Musculoskeletal injury rates in Thoroughbred racehorses following local corticosteroid injection.
Abstract: A retrospective cohort study was performed to compare the rates of musculoskeletal injury (MSI) in horses receiving local corticosteroid injection (LCI) with those that were untreated and those prior to treatment. Of the 1911 study horses, 392 had been treated. A LCI was defined as any injection of corticosteroid into or adjacent to a synovial structure, muscle, or tendon/ligament. A MSI was defined as any limb injury identified by a veterinarian, following which the horse did not race for at least 6 months, or was retired. Hazard ratios (HR) comparing hazard of injury following injection to that in non-injected horses and prior to injection were calculated using Cox proportional hazards models. At least one LCI was administered to 392 horses (20.5%; median 2, range 1-16). Most LCIs were performed bilaterally (70.9%) and intra-articularly into the carpal (49.7%) or fore fetlock (29.3%) joints. There were 219 MSIs of which carpal injuries (47%), fore fetlock (22%) and forelimb tendon injuries (16%) were the most common. The incidence rate of MSI in untreated horses and those prior to injection was 1.22 (95% CI 1.04-1.44) injuries/100 horse-months, and following LCI the hazard of MSI was greater (HR 4.83, 3.54-6.61, P<0.001). The hazard ratio returned to levels indistinguishable from before treatment after 49 days. The hazard of MSI in horses following second and subsequent LCIs in the data collection period was greater than in horses following their first LCI (HR 2.10, 1.31-3.36, P=0.002). There was a positive association between LCI and subsequent musculoskeletal injury rates which was most likely due to progression of the musculoskeletal condition which prompted treatment. Assuming horses that received LCI were at increased risk of MSI subsequently, any beneficial effects of the LCI were insufficient to counter this increased risk for at least 49 days after the injection.
Copyright © 2013 Elsevier Ltd. All rights reserved.
Publication Date: 2013-09-12 PubMed ID: 24690214DOI: 10.1016/j.tvjl.2013.09.003Google Scholar: Lookup
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- Journal Article
- Clinical Study
- Corticosteroids
- Diagnosis
- Disease
- Disease Diagnosis
- Disease Treatment
- Epidemiology
- Equine Health
- Horse Racing
- Horse Training
- Horses
- Injury
- Intra-Articular Injection
- Musculoskeletal System
- Retrospective Study
- Risk Factors
- Thoroughbreds
- Veterinary Care
- Veterinary Medicine
- Veterinary Procedure
- Veterinary Research
Summary
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The abstract presents a study that discovered a higher rate of musculoskeletal injuries in thoroughbred racehorses that had been treated with local corticosteroid injections, compared to untreated horses or those before treatment.
Research and Methods
- The study was a retrospective cohort design. This means that the researchers looked at existing data and categorised the horses into those who had received local corticosteroid injection (LCI) and those who had not.
- LCI was defined as any injection of corticosteroid given to a horse either into or adjacent to a synovial structure, muscle or tendon/ligament. This injection is usually given to reduce inflammation and pain.
- A musculoskeletal injury (MSI) was defined as any limb injury identified by a veterinarian that incapacitated the horse from racing for at least 6 months, or led to its retirement.
- The study involved analysing data from 1911 horses, 392 of which had received at least one LCI.
- The researchers used statistical models to calculate hazard ratios (HR), which show the risk of injury after the injection, compared to the risk in non-injected horses and before the injection.
Results
- Most LCIs were performed bilaterally (70.9%) and intra-articularly into the carpal (49.7%) or fore fetlock (29.3%) joints.
- There were 219 MSIs noted, with the most common injuries being carpal injuries (47%), fore fetlock (22%) and forelimb tendon injuries (16%).
- The incidence of MSI in untreated horses and those before injection was found to be 1.22 injuries per 100 horse-months.
- The hazard of MSI was found to be higher following LCI, with a HR of 4.83. This indicates that horses were almost five times as likely to suffer a MSI following LCI.
- The higher risk returned to normal after 49 days post-injection.
- Horses that received multiple LCIs during the study period had a higher hazard of MSI than those who only received their first LCI.
Conclusions
- The study concluded there was a positive association between LCI and subsequence musculoskeletal injury rates in thoroughbred racehorses.
- This increased risk most likely resulted from the progression of the original musculoskeletal condition that prompted the treatment.
- Furthermore, the benefits of LCI were not sufficient to counteract this increased risk until at least 49 days after the treatment.
Cite This Article
APA
Whitton RC, Jackson MA, Campbell AJ, Anderson GA, Parkin TD, Morton JM, Boden LA.
(2013).
Musculoskeletal injury rates in Thoroughbred racehorses following local corticosteroid injection.
Vet J, 200(1), 71-76.
https://doi.org/10.1016/j.tvjl.2013.09.003 Publication
Researcher Affiliations
- Faculty of Veterinary Science, University of Melbourne, 250 Princes Hwy, Werribee 3030, Australia. Electronic address: cwhitton@unimelb.edu.au.
- Faculty of Veterinary Science, University of Melbourne, 250 Princes Hwy, Werribee 3030, Australia.
- Faculty of Veterinary Science, University of Melbourne, 250 Princes Hwy, Werribee 3030, Australia.
- Faculty of Veterinary Science, University of Melbourne, 250 Princes Hwy, Werribee 3030, Australia.
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, 464 Bearsden Rd, Glasgow G61 1QH, UK.
- Jemora Pty Ltd., P.O. Box 2277, Geelong 3220, Australia.
- School of Veterinary Medicine, College of Medical, Veterinary and Life Sciences, University of Glasgow, 464 Bearsden Rd, Glasgow G61 1QH, UK.
MeSH Terms
- Adrenal Cortex Hormones / adverse effects
- Animals
- Female
- Horses / injuries
- Injections, Intramuscular / adverse effects
- Injections, Intramuscular / veterinary
- Male
- Musculoskeletal System / injuries
- Physical Conditioning, Animal
- Retrospective Studies
- Risk Assessment
Citations
This article has been cited 3 times.- Gibson MJ, Legg KA, Gee EK, Rogers CW. The Reporting of Racehorse Fatalities in New Zealand Thoroughbred Flat Racing in the 2011/12-2021/22 Seasons.. Animals (Basel) 2023 Feb 9;13(4).
- Hale J, Hughes K, Hall S, Labens R. Effects of Production Method and Repeated Freeze Thaw Cycles on Cytokine Concentrations and Microbial Contamination in Equine Autologous Conditioned Serum.. Front Vet Sci 2021;8:759828.
- Hitchens PL, Hill AE, Stover SM. Relationship Between Historical Lameness, Medication Usage, Surgery, and Exercise With Catastrophic Musculoskeletal Injury in Racehorses.. Front Vet Sci 2018;5:217.
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