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Li X, Chen W, Liu D, Chen P, Wang S, Li F, Chen Q, Lv S, Li F, Chen C, Guo S, Yuan W, Li P, Hu Z. Pathological progression of osteoarthritis: a perspective on subchondral bone. Front Med 2024; 18:237-257. [PMID: 38619691 DOI: 10.1007/s11684-024-1061-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 01/17/2024] [Indexed: 04/16/2024]
Abstract
Osteoarthritis (OA) is a degenerative bone disease associated with aging. The rising global aging population has led to a surge in OA cases, thereby imposing a significant socioeconomic burden. Researchers have been keenly investigating the mechanisms underlying OA. Previous studies have suggested that the disease starts with synovial inflammation and hyperplasia, advancing toward cartilage degradation. Ultimately, subchondral-bone collapse, sclerosis, and osteophyte formation occur. This progression is deemed as "top to bottom." However, recent research is challenging this perspective by indicating that initial changes occur in subchondral bone, precipitating cartilage breakdown. In this review, we elucidate the epidemiology of OA and present an in-depth overview of the subchondral bone's physiological state, functions, and the varied pathological shifts during OA progression. We also introduce the role of multifunctional signal pathways (including osteoprotegerin (OPG)/receptor activator of nuclear factor-kappa B ligand (RANKL)/receptor activator of nuclear factor-kappa B (RANK), and chemokine (CXC motif) ligand 12 (CXCL12)/CXC motif chemokine receptor 4 (CXCR4)) in the pathology of subchondral bone and their role in the "bottom-up" progression of OA. Using vivid pattern maps and clinical images, this review highlights the crucial role of subchondral bone in driving OA progression, illuminating its interplay with the condition.
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Affiliation(s)
- Xuefei Li
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Wenhua Chen
- Research and Development Center of Chinese Medicine Resources and Biotechnology, Shanghai University of Traditional Chinese Medicine, Shanghai, 201203, China
| | - Dan Liu
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Pinghua Chen
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Shiyun Wang
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Fangfang Li
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Qian Chen
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Shunyi Lv
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Fangyu Li
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Chen Chen
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Suxia Guo
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Weina Yuan
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Pan Li
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China
| | - Zhijun Hu
- Longhua Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai, 200032, China.
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von Rechenberg B, Gehrke RS, Klein K, Kronen P, Darwiche S, Zbinden J, Wieser K, Lädermann A. Studying Edema Formation After Release of the Infraspinatus Muscle as an Experimental Model of Rotator Cuff Lesions in Sheep: A Histological Analysis. Am J Sports Med 2024; 52:1319-1327. [PMID: 38459680 DOI: 10.1177/03635465241226961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2024]
Abstract
BACKGROUND Muscle edema formation and inflammatory processes are early manifestations of acute rotator cuff lesions in sheep. Histological analysis of affected muscles revealed edema formation, inflammatory changes, and muscle tissue disruption in MRs. HYPOTHESIS Edema contributes to inflammatory reactions and early muscle fiber degeneration before the onset of fatty infiltration. STUDY DESIGN Controlled laboratory study. METHODS Osteotomy of the greater tuberosity, including the insertion of the infraspinatus tendon, was performed on 14 sheep. These experimental animal models were divided into 2 groups: a nontrauma group with surgical muscle release alone (7 sheep) and a trauma group with standardized application of additional trauma to the musculotendinous unit (7 sheep). Excisional biopsy specimens of the infraspinatus muscle were taken at 0, 3, and 4 weeks. RESULTS Edema formation was histologically demonstrated in both groups and peaked at 3 weeks. At 3 weeks, signs of muscle fiber degeneration were observed. At 4 weeks, ingrowth of loose alveolar and fibrotic tissue between fibers was detected. Fatty tissue was absent. The diameter of muscle fibers increased in both groups, albeit to a lesser degree in the trauma group, and practically normalized at 4 weeks. Immunohistology revealed an increase in macrophage types 1 and 2, as well as inflammatory mediators such as prostaglandin E2 and nuclear factor kappa-light-chain-enhancer of activated B cells. CONCLUSION Early muscle edema and concomitant inflammation precede muscle fiber degeneration and fibrosis. Edema formation results from tendon release alone and is only slightly intensified by additional trauma. CLINICAL RELEVANCE This study illustrates that early edema formation and inflammation elicit muscle fiber degeneration that precedes fatty infiltration. Should this phenomenon be applicable to human traumatic rotator cuff tears, then surgery should be performed as soon as possible, ideally within the first 21 days after injury.
