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Home / Equine Research Bank / Equine Vet J / Intra-articular anaesthesia of the equine stifle improves fo...
Equine veterinary journal2019; 52(2); 314-319; doi: 10.1111/evj.13135

Intra-articular anaesthesia of the equine stifle improves foot lameness.

Abstract: Equine diagnostic anaesthesia can be a useful tool in challenging lameness examinations. However, anaesthetics diffuse over time leading to nonspecific desensitisation of periarticular structures. Nerves that convey sensation from the distal limb to the central nervous system pass in close proximity to the caudal stifle joint capsule. Therefore, diffusion of intra-articular (IA) anaesthetics could cause inadvertent desensitisation of the distal limb resulting in a false diagnosis of stifle lameness. Objective: To determine if IA stifle anaesthesia can alleviate lameness originating in the distal limb. Methods: Crossover experiment. Methods: Nine horses were fitted with a circumferential hoof clamp to induce a moderate unilateral hindlimb lameness. Intra-articular stifle anaesthesia was performed and gait was evaluated every 10 min during the 90-min trial using an inertial sensor system. Push-off and landing components of the lameness were assessed by measuring the mean inter-stride difference between the maximum and minimum heights of the pelvis respectively. Differences were compared using a Wilcoxon signed-rank test. Results: Overall, horses with hoof clamp-induced foot pain had a reduction in push-off lameness after IA stifle anaesthesia. The mean change in diffmax at 90 min was -4.3 mm (P = 0.005) for the experimental group vs. -2.3 mm (P = 0.2) for the control group. Lameness decreased over time, with an average improvement of 23% at 30 min, 33% at 60 min and 38% at 90 min. There was high inter-horse variability; 3/9 horses improved by ~50% within 30 min, while 2/9 improved by ~30% and 4/9 had minimal (<10%) or no improvement in lameness. Improvement after IA stifle anaesthesia was not related to the severity of baseline lameness (P = 0.3-0.7). Conclusions: Limited clinical applicability of our lameness induction model. Conclusions: Intra-articular stifle anaesthesia reduces foot lameness in a third of horses by up to 50% within 30 min. Clinically, the results of IA stifle anaesthesia should be considered in the light of these findings before treatment recommendations are made, as additional diagnostics may be required to rule out pain originating in the distal limb.
© 2019 EVJ Ltd.
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Publication Date: 2019-06-27 PubMed ID: 31087355PubMed Central: PMC6851447DOI: 10.1111/evj.13135Google Scholar: Lookup
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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.

This research investigates if intra-articular anaesthesia of a horse’s stifle joint (where the thigh bone meets the lower leg bones) can lessen foot lameness. The findings indicate that anesthesia in this area can help mitigate foot lameness in about a third of horses, with the improvement noticeable within 30 minutes.

Objective and Background

The study sets out to explore intra-articular stifle anaesthesia’s potential impact part of the horse’s limb below the stifle joint, particularly in addressing lameness in the foot. This is borne out of the understanding that anaesthetics can diffuse and desensitize other areas, which might cause a false diagnosis of stifle lameness.

Methodology

  • Nine horses were involved in this crossover experiment.
  • A circumferential hoof clamp was used to deliberately induce moderate unilateral hindlimb lameness in each horse.
  • Then, intra-articular stifle anaesthesia was applied.
  • Every ten minutes, over a period of ninety minutes, the gait of the horses was evaluated using an inertial sensor system.
  • The assessment focused on the push-off and landing components of the lameness, gauged by measuring the inter-stride difference between maximum and minimum pelvic heights.
  • A Wilcoxon signed-rank test was used to compare differences.

Results

  • For horses with foot pain induced by the hoof clamp, the use of intra-articular stifle anaesthesia led to a reduction in push-off lameness.
  • Improvement of lameness progressed over time, with an average amelioration of 23% at 30 minutes, 33% at 60 minutes, and 38% at 90 minutes.
  • However, there was a high variability in how the horses responded: three out of nine horses showed substantial (approximately 50%) improvement within 30 minutes, two out of nine improved by approximately 30%, while the remaining four had minimal (<10%) or no improvement in lameness.
  • The improvements after anaesthesia were not related to the baseline severity of lameness.

