Analyze Diet
Veterinary surgery : VS2020; 49(5); 840-851; doi: 10.1111/vsu.13441

Physiologic effects of long-term immobilization of the equine distal limb.

Abstract: To describe the effects of distal limb immobilization and remobilization in the equine metacarpophalangeal joint. Methods: Randomized, prospective experimental study. Methods: Eight healthy, skeletally mature horses. Methods: One forelimb of each horse was immobilized in a fiberglass cast for 8 weeks; this was followed by 12 weeks of a treadmill-based training program after the cast had been removed. Clinical examinations, radiography, computed tomography (CT), nuclear scintigraphy, MRI, and histomorphometry were used to examine the third metacarpal (MC3), proximal phalanx, proximal sesamoid bones, and associated soft tissues in each horse. Serum and synovial fluid were collected for biomarker analyses. Results: Distal limb immobilization resulted in persistent lameness (P < .001), effusion (P = .002), and a decreased range of motion (P = .012) as well as radiographically visible fragments (P = .036) in the cast forelimb. Bone density was decreased (P < .001) in MC3 according to CT, and trabecular bone fluid was increased (P < .001) according to MRI in the cast forelimb. The cast forelimbs had a change (P = .009) in the appearance of the deep digital flexor tendon according to MRI immediately after removal of the cast. Numerous clinical, radiographic, CT, and MR abnormalities were visible at the end of the study period. Conclusions: Eights weeks of cast immobilization induced changes in bone, cartilage, and periarticular soft tissues that were not reversed after 12 weeks of remobilization. Conclusions: Cast application should be used judiciously in horses with musculoskeletal injuries, balancing appropriate stabilization with potential morbidity secondary to cast placement.
Publication Date: 2020-05-15 PubMed ID: 32412662DOI: 10.1111/vsu.13441Google 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

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.

The research studies the impact of immobilization and remobilization on a horse’s limb. It discovered that putting a horse’s limb in a cast for eight weeks resulted in changes in bone density, bone fluid, and other related tissues, which were not fully reversed after twelve weeks of removement.

Methodology

  • This study followed a randomized, prospective experimental design involving eight healthy, fully-grown horses.
  • One of each horse’s forelimbs was immobilized in a fiberglass cast for a period of 8 weeks. Subsequently, the cast was removed, and the horses underwent a treadmill-based training program for 12 weeks.
  • The researchers used a variety of diagnostic methods to examine the third metacarpal (MC3), proximal phalanx, proximal sesamoid bones, and associated soft tissues of each horse. These methods included physical examinations, radiography, computed tomography (CT), nuclear scintigraphy, MRI, and histomorphometry.
  • Samples of serum and synovial fluid were collected for analysis of biometric markers.

Findings

  • Immobility of the limb led to various negative outcomes, including the horse continuing to experience lameness, effusion (swelling), and a decreased range of motion. Additionally, fragments visible via radiography emerged in the immobilized limb.
  • Dist scan revealed that bone density of MC3 had decreased in the cast forelimb, while an MRI demonstrated an increase in trabecular bone fluid in the same area.
  • Upon cast removal, MRI scans showed changes in the appearance of the deep digital flexor tendon of the cast forelimbs.
  • Even at the end of the study, clinical, radiographic, CT, and MR abnormalities were seen in the cast limbs.

Conclusions

  • The study concluded that immobilizing a horse’s limb for eight weeks resulted in changes to the bone, cartilage, and periarticular soft tissues that were not completely reversed after twelve weeks of remobilization.
  • The findings suggest that the use of a cast should be carefully considered for treating horses with musculoskeletal injuries. The use of immobilization through casting needs to strike a balance between providing necessary stabilization for the injury, and the potential for additional problems resulting from the placement of the cast.

Cite This Article

APA
Stewart HL, Werpy NM, McIlwraith CW, Kawcak CE. (2020). Physiologic effects of long-term immobilization of the equine distal limb. Vet Surg, 49(5), 840-851. https://doi.org/10.1111/vsu.13441

Publication

ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 49
Issue: 5
Pages: 840-851

Researcher Affiliations

Stewart, Holly L
  • Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Werpy, Natasha M
  • Ocala Equine Hospital, Ocala, Florida, USA.
McIlwraith, C Wayne
  • Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Kawcak, Christopher E
  • Equine Orthopaedic Research Center, Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.

