- Collagen Type II / metabolism
- Epitopes / blood
- Female
- Glycosaminoglycans / administration & dosage
- Glycosaminoglycans / therapeutic use
- High-Energy Shock Waves / therapeutic use
- Horse Diseases / blood
- Horse Diseases / pathology
- Horse Diseases / therapy
- Horses
- Lameness, Animal / blood
- Lameness, Animal / classification
- Lameness, Animal / therapy
- Male
- Osteoarthritis / blood
- Osteoarthritis / pathology
- Osteoarthritis / therapy
- Osteoarthritis / veterinary
- Synovial Fluid / chemistry
Citations
This article has been cited 10 times.- Boström A, Bergh A, Hyytiäinen H, Asplund K. Systematic Review of Complementary and Alternative Veterinary Medicine in Sport and Companion Animals: Extracorporeal Shockwave Therapy. Animals (Basel) 2022 Nov 12;12(22).
- Tellegen A, Beukers M, Rudnik-Jansen I, van Klaveren N, How KL, Woike N, Mihov G, Thies J, Teske E, Creemers L, Tryfonidou M, Meij B. Intra-Articular Slow-Release Triamcinolone Acetonide from Polyesteramide Microspheres as a Treatment for Osteoarthritis. Pharmaceutics 2021 Mar 11;13(3).
- Moser DK, Schoonover MJ, Sippel KM, Dieterly AM, Ritchey JW, Wall CR. Catastrophic complication following injection and extracorporeal shock wave therapy of a medial femoral condyle subchondral cystic lesion in a 14 year old Arabian mare. Open Vet J 2017;7(2):111-116.
- Zhang Y, Wang T, Cao Y. Osteopontin can decrease the expression of Col-II and COMP in cartilage cells in vitro. Int J Clin Exp Med 2015;8(2):2254-60.
- McIlwraith CW, Frisbie DD, Kawcak CE. The horse as a model of naturally occurring osteoarthritis. Bone Joint Res 2012 Nov;1(11):297-309.
- Qiu Z, Wang J, Zhang Y, Liu X, Wei C, Ma T. Extracorporeal shock wave therapy for equine musculoskeletal disorders: from biological mechanisms to clinical applications. Front Vet Sci 2025;12:1719123.
- Khadour FA, Khadour YA, Khouly OI, Dao X. Combined low-intensity pulsed ultrasound and extracorporeal shock wave therapy reduces pain and inflammation in knee osteoarthritis patients. Sci Rep 2025 Nov 29;16(1):1221.
- White GW. Polysulfated glycosaminoglycan as a treatment for osteoarthritis in veterinary medicine: Summary of the pharmacological, laboratory, and clinical data. Open Vet J 2025 Sep;15(9):4007-4023.
- Liu S, Chen Q, Zhang Q, Tao K, Li C, Chang B, Wang W, Wu Z. Electroacupuncture combined with extracorporeal shock wave therapy improves pain symptoms and inflammatory factor levels in knee osteoarthritis patients. Heliyon 2023 Oct;9(10):e20771.
- O'Brien TJ, Hollinshead F, Goodrich LR. Extracellular vesicles in the treatment and prevention of osteoarthritis: can horses help us translate this therapy to humans?. Extracell Vesicles Circ Nucl Acids 2023 Jun;4(2):151-169.
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