Conclusions

  • Intra-articular stifle anaesthesia can reduce foot lameness in around a third of horses, with notable improvement within 30 minutes.
  • Before proceeding with treatment recommendations, clinical decisions considering these findings should involve additional diagnostic inquiries to eliminate possible pain in the lower part of the limb (distal limb).
  • The authors also acknowledge the limited clinical application of their lameness induction model in real-life clinical situations.

Cite This Article

APA
Radtke A, Fortier LA, Regan S, Kraus S, Delco ML. (2019). Intra-articular anaesthesia of the equine stifle improves foot lameness. Equine Vet J, 52(2), 314-319. https://doi.org/10.1111/evj.13135

Publication

Equine veterinary journal
ISSN: 2042-3306
NlmUniqueID: 0173320
Country: United States
Language: English
Volume: 52
Issue: 2
Pages: 314-319

Researcher Affiliations

Radtke, A
  • Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
Fortier, L A
  • Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
Regan, S
  • Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
Kraus, S
  • Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
Delco, M L
  • Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.

MeSH Terms

  • Anesthesia / veterinary
  • Animals
  • Hoof and Claw
  • Horse Diseases
  • Horses
  • Lameness, Animal
  • Stifle

Grant Funding

  • K08 AR068470 / NIAMS NIH HHS
  • Harry M. Zweig Fund for Equine Research
  • 1K08AR068470 / NIH Mentored Clinical Scientist Development Award

Conflict of Interest Statement

Authors’ declaration of interests. No competing interests have been declared.