MeSH Terms

  • Animals
  • Carpometacarpal Joints / physiology
  • Female
  • Forelimb / physiology
  • Horses / physiology
  • Immobilization / veterinary
  • Male
  • Metacarpal Bones / physiology
  • Sesamoid Bones / physiology
  • Toe Phalanges / physiology

Grant Funding

  • CEVA Sante Animale, Liborne, France

References

This article includes 37 references
  1. Bikle DD, Halloran BP. The response of bone to unloading.. J Bone Miner Metab 1999;17:233-244.
  2. Takata S, Yasui N. Disuse osteoporosis.. J Med Invest 2001;48:147-156.
  3. Delguste C, Amory H, Doucet M. Pharmacological effects of tiludronate in horses after long-term immobilization.. Bone 2007;41:414-421.
  4. Van Harreveld PD, Lillich JD, Kawcak CE, Gaughan EM, McLaughlin RM, DeBowes RM. Clinical evaluation of the effects of immobilization followed by remobilization and exercise on the metacarpophalangeal joint in horses.. Am J Vet Res 2002;63:282-288.
  5. Richardson DW, Clark CC. Effects of short-term cast immobilization on equine articular cartilage.. Am J Vet Res 1993;54:449-453.
  6. Buckingham SH, Jeffcott LB. Osteopenic effects of forelimb immobilisation in horses.. Vet Rec 1991;128:370-373.
  7. Van Harreveld PD, Lillich JD, Kawcak CE, Turner AS, Norrdin RW. Effects of immobilization followed by remobilization on mineral density, histomorphometric features, and formation of the bones of the metacarpophalangeal joint in horses.. Am J Vet Res 2002;63:276-281.
  8. Akeson WH, Woo SL, Amiel D, Coutts RD, Daniel D. The connective tissue response to immobility: biochemical changes in periarticular connective tissue of the immobilized rabbit knee.. Clin Orthop 1973;93:356-362.
  9. Enneking W, Horowitz M. The intra-articular effects of immobilization on the human knee.. J Bone Joint Surg Am 1972;54:973-985.
  10. Palmoski MJ, Colyer RA, Brandt KD. Joint motion in the absence of normal loading does not maintain normal articular cartilage.. Arthritis Rheum 1980;23:325-334.
  11. Akeson W, Amiel D, Abel M, Garfin SR, Woo SL. Effects of immobilization on joints.. Clin Orthop Relat Res 1987;28-37.
  12. Tuukkanen J, Peng Z, Väänänen H. The effect of training on recovery from immobilization-induced bone loss in rats.. Acta Physiol Scand 1992;145:407-411.
  13. Bourrin S, Palle S, Genty C, Alexandre C. Physical exercise during remobilization restores a normal bone trabecular network after tail suspension-induced osteopenia in young rats.. J Bone Miner Res 2009;10:820-828.
  14. Bergula A, Huang W, Frangos J. Femoral vein ligation increases bone mass in the hindlimb suspended rat.. Bone 1999;24:171-177.
  15. Rubin C, McLeod K, Lanyon L. Prevention of osteoporosis by pulsed electromagnetic fields.. J Bone Joint Surg Am 1969;71:411-417.
  16. Rubin CT, Lanyon LE. Bone remodeling in response to applied dynamic loads.. J Bone Joint Surg Am 1984;66:397-402.
  17. Kannus P, Sievänen H, Järvinen TLN. Effects of free mobilization and low- to high-intensity treadmill running on the immobilization-induced bone loss in rats.. J Bone Miner Res 2009;9:1613-1619.
  18. Kamm L, McIlwraith W, Kawcak C. A review of the efficacy of tiludronate in the horse.. J Equine Vet Sci 2008;28:209-214.
  19. Soto SA, Chiappe BA. Bisphosphonates: pharmacology and clinical approach to their use in equine osteoarticular diseases.. J Equine Vet Sci 2014;34:727-737.
  20. Baxter G, Stashak T. Examination for lameness.. In: Baxter G, ed. Adams and Stashak's Lameness in Horses. 6th ed. Chichester, West Sussex, England: Wiley-Blackwell; 2011:118.