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Affiliation(s)
- Brigitte von Rechenberg
- Musculoskeletal Research Unit, Department of Molecular Mechanisms of Disease, Vetsuisse Faculty ZH, University of Zurich, Zurich, Switzerland
- Competence Center for Applied Biotechnology and Molecular Medicine, Department of Molecular Mechanisms of Disease, Vetsuisse Faculty ZH, University of Zurich, Zurich, Switzerland
| | - Rieke S Gehrke
- Musculoskeletal Research Unit, Department of Molecular Mechanisms of Disease, Vetsuisse Faculty ZH, University of Zurich, Zurich, Switzerland
| | - Karina Klein
- Musculoskeletal Research Unit, Department of Molecular Mechanisms of Disease, Vetsuisse Faculty ZH, University of Zurich, Zurich, Switzerland
| | - Peter Kronen
- Musculoskeletal Research Unit, Department of Molecular Mechanisms of Disease, Vetsuisse Faculty ZH, University of Zurich, Zurich, Switzerland
| | - Salim Darwiche
- Musculoskeletal Research Unit, Department of Molecular Mechanisms of Disease, Vetsuisse Faculty ZH, University of Zurich, Zurich, Switzerland
- Competence Center for Applied Biotechnology and Molecular Medicine, Department of Molecular Mechanisms of Disease, Vetsuisse Faculty ZH, University of Zurich, Zurich, Switzerland
| | - Jeanni Zbinden
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland
- Faculty of Medicine, Université de Genève, Geneva, Switzerland
| | - Karl Wieser
- Universitatsklinik Balgrist, University of Zurich, Zurich, Switzerland
| | - Alexandre Lädermann
- Division of Orthopaedics and Trauma Surgery, La Tour Hospital, Meyrin, Switzerland
- Faculty of Medicine, Université de Genève, Geneva, Switzerland
- Division of Orthopaedics and Trauma Surgery, Department of Surgery, Hopitaux Universitaires de Genève, Geneva, Switzerland
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Santschi EM. Equine subchondral lucencies: Knowledge from the medial femoral condyle. Vet Surg 2024; 53:426-436. [PMID: 38229531 DOI: 10.1111/vsu.14062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Revised: 11/25/2023] [Accepted: 12/02/2023] [Indexed: 01/18/2024]
Abstract
Equine subchondral lucencies (SCL) have been described since the first availability of suitable radiographic equipment. The initial clinical sign can be lameness, but SCLs are often first found on surveys of juvenile horses and are primarily a radiographic concern for public auctions. When lameness is present, it varies from subtle to obvious and can be intermittent. Some SCLs heal spontaneously, and some remain blemishes, but when the SCL and lameness are persistent, further damage to the joint and limitations to an athletic career are likely. SCLs were initially described in the distal limb followed by the stifle, and the medial femoral condyle (MFC) is now considered the most common location. The aim of this review is to highlight the initial pathology and discuss the clinical and experimental information available on equine SCLs. SCL treatment has evolved from rest alone and has progressed to debridement, grafting, intralesional injection, and most recently, transcondylar screw and absorbable implant placement. Comparison of success rates between techniques is difficult due to variations in follow-up and outcome measures, and no single technique is best for all SCLs. Treatment appears to increase success by 15%-20% over rest alone, but the method chosen depends on many factors. This review emphasizes the need for further work to fully understand SCL formation and all aspects of trabecular bone healing to optimize surgical therapy and improve treatment success.
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Young N, Barker W, Minshall G, Wright I. Arthroscopically guided lag screw fixation of subchondral bone cysts in the medial femoral condyle in Thoroughbred racehorses: description of technique and comparative results. Vet Surg 2024; 53:330-340. [PMID: 37280742 DOI: 10.1111/vsu.13972] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/25/2023] [Accepted: 05/08/2023] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To describe an arthroscopically guided technique for lag screw placement across subchondral bone cyst (SBC) in the medial femoral condyle (MFC) and to compare postoperative racing performance with corticosteroid injection and cyst debridement. STUDY DESIGN Retrospective cohort study. ANIMALS One hundred twenty-three horses with 134 MFC SBCs undergoing treatment at a single referral hospital in the UK between January, 2009, and December, 2020. METHODS Sex, age, limb affected, radiographic cyst dimensions, preoperative and postoperative lameness, surgical technique (lag screw placement, cyst debridement, intralesional corticosteroid injection), and, where applicable, screw positioning were recorded retrospectively. A ratio was calculated using measurements from preoperative and postoperative radiographs. Outcome was assessed by resolution or improvement in lameness, reduction in cyst size, and starting one race after treatment. Outcome data was compared between treatment groups. RESULTS Twenty-six of 45 (57.8%) horses that underwent transcondylar screw placement raced postoperatively, at a median of 403 days between surgery and first postoperative race. There was no difference between treatment groups with regard to racing or preoperative and postoperative lameness. Cysts treated with transcondylar screw placement had a greater reduction in cyst size and a reduced period of convalescence in comparison with those that underwent debridement; the results were similar to those treated by intralesional corticosteroid injection. CONCLUSION Postoperative racing rates were similar for all techniques. Convalescence was reduced for lag screw placement and corticosteroid injection compared to debridement. CLINICAL SIGNIFICANCE The arthroscopically guided technique results in radiographically consistent screw placement and cyst engagement and offers a viable alternative to other treatments.
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Affiliation(s)
- Natalie Young
- Department of Clinical Science and Services, The Royal Veterinary College, Hatfield, UK
- Newmarket Equine Hospital, Suffolk, UK
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Tönük ŞB, Yorgancıoğlu ZR, Ramadan SU, Kocaoğlu S. Relationship between DXA measured systemic bone mineral density and subchondral bone cysts in postmenopausal female patients with knee osteoarthritis: a cross-sectional study : Osteoarthritis cysts and bone mineral density. BMC Musculoskelet Disord 2024; 25:50. [PMID: 38212780 PMCID: PMC10782551 DOI: 10.1186/s12891-023-07141-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 12/20/2023] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Individuals with high systemic bone mineral density (BMD) may have an increased risk of incident knee osteoarthritis (OA). Besides that, radiographic osteophytes are strongly associated with BMD. Because of these reasons, the aim of the study was to investigate the possible association between radiological subchondral bone cyst (SBC) grade and systemic BMD and vitamin D status in the postmenopausal female patients with knee OA in a crosss-sectional study. METHODS This study included of 48 osteoporosis treatment-free postmenopausal patients diagnosed with symptomatic medial compartment knee OA. BMD analysis was performed using dual-energy X-ray absorptiometry (DXA) and serum vitamin D levels were measured after recording patients' findings. Each knee was scanned using computed tomography (CT), and categorical SBC scores were graded for the medial and lateral tibiofemoral (TF) and patellofemoral (PF) compartments and further calculated as compartmental total, total TF and grand total of both TF compartments. SBC scores were analysed with correlation analysis. RESULTS The patient population was characterized by radiographic joint space narrowing, obesity and low vitamin D status. Median medial total and grand total TF SBC scores were significantly different between the patient groups according to the Kellgren-Lawrence (KL) radiographic grading (p = 0.006 and p = 0.007, respectively). There were no correlations between femoral BMD values and SBC scores. However, positive correlations were detected significantly between L1 - 4 DXA values and TF SBC scores, but not with PF SBC scores (p = 0.005 for the correlation between L1 - 4 BMD and medial compartments total TF SBC score, p = 0.021 for the correlation between L1 - 4 BMD and grand total TF SBC score). No significant correlations were found with Vitamin D levels. CONCLUSIONS Development of TF OA high-grade SBCs may be linked to systemic bone mass as represented by trabecular bone-rich lumbar vertebrae. The relationship might point to the importance of bone stiffness as an acting factor in knee OA possibly with mechanical energy transfer to the joint.