References

This article includes 23 references
  1. Kaneene JB, Ross WA, Miller R. The Michigan equine monitoring system. II. Frequencies and impact of selected health problems.. Prev. Vet. Med 29, 277–292.
    pubmed: 9234436
  2. Dyson S. Recognition of lameness: man versus machine.. Vet. J 201, 245–248.
    pubmed: 24923757
  3. Bell RP, Reed S, Schoonover M, Whitfield C, Yonezawa Y, Maki H, Pai P, Keegan KG. Associations of force plate and body-mounted inertial sensor measurement for identification of hind limb lameness in horses.. Am. J. Vet. Res 77, 337–345.
    pubmed: 27027831
  4. Hinchcliff KW, Kaneps AJ, Geor R. Diagnosis of lameness.. In: Equine Sports Medicine and Surgery, 2nd edn., Ed: Hinchcliff KW, Elsevier Ltd., St. Louis, Missouri: pp 247–259.
  5. Barrett MF, McIlwraith CW, Contino EK, Park RD, Kawcak CE, Frisbie DD, ZumBrunnen JR. Relationship between repository radiographic findings competing in cutting events.. J. Am. Vet. Med. Ass 252, 108–115.
    pubmed: 29244597
  6. Kane AJ, McIlwraith CW, Park RD, Rantanen NW, Morehead JP, Bramlage LR. Radiographic changes in Thoroughbred yearlings. Part 2: associations with racing performance.. Equine Vet. J 35, 366–374.
    pubmed: 12880004
  7. Walmsley JP. The Stifle. In: Diagnosis and Management of Lameness in the Horse, 2nd edn., Eds: Ross MW and Dyson SJ, Elsevier Ltd., St. Louis, Missouri: pp 532–549.
  8. Jordana M, Martens A, Duchateau L, Vanderperren K, Saunders J, Oosterlinck M, Pille F. Distal limb desensitisation following analgesia of the digital flexor tendon sheath in horses using four different techniques.. Equine Vet. J 46, 488–493.
    pubmed: 24033590
  9. Moyer W, Schumacher J, Schumacher J. Equine Joint Injection and Regional Anesthesia, 5th edn.. Academic Veterinary Sol. LLC, Chadds Ford, Pennsylvania: pp 2–32.
  10. Rankin JS, Diesem CD. Innervation of the equine hip and stifle joint capsules.. J. Am. Vet. Med. Ass 169, 614–619.
    pubmed: 965281
  11. . Lameness Exams: Evaluating the Lame Horse.. .
  12. Keegan KG. Pelvic movement pattern in horses with hindlimb and forelimb lameness.. Proc. Am. Ass. Equine Practnrs. 51, 121–127.
  13. McCracken M, Kramer J, Keegan KG, Lopes M, Wilson DA, Reed S, LaCarruba A, Rasch M. Comparison of an inertial sensor system of lameness quantification with subjective lameness evaluation.. Equine Vet. J 44, 652–656.
    pubmed: 22563674
  14. Galisteo A, Cano M, Morales J, Miro F, Vivo J, Aguera E. Kinematics in horses at the trot before and after an unduced forelimb supporting lameness.. Equine Vet. J 23, 97–101.
    pubmed: 9354300
  15. Swaab ME, Mendez-Angulo JL, Groschen DM, Ernst NS, Brown MP, Trumble TN. Circumferential hoof clamp method of lameness induction in the horse.. Vet. J 205, 81–86.
    pubmed: 26045357
  16. Keegan KG. Evidence-based lameness detection and quantification.. Vet. Clin. N. Am.: Equine Pract 23, 403–423.
    pubmed: 17616320
  17. Budras K, Sack W, Rock S. Chapter 3: Pelvic Limb. In: Anatomy of the Horse: An Illustrated Text, 5th edn., Ed: Rock S, Schlutersche, Frankfurt, Germany: pp 16–30.
  18. Jordana M, Martens A, Duchateau L, Haspeslagh M, Vanderperren K, Oosterlinck M, Pille F. Diffusion of mepivacaine to adjacent synovial structures after intrasynovial analgesia of the digital flexor tendon sheath.. Equine Vet. J 48, 326–330.
    pubmed: 25827158
  19. Schumacher J, Schramme MC, Schumacher J, Degraves FJ. Diagnostic analgesia of the equine digit.. Equine Vet. Educ 25, 408–421.
  20. Nagy A, Bodo G, Dyson SJ, Szabo F, Barr ARS. Diffusion of contrast medium after perineural injection of the palmar nerves: an in vivo and in vitro study.. Equine Vet. J 41, 379–383.
    pubmed: 19562900
  21. Hoerdemann M, Smith R, Hosgood G. Duration of action of mepivacaine and lidocaine in equine palmar digital perineural blocks in an experimental lameness model.. Vet. Surg 46, 986–993.
    pubmed: 28703891
  22. Walmsley JP. Diagnosis and treatment of ligamentous and meniscal injuries in the equine stifle.. Vet. Clin. N. Am.: Equine Pract 21, 651–672.
    pubmed: 16297726
  23. Thomason JJ, McClinchey HL, Jofriet JC. Analysis of strain and stress in the equine hoof capsule using finite element methods: comparison with principal strains recorded in vivo.. Equine Vet. J 34, 719–725.
    pubmed: 12455844

Citations

This article has been cited 3 times.
  1. Osborne C, Elce YA, Byrant B, Meehan-Howard L. Effects of intra-articular anesthesia of the tarsometatarsal joint on skin sensation of the distal limb in horses. Can Vet J 2024 Aug;65(8):808-812.
    pubmed: 39091475
  2. Bolz NM, Sánchez-Andrade JS, Torgerson PR, Bischofberger AS. Diagnostic Performance of Multi-Detector Computed Tomography Arthrography and 3-Tesla Magnetic Resonance Imaging to Diagnose Experimentally Created Articular Cartilage Lesions in Equine Cadaver Stifles. Animals (Basel) 2023 Jul 14;13(14).
    doi: 10.3390/ani13142304pubmed: 37508081google scholar: lookup
  3. Quam V, Yardley J, Quam M, Paz C, Belknap J. Cryotherapy provides transient analgesia in an induced lameness model in horses. Can Vet J 2021 Aug;62(8):834-838.
    pubmed: 34341594
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