  21. Kawcak CE, McIlwraith CW, Norrdin RW, Park RD, Steyn PS. Clinical effects of exercise on subchondral bone of carpal and metacarpophalangeal joints in horses.. Am J Vet Res 2000;61:1252-1258.
  22. McIlwraith CW, Frisbie DD, Kawcak CE, Fuller CJ, Hurtig M, Cruz A. The OARSI histopathology initiative-recommendations for histological assessments of osteoarthritis in the horse.. Osteoarthritis Cartilage 2010;18:S93-S105.
  23. Frisbie DD, Al-Sobayil F, Billinghurst RC, Kawcak CE, McIlwraith CW. Changes in synovial fluid and serum biomarkers with exercise and early osteoarthritis in horses.. Osteoarthritis Cartilage 2008;16:1196-1204.
  24. Farndale RW, Buttle DJ, Barrett AJ. Improved quantitation and discrimination of sulphated glycosaminoglycans by use of dimethylmethylene blue.. Biochim Biophys Acta 1986;883:173-177.
  25. Kawcak CE, Frisbie DD, Trotter GW. Effects of intravenous administration of sodium hyaluronate on carpal joints in exercising horses after arthroscopic surgery and osteochondral fragmentation.. Am J Vet Res 1997;58:1132-1140.
  26. Barr ED, Pinchbeck GL, Clegg PD, Boyde A, Riggs CM. Post mortem evaluation of palmar osteochondral disease (traumatic osteochondrosis) of the metacarpo/metatarsophalangeal joint in Thoroughbred racehorses.. Equine Vet J 2009;41:366-371.
  27. Lane Smith R, Thomas KD, Schurman DJ, Carter DR, Wong M, van der Meulen MC. Rabbit knee immobilization: bone remodeling precedes cartilage degradation.. J Orthop Res 1992;10:88-95.
  28. Ijiri K, Jee WSS, Ma YF, Yuan Z. Remobilization partially restored the bone mass in a non-growing cancellous bone site following long term immobilization.. Bone 1995;17:S213-S217.
  29. Riggs C, Whitehouse GH, Boyde A. Structural variation of the distal condyles of the third metacarpal and third metatarsal bones in the horse.. Equine Vet J 1999;31:130-139.
  30. Felson DT, Chaisson CE, Hill CL. The association of bone marrow lesions with pain in knee osteoarthritis.. Ann Intern Med 2001;134:541.
  31. Powell SE, Ramzan PHL, Head MJ, Shepherd MC, Baldwin GI, Steven WN. Standing magnetic resonance imaging detection of bone marrow oedema-type signal pattern associated with subcarpal pain in 8 racehorses: a prospective study.. Equine Vet J 2010;42:10-17.
  32. Zani DD, De Zani D, Biggi M, Scandella M, Travetti O, Di Giancamillo M. Use of magnetic resonance imaging in the diagnosis of bone marrow edema in the equine distal limb: six cases.. Vet Res Commun 2009;33:225-228.
  33. Zanetti M, Bruder E, Romero J, Hodler J. Bone marrow edema pattern in osteoarthritic knees: correlation between mr imaging and histologic findings.. Radiology 2000;215:835-840.
  34. Calvo MS, Eyre DR, Gundberg CM. Molecular basis and clinical application of biological markers of bone turnover.. Endocr Rev 1996;17:333-368.
  35. Riggs CM. Indications for and application of limb casts in the mature horse.. Equine Vet Educ 1997;9:190-197.
  36. Malone ED, Anderson BH, Turner TA. Proximal sesamoid bone fracture following cast removal in two horses.. Equine Vet Educ 1997;9:185-188.
  37. Baxter GM, Stashak TS. Conformation and movement.. In: Baxter GM, ed. Adams & Stashak's Lameness in Horses. 6th ed. Chichester, West Sussex, England: Wiley-Blackwell; 2011:75.

Citations

This article has been cited 1 times.
  1. Micheau L, Audigié F, Moiroud C, Jacquet S. New Model of Disuse-Induced Bone Density Loss in Horses. Animals (Basel) 2025 Oct 29;15(21).
    doi: 10.3390/ani15213137pubmed: 41227467google scholar: lookup