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Affiliation(s)
- Şükrü Burak Tönük
- Department of Physical Medicine and Rehabilitation, Bolu Abant Izzet Baysal University, Karacasu, Bolu, Turkey.
| | - Zeynep Rezan Yorgancıoğlu
- Department of Physical Medicine and Rehabilitation, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey
| | - Selma Uysal Ramadan
- Department of Radiology, Ministry of Health Kecioren Training and Research Hospital, Ankara, Turkey
| | - Seher Kocaoğlu
- Department of Physical Medicine and Rehabilitation, Ministry of Health Ankara Training and Research Hospital, Ankara, Turkey
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Canonici F, Marcoccia D, Bonini P, Monteleone V, Innocenzi E, Zepparoni A, Altigeri A, Caciolo D, Tofani S, Ghisellini P, Rando C, Pechkova E, Rau JV, Eggenhöffner R, Scicluna MT, Barbaro K. Arthroscopic Treatment of a Subchondral Bone Cyst via Stem Cells Application: A Case Study in Equine Model and Outcomes. Biomedicines 2023; 11:3307. [PMID: 38137527 PMCID: PMC10741679 DOI: 10.3390/biomedicines11123307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Revised: 11/30/2023] [Accepted: 12/05/2023] [Indexed: 12/24/2023] Open
Abstract
Subchondral bone cysts in horses represent one of the main causes of lameness that can occur in different anatomical locations. The study describes the treatment in regenerative therapy of the intracystic implantation of adipose tissue mesenchymal stromal cells (AMSCs) included in platelet-rich plasma (PRP). The ability of AMSCs to differentiate in osteogenic cells was tested in vitro and in vivo. Given the aim to investigate the application of AMSCs in bone defects and orthopedic pathologies in horses, a four-year-old male thoroughbred racing horse that had never raced before was treated for lameness of the left hind leg caused by a cyst of the medial femoral condyle. The horse underwent a new surgery performed with an arthroscopic approach in which the cystic cavity was filled with AMSCs contained in the PRP. Radiographs were taken 3, 5, and 10 months after the surgery to assess the development of newly regenerated bone tissue in the gap left by the cyst. Twelve months after the operation and after six months of regular daily training, the horse did not show any symptoms of lameness and started a racing career. According to the study, the use of AMSCs and PRP suggests promising benefits for treating subchondral bone cysts.
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Affiliation(s)
- Fernando Canonici
- Equine Practice srl, Campagnano, Strada Valle del Baccano 80, 00063 Roma, Italy;
| | - Daniele Marcoccia
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Via Appia Nuova 1411, 00178 Rome, Italy; (D.M.); (P.B.); (V.M.); (E.I.); (A.Z.); (A.A.); (D.C.); (S.T.); (M.T.S.)
| | - Pamela Bonini
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Via Appia Nuova 1411, 00178 Rome, Italy; (D.M.); (P.B.); (V.M.); (E.I.); (A.Z.); (A.A.); (D.C.); (S.T.); (M.T.S.)
| | - Valentina Monteleone
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Via Appia Nuova 1411, 00178 Rome, Italy; (D.M.); (P.B.); (V.M.); (E.I.); (A.Z.); (A.A.); (D.C.); (S.T.); (M.T.S.)
| | - Elisa Innocenzi
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Via Appia Nuova 1411, 00178 Rome, Italy; (D.M.); (P.B.); (V.M.); (E.I.); (A.Z.); (A.A.); (D.C.); (S.T.); (M.T.S.)
| | - Alessia Zepparoni
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Via Appia Nuova 1411, 00178 Rome, Italy; (D.M.); (P.B.); (V.M.); (E.I.); (A.Z.); (A.A.); (D.C.); (S.T.); (M.T.S.)
| | - Annalisa Altigeri
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Via Appia Nuova 1411, 00178 Rome, Italy; (D.M.); (P.B.); (V.M.); (E.I.); (A.Z.); (A.A.); (D.C.); (S.T.); (M.T.S.)
| | - Daniela Caciolo
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Via Appia Nuova 1411, 00178 Rome, Italy; (D.M.); (P.B.); (V.M.); (E.I.); (A.Z.); (A.A.); (D.C.); (S.T.); (M.T.S.)
| | - Silvia Tofani
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Via Appia Nuova 1411, 00178 Rome, Italy; (D.M.); (P.B.); (V.M.); (E.I.); (A.Z.); (A.A.); (D.C.); (S.T.); (M.T.S.)
| | - Paola Ghisellini
- Department of Surgical Sciences and Integrated Diagnostics (DISC), Genova University, Corso Europa 30, 16132 Genova, Italy; (P.G.); (C.R.); (R.E.)
| | - Cristina Rando
- Department of Surgical Sciences and Integrated Diagnostics (DISC), Genova University, Corso Europa 30, 16132 Genova, Italy; (P.G.); (C.R.); (R.E.)
| | - Eugenia Pechkova
- Consorzio Interuniversitario INBB, Viale delle Medaglie d’Oro, 305, 00136 Roma, Italy;
- Laboratories of Biophysics and Nanotechnology, Department of Experimental Medicine (DIMES), Genova University, Via Pastore 3, 16132 Genova, Italy
| | - Julietta V. Rau
- Istituto di Struttura della Materia, Consiglio Nazionale delle Ricerche (ISM-CNR), Via del Fosso del Cavaliere 100, 00133 Rome, Italy;
| | - Roberto Eggenhöffner
- Department of Surgical Sciences and Integrated Diagnostics (DISC), Genova University, Corso Europa 30, 16132 Genova, Italy; (P.G.); (C.R.); (R.E.)
| | - Maria Teresa Scicluna
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Via Appia Nuova 1411, 00178 Rome, Italy; (D.M.); (P.B.); (V.M.); (E.I.); (A.Z.); (A.A.); (D.C.); (S.T.); (M.T.S.)
| | - Katia Barbaro
- Istituto Zooprofilattico Sperimentale del Lazio e della Toscana “M. Aleandri”, Via Appia Nuova 1411, 00178 Rome, Italy; (D.M.); (P.B.); (V.M.); (E.I.); (A.Z.); (A.A.); (D.C.); (S.T.); (M.T.S.)
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Kaspiris A, Hadjimichael AC, Lianou I, Iliopoulos ID, Ntourantonis D, Melissaridou D, Savvidou OD, Papadimitriou E, Chronopoulos E. Subchondral Bone Cyst Development in Osteoarthritis: From Pathophysiology to Bone Microarchitecture Changes and Clinical Implementations. J Clin Med 2023; 12:jcm12030815. [PMID: 36769464 PMCID: PMC9917649 DOI: 10.3390/jcm12030815] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/10/2023] [Accepted: 01/14/2023] [Indexed: 01/22/2023] Open
Abstract
Osteoarthritis is a degenerative joint disease affecting middle-aged and elderly patients. It mainly involves weight-bearing joints such as the hip, knee and spine as well as the basilar joint of the thumb, causing dysfunction and painful symptoms. Often, joint arthritis is accompanied by cartilage defects, joint space narrowing, osteophytes, bone sclerosis and subchondral bone cysts (SBC). The aim of the present study was to explore the pathophysiology responsible for the development of SBCs as well as the association between SBCs and disease progress, the level of clinical symptoms and their impact on postoperative outcomes and risk of possible complications following joint replacements if left untreated. A literature review on PubMed articles was conducted to retrieve and evaluate all available evidence related to the main objective mentioned above. A few theories have been put forth to explain the formation process of SBCs. These involve MMPs secretion, angiogenesis, and enhanced bone turnover as a biological response to abnormal mechanical loads causing repeated injuries on cartilage and subchondral tissue during the development of arthritis. However, the application of novel therapeutics, celecoxib-coated microspheres, local administration of IGF-1 and activated chondrocytes following surgical debridement of SBCs hinders the expansion of SBCs and prevents the progression of osteoarthritis.
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Affiliation(s)
- Angelos Kaspiris
- Laboratory of Molecular Pharmacology, Department of Pharmacy, School of Health Sciences, University of Patras, 26504 Patras, Greece
- Correspondence: ; Tel.: +30-2610962336; Fax: +30-2610623049
| | - Argyris C. Hadjimichael
- Department of Orthopaedics, St Mary’s Hospital, Imperial College Healthcare NHS Trust, Praed Street, London W2 1NY, UK
| | - Ioanna Lianou
- Department of Orthopaedic Surgery, “Rion” University Hospital and Medical School, School of Health Sciences, University of Patras, 26504 Patras, Greece
| | - Ilias D. Iliopoulos
- Department of Orthopaedic Surgery, “Rion” University Hospital and Medical School, School of Health Sciences, University of Patras, 26504 Patras, Greece
| | - Dimitrios Ntourantonis
- Accident and Emergency Department, “Rion” University Hospital and Medical School, School of Health Sciences, University of Patras, 26500 Patras, Greece
| | - Dimitra Melissaridou
- First Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “ATTIKON” University General Hospital, Rimini 1, 12462 Athens, Greece
| | - Olga D. Savvidou
- First Department of Orthopaedic Surgery, School of Medicine, National and Kapodistrian University of Athens, “ATTIKON” University General Hospital, Rimini 1, 12462 Athens, Greece
| | - Evangelia Papadimitriou
- Laboratory of Molecular Pharmacology, Department of Pharmacy, School of Health Sciences, University of Patras, 26504 Patras, Greece
| | - Efstathios Chronopoulos
- Laboratory for Research of the Musculoskeletal System, School of Medicine, National and Kapodistrian University of Athens, 14561 Athens, Greece
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Ammann L, Ohlerth S, Fürst AE, Jackson MA. Differences of morphological attributes between 62 proximal and distal subchondral cystic lesions of the proximal phalanx as determined by radiography and computed tomography. Am J Vet Res 2022; 83:ajvr.22.04.0071. [DOI: 10.2460/ajvr.22.04.0071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Abstract
OBJECTIVE
To determine morphological characteristics of subchondral cystic lesions (SCLs) in the proximal phalanx (PP) of adult horses.
SAMPLE
Radiographs and/or CT scans of PP from 46 horses.
PROCEDURES
There were horses with a SCL in PP, which was diagnosed by radiography and/or computed tomography, included. Additional data (signalment, history, orthopedic examination) were collected retrospectively for each case.
RESULTS
Forty-six horses met the required inclusion criteria, with a total of 62 SCLs. Forty-three SCLs (70.5%) were located in the proximal PP (group A). Forty-four percent of these were associated with short, incomplete fractures, while 30 of the proximal PP SCLs (69.7%) were found mid sagittal. Proximal SCLs mostly showed a blurred, irregular shape (62.8%) and long, as well as wide, but shallow shapes in CT. Eighteen SCLs (29.5%) were found in the distal PP, near the proximal interphalangeal joint (group B). In contrast to the described proximal SCLs, the distal SCLs were of circular or oval shape, well delineated (77.8%), and distinctly larger. Horses of group A were significantly older (mean age, 11.47 years) than horses of group B (mean age, 6.72 years).
CLINICAL RELEVANCE
The distribution and morphological attributes of proximal PP SCLs as well as their association to subchondral bone lesions and short, incomplete proximal fractures indicate more recently developed lesions due to chronic stress factors, such as repetitive trauma to the cartilage and subchondral bone. In contrast, morphology and distribution of distal SCLs showed high accordance with developmental bone cysts originating from a failure of endochondral ossification.
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Affiliation(s)
- Liliane Ammann
- Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Stefanie Ohlerth
- Clinic of Diagnostic Imaging, Department of Clinical Diagnostics and Services, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Anton E. Fürst
- Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
| | - Michelle A. Jackson
- Equine Department, Vetsuisse Faculty, University of Zurich, Zurich, Switzerland
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Klein CE, Bramlage LR, Stefanovski D, Ruggles AJ, Embertson RM, Hopper SA. Comparative results of 3 treatments for medial femoral condyle subchondral cystic lesions in Thoroughbred racehorses. Vet Surg 2022; 51:455-463. [PMID: 35167130 DOI: 10.1111/vsu.13782] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 12/31/2021] [Accepted: 01/25/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVES To compare 3 different methods for treatment of medial femoral condyle (MFC) subchondral cystic lesions in Thoroughbred horses <24 months old based on the criterion of ability to race post-treatment. STUDY DESIGN Retrospective cohort study. ANIMALS Thoroughbreds (n = 107, age < 24 months) diagnosed with MFC subchondral cystic lesions. METHODS Medical records between January 2004 and December 2017 were reviewed. Three treatment methods were used in these horses during that time frame: arthroscopic debridement, intralesional autologous mesenchymal stem cell (MSC) injection, and intralesional corticosteroid injection. The outcome evaluated was the ability to compete in a pari-mutuel race. RESULTS Seventy-eight of 107 Thoroughbreds (73%) raced post-treatment; 41/57 (72%) of horses treated by arthroscopic debridement raced; 16/19 (84%) of horses treated with intralesional MSCs raced; 21/31 (68%) of horses treated with intralesional corticosteroids raced. There was no difference between groups in the ability to start a race. Sex, limb affected, and lesion size also had no effect on the ability to start a race. There was a trend for increasing lesion size reducing the probability of racing. CONCLUSIONS Seventy-three percent of the horses raced, but there was no difference in the ability of unraced Thoroughbreds to race after treatment of MFC subchondral cystic lesions with arthroscopic debridement, intralesional mesenchymal stem cells, or intralesional corticosteroids. CLINICAL SIGNIFICANCE The 3 reported treatment options may be considered for treatment of MFC subchondral cystic lesions with a good prognosis for racing post-treatment. Owners should be advised that increasing lesion size decreases the probability of racing.
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Affiliation(s)
| | | | - Darko Stefanovski
- New Bolton Center, Department of Clinical Sciences, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Alan J Ruggles
- Rood and Riddle Equine Hospital, Lexington, Kentucky, USA
| | | | - Scott A Hopper
- Rood and Riddle Equine Hospital, Lexington, Kentucky, USA
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Moreno CR, Santschi EM, Younkin JT, Larson RL, Litsky AS. The failure mode of a mechanically loaded equine medial femoral condyle analog with a void and the impact of lag and neutral screw placement. Vet Surg 2022; 51:474-481. [PMID: 35102588 DOI: 10.1111/vsu.13765] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 11/08/2021] [Accepted: 12/18/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To determine the failure method of simulated equine medial femoral condyle (MFC) subchondral bone defects under compression and the influence of screw placement on failure resistance. STUDY DESIGN In vitro study. SAMPLE POPULATION Composite disks (CD) simulating the moduli of yearling bone in the MFC. METHODS Four CD conditions were tested, all with a 12.7 mm void (n = 6 per condition): intact (no void), void only, void with a 4.5 mm screw placed in neutral fashion, and void with a 4.5 mm screw placed in lag fashion. Composite disks of each condition were tested under monotonic compression to 6000 N and cyclic compression to 10 000 cycles. Observable failure, load at first observable failure, and displacement at peak 2000 N load were compared among conditions. RESULTS Specimens failed by cracking at the superior aspect of the void or the screw exit hole. After monotonic loading, cracks were observed 6/6 CD with a void, 6/6 CD with a void/lag screw, and 5/6 CD with a void/neutral screw. After cyclical testing, cracks were noted only on the superior aspect of 6/6 CD with a void and 3/6 CD with a void/lag screw. Displacement at peak load was 0.06 mm (intact), 0.32 mm (void), 0.24 mm (void/lag screw), and 0.11 mm (void/neutral screw). CONCLUSION Model MFC voids failed by superior cracking that was resisted by lag and neutral screw placement. CLINICAL SIGNIFICANCE Neutral screws may be an acceptable treatment for subchondral lucencies in the MFC.
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Affiliation(s)
- Caitlin R Moreno
- Department of Clinical Sciences, Kansas State University, Manhattan, Kansas, USA
| | - Elizabeth M Santschi
- Department of Clinical Sciences, Kansas State University, Manhattan, Kansas, USA
| | - Jarrod T Younkin
- Department of Clinical Sciences, Kansas State University, Manhattan, Kansas, USA
| | - Robert L Larson
- Department of Clinical Sciences, Kansas State University, Manhattan, Kansas, USA
| | - Alan S Litsky
- Departments of Orthopaedics and Biomedical Engineering, The Ohio State University, Columbus, Ohio, USA.,Orthopaedic BioMaterials Laboratory, The Ohio State University, Columbus, Ohio, USA
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11
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Fortin-Trahan R, Lemirre T, Santschi EM, Janes JG, Richard H, Fogarty U, Beauchamp G, Girard CA, Laverty S. Osteoclast density is not increased in bone adjacent to radiolucencies (cysts) in juvenile equine medial femoral condyles. Equine Vet J 2021; 54:989-998. [PMID: 34716940 DOI: 10.1111/evj.13530] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/02/2021] [Accepted: 10/18/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND There is a knowledge gap about how equine MFC subchondral radiolucencies (SR) arise and evolve. Osteoclasts are believed to have a role but have not been studied in situ. OBJECTIVES To measure and compare osteoclast density and the percentage of chondroclasts in healthy and MFC SR specimens from juvenile Thoroughbreds. STUDY DESIGN Cadaveric study. METHODS Medial femoral condyles (MFC) from a tissue bank of equine stifles were studied. Inclusion criteria were MFCs (≤8 months old) with a computed tomography SR lesion and histological focal failure of endochondral ossification (L group). Contralateral, lesion-free, MFCs were a control group (CC). Osteochondral slabs were cut through the lesion (L), a healthy site immediately caudal to the lesion, (internal control; IC) and the contralateral, site-matched controls (CC). Histological sections were immunostained with Cathepsin K for osteoclast counting. Osteoclasts in contact with the growth cartilage (chondroclasts) were also counted. The sections were segmented into regions of interest (ROI) at different depths in the subchondral bone: ROI1 (0-1 mm), ROI2 (1-3 mm) and ROI3 (3-6 mm). Osteoclasts were counted and the bone area was measured in each ROI to calculate their density. Chondroclasts were counted in ROI1 . RESULTS Sections were studied from L and IC (n = 6) and CC sites (n = 5). Osteoclast density was significantly higher in ROI1 when compared with ROI3 in all groups. Although higher osteoclast density was measured in ROI1 in the L group, no significant differences were detected when compared with control ROIs. The proportion of chondroclasts in ROI1 was lower in the L sections when compared with controls but no significant differences were detected. MAIN LIMITATIONS Limited sample size. CONCLUSIONS Osteoclasts are important actors in MFC subchondral bone development, digesting both growth cartilage (chondroclasts) and bone, but the pathophysiology of early MFC SRs cannot be explained solely by an increased osteoclast presence in the subchondral bone.
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Affiliation(s)
- Rosalie Fortin-Trahan
- Comparative Orthopaedic Research Laboratory, Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - Thibaut Lemirre
- Comparative Orthopaedic Research Laboratory, Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - Elizabeth M Santschi
- Department of Clinical Sciences, College of Veterinary Medicine, Kansas State University, Manhattan, Kansas, USA
| | - Jennifer G Janes
- Department of Veterinary Science, University of Kentucky, Lexington, Kentucky, USA
| | - Hélène Richard
- Comparative Orthopaedic Research Laboratory, Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Quebec, Canada
| | | | - Guy Beauchamp
- Comparative Orthopaedic Research Laboratory, Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - Christiane A Girard
- Comparative Orthopaedic Research Laboratory, Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Quebec, Canada
| | - Sheila Laverty
- Comparative Orthopaedic Research Laboratory, Département de Sciences Cliniques, Faculté de Médecine Vétérinaire, Université de Montréal, St-Hyacinthe, Quebec, Canada
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SIRT1 + Adipose Derived Mesenchymal Stromal Stem Cells (ASCs) Suspended in Alginate Hydrogel for the Treatment of Subchondral Bone Cyst in Medial Femoral Condyle in the Horse. Clinical Report. Stem Cell Rev Rep 2021; 16:1328-1334. [PMID: 32803696 PMCID: PMC7667135 DOI: 10.1007/s12015-020-10025-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Stem cell based therapy are now commonly applied in human and veterinary medical practice especially in orthopaedics. Mesenchymal stromal stem cells isolated from adipose tissue (ASC) are first choice option due to relatively non-invasive and safe procedure of tissue harvesting. However, ASC therapeutic potential strongly rely on patients general health condition, age and life-style. For that reason, to enhance therapeutic potential of cells, they are modified in vitro using different approaches. Previous studies have shown, that ASC treated with resveratrol, herein called SIRT+, are characterised by decreased senescence, increased proliferation rate and improved clinical outcome in autologous therapies. Herein, SIRT + cells in alginate hydrogel were applied to 5 years old warm breed mare was clinically evaluated due to the left hind lameness due to subchondral bone cyst. The therapeutic effect was assessed by the analysis of lameness score and radiological evaluation. This case report demonstrates the therapeutic potential of SIRT + cells in the treatment of orthopaedics disorders in horses as complete bone remodelling occurred after therapy and horse came back to training.
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13
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Corraretti G, Meulyzer M, Simon O. Treatment of a subchondral cystic‐like lesion in the distal scapula with a translesional bone screw in a horse. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13245] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - O. Simon
- Equine Clinic De Morette Asse Belgium
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Jenner F. Treatment of osseous cyst‐like lesions. EQUINE VET EDUC 2021. [DOI: 10.1111/eve.13269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- F. Jenner
- Equine Surgery University of Veterinary Medicine Vienna Vienna Austria
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15
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Ravanetti P, Lechartier A, Hamon M, Zucca E. A composite absorbable implant used to treat subchondral bone cysts in 38 horses. Equine Vet J 2021; 54:97-105. [PMID: 33502044 DOI: 10.1111/evj.13428] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 12/16/2020] [Accepted: 01/21/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND In the last 30 years, several treatments have been proposed to treat subchondral cystic lesions (SCLs) but there have been no randomised studies to compare different methods and there is no consensus as to the optimal treatment. OBJECTIVES To evaluate a biocompatible absorbable implant for the treatment of SCLs in young horses in different anatomical locations. STUDY DESIGN Retrospective case series. METHODS Horses with SCLs were treated with debridement through a trans-cortical extra-articular approach and an absorbable implant was inserted in the cavity. Clinical and radiographic follow-up was recorded and follow up ranged from 28 to 46 months (mean 37 months). Racing records were reviewed. RESULTS Thirty-eight horses between 10 and 24 months of age were included in the study. In 36 of 38 horses treated, lameness resolved, and 77% average filling of the cyst was measured 120 days after surgery on radiographs. In two cases, surgical complications were recorded. MAIN LIMITATIONS Information about the resorption of the implant is not available. Radiographs were performed in various hospitals or at farms or training stables, therefore, possible minor variations in technique and positioning occurred. CONCLUSIONS The extra-articular approach to the SCLs followed by the insertion of the absorbable implant led to clinical and radiographic improvement of the SCLs at 120 days after surgery. This technique, feasible in different anatomical locations, may offer an alternative to treat SCLs in young horses.
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Affiliation(s)
| | | | - Muriel Hamon
- Clinique Veterinaire Equine Méheudin, Ecouché, France
| | - Enrica Zucca
- Department of Veterinary Medicine, Università degli Studi di Milano, Milan, Italy
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16
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Gao L, Cucchiarini M, Madry H. Cyst formation in the subchondral bone following cartilage repair. Clin Transl Med 2020; 10:e248. [PMID: 33377663 PMCID: PMC7733665 DOI: 10.1002/ctm2.248] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2020] [Revised: 11/23/2020] [Accepted: 11/27/2020] [Indexed: 12/20/2022] Open
Abstract
Subchondral bone cysts represent an early postoperative sign associated with many articular cartilage repair procedures. They may be defined as an abnormal cavity within the subchondral bone in close proximity of a treated cartilage defect with a possible communication to the joint cavity in the absence of osteoarthritis. Two synergistic mechanisms of subchondral cyst formation, the theory of internal upregulation of local proinflammatory factors, and the external hydraulic theory, are proposed to explain their occurrence. This review describes subchondral bone cysts in the context of articular cartilage repair to improve investigations of these pathological changes. It summarizes their epidemiology in both preclinical and clinical settings with a focus on individual cartilage repair procedures, examines an algorithm for subchondral bone analysis, elaborates on the underlying mechanism of subchondral cyst formation, and condenses the clinical implications and perspectives on subchondral bone cyst formation in cartilage repair.
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Affiliation(s)
- Liang Gao
- Center of Experimental OrthopaedicsSaarland University Medical Center and Saarland UniversityHomburgGermany
| | - Magali Cucchiarini
- Center of Experimental OrthopaedicsSaarland University Medical Center and Saarland UniversityHomburgGermany
| | - Henning Madry
- Center of Experimental OrthopaedicsSaarland University Medical Center and Saarland UniversityHomburgGermany
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17
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Santschi EM, Juzwiak JS, Honnas C, Walker WT, Hunter B, Whitman JL, Prichard MA, Morehead JP. Management of Subchondral Lucencies of the Medial Aspect of the Equine Antebrachiocarpal Joint. J Equine Vet Sci 2020; 94:103266. [PMID: 33077089 DOI: 10.1016/j.jevs.2020.103266] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 09/10/2020] [Accepted: 09/10/2020] [Indexed: 11/25/2022]
Abstract
The objective of this study is to describe the management and outcomes of eight horses with subchondral lucencies (SCLs) of the medial aspect of the antebrachiocarpal (ABC) joint. The medical records and radiographs of the carpi of 8 horses with SCLs of the medial aspect of the ABC joint were reviewed. Follow-up clinical information was obtained for 6-60 months (the median duration of 14 months). Treatment was successful if radiographic healing was apparent or lameness was reduced or eliminated. Four horses had SCLs in the distomedial radius (DMR) and four in the proximal aspect of the radiocarpal bone (RCB). Lameness was present in all horses with DMR SCLs and in one horse with an RCB SCL. Treatments included restriction of exercise (n = 3), intra-articular administration of corticosteroids (n = 2), or placement of a screw across the SCL (n = 3). Exercise restriction alone was successful in three nonlame horses younger than one year with proximal RCB SCL and intra-articular corticosteroid administration in the ABC joint in two horses aged 2 years or younger with DMR SCLs. A yearling with a large proximal RCB SCL and two horses aged 5 years or older with DMR SCLs were successfully treated with screw placement across the SCL. Exercise restrictions and intra-articular administration of corticosteroids were successful in management of DMR SCLs in five horses. Placing a screw across the SCL of three horses resulted in resolution of lameness and substantial improvement of the radiographic appearance of the lesion in the RCB or DMR.
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Affiliation(s)
| | | | | | | | | | - Jeremy L Whitman
- Equine Medical Associates, 996 Nandino Blvd, Lexington, KY, 40583
| | | | - James P Morehead
- Equine Medical Associates, 996 Nandino Blvd, Lexington, KY, 40583
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18
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Pérez-Nogués M, Derham A, Marmion J, True Baker W. Progression of shallow medial femoral condyle radiographic lucencies in Thoroughbred repository radiographs and their influence on future racing careers. Equine Vet J 2020; 53:287-293. [PMID: 32500531 DOI: 10.1111/evj.13298] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 04/14/2020] [Accepted: 05/18/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Shallow lucencies less than 4 mm deep into the medial femoral condyle (MFC) are frequent in Thoroughbred horses undergoing screening sales radiographs. It is unclear if these shallow defects are precursors to larger cystic lesions or if they are fully developed defects that remodel into a flattened femoral condyle. OBJECTIVE To evaluate radiological lucencies of the MFC and their progression in size, in a cohort of Thoroughbred horses, ranging from 5 to 18 months of age and to report on the racing careers of these horses compared to their maternal siblings free of stifle pathology. STUDY DESIGN Retrospective cohort. METHODS Radiographic reports were reviewed to identify cases with MFC lucency. Medical data including age at the time of radiographic sale set, sex, and MFC lucency radiographic measurements were recorded. The data were analysed for changes in lucency morphology. Racing data were collected and analysed for the following 5 years. RESULTS From 12 938 sales reports reviewed, 3874 horses were found to have radiographic sets available at both weanling and yearling sales. A MFC lucency ≤3 mm in depth was diagnosed in at least one radiographic sales set in 248 horses (6.4%). The right femur was more commonly affected (73.9%) than the left. Radiographic lucencies in the left femur were significantly smaller (P = .02) than lucencies in the right femur. Radiographic lucencies resolved in 6.1% of cases, 3.6% of cases developed into a cyst, 40.7% of cases were unchanged in size, 23.6% of lucencies decreased in size and 8.2% increased in size. Cysts >3 mm deep regressed into smaller lesions accounting for 4.9% of the lucencies, and 12.9% of lucencies developed from a normal or flat medial femoral condyle contour. Horses with a medial femoral condyle lucency had significantly less starts as a 2-year-old vs. their maternal siblings (P < .01). MAIN LIMITATIONS Data were collected retrospectively. Measurement errors may have occurred due to the measuring tool scale, small size of the defects and/or radiographic position. Treatments between radiographic studies were unknown and could not be accounted for. Observers were not blinded to radiographic sales reports. CONCLUSIONS Radiographically diagnosed lucencies in the MFC of immature Thoroughbreds have the potential to fully resolve or develop into a cyst. However, most radiographic lucencies do not change in size. Thoroughbreds with MFC lucencies had less starts as 2-year-olds when compared to their maternal siblings free of stifle pathology.
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Affiliation(s)
- Marcos Pérez-Nogués
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California, Davis, Davis, CA, USA
| | - Ann Derham
- Oaklands Equine Hospital, Yarm, Yorkshire, UK
| | - James Marmion
- Professional Equine Sports Medicine, Kennett Square, PA, USA
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19
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Multimodal Imaging to Identify and Characterize a P3 Cystic Lesion and Pathologic Fracture. J Equine Vet Sci 2019; 86:102898. [PMID: 32067665 DOI: 10.1016/j.jevs.2019.102898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Revised: 12/11/2019] [Accepted: 12/16/2019] [Indexed: 11/23/2022]
Abstract
Lameness remains a common cause of retirement in the equine athlete and among hobby enthusiasts. The distal limb is one of the most frequently imaged areas, and recent advances in diagnostic imaging capabilities help practicing veterinarians differentiate normal variants from informative pathology. Although acute, non-weight-bearing lameness is commonly associated with etiologies, such as fractures, abscesses, and laminitis, other uncommon differentials such as cystic lesions and neoplasia might also be considered. This report describes the characterization of a large, cystic lesion in the third phalanx (P3), which resulted in an acute, pathologic fracture. The lesion was fully characterized with the use of postmortem magnetic resonance imaging, gross pathology, and histopathology.
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20
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Subchondral bone deterioration in femoral heads in patients with osteoarthritis secondary to hip dysplasia: A case-control study. J Orthop Translat 2019; 24:190-197. [PMID: 33101970 PMCID: PMC7548347 DOI: 10.1016/j.jot.2019.10.014] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2019] [Revised: 08/20/2019] [Accepted: 10/28/2019] [Indexed: 11/23/2022] Open
Abstract
Objectives Residual hip dysplasia is the most common underlying condition leading to secondary osteoarthritis (OA) of the hip. Subchondral bone alterations in OA secondary to hip dysplasia (HD-OA) are poorly investigated. The aim of the present study was to analyse the microarchitecture, bone remodelling and pathological alterations of subchondral bone in femoral heads from patients with HD-OA. Methods Subchondral bone specimens were extracted from both weight-bearing and non–weight-bearing regions of femoral heads from 20 patients with HD-OA and 20 patients with osteoporotic femoral neck fracture, during hip replacement surgery. Micro-CT and histological examination were performed to assess the microarchitecture and histopathological changes. Results The weight-bearing subchondral bone showed significantly more sclerotic microarchitecture and higher bone remodelling level in HD-OA as compared with osteoporosis. In the non–weight-bearing region, the two diseases shared similar microarchitectural characteristics, but higher bone remodelling level was detected in HD-OA. Distinct regional differences were observed in HD-OA, whereas the two regions exhibited similar characteristics in osteoporosis. In addition, HD-OA displayed more serious pathological alterations, including subchondral bone cyst, metaplastic cartilaginous tissue, bone marrow oedema and fibrous tissue, especially in the weight-bearing region. Conclusions Osteoarthritic deteriorations of subchondral bone induced by hip dysplasia spread throughout the whole joint, but exhibit region-dependent variations, with the weight-bearing region more seriously affected. Biomechanical stress might exert a pivotal impact on subchondral bone homeostasis in hip dysplasia. The translational potential of this article The histomorphometric findings in the project indicate an early intervention for the development of hip dysplasia in clinic.
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Affiliation(s)
- A. G. Bonilla
- Faculté de Médicine Vétérinaire Université de Montréal Saint‐Hyacinthe Québec Canada
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22
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Surgical Treatment of an Osseous Cyst-Like Lesion in the Middle Phalanx Communicating With the Distal Interphalangeal Joint of a Horse. J Equine Vet Sci 2019; 78:138-143. [PMID: 31203978 DOI: 10.1016/j.jevs.2019.05.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 05/06/2019] [Accepted: 05/07/2019] [Indexed: 11/22/2022]
Abstract
Subchondral or osseous cyst-like lesions within the distal aspect of the middle phalanx are not commonly reported in equids. These osseous lesions, which can communicate with the distal interphalangeal joint, can result in significant lameness and may not respond well to medical management. This report describes the clinical, diagnostic imaging, and surgical management of a 4-year-old mixed breed gelding where medical management of a chronic subchondral osseous cyst-like lesion of the middle phalanx, which communicated with the distal interphalangeal joint, was unsuccessful. A successful outcome was accomplished after surgical cyst debridement and packing with tricalcium phosphate, a bone marrow aspirate, and platelet-rich plasma.
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Jackson MA, Ohlerth S, Brink P, Simon O, Kummer M, Fürst AE. Treatment of subchondral cystic lesions (SCLs) with parathyroid hormone peptide (PTH
1‐34
)‐enriched fibrin hydrogel in three different concentrations: A dose‐blinded, randomised study. EQUINE VET EDUC 2018. [DOI: 10.1111/eve.13022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- M. A. Jackson
- Equine Department Vetsuisse Faculty University of Zurich ZurichSwitzerland
| | - S. Ohlerth
- Clinic of Diagnostic Imaging Vetsuisse Faculty University of Zurich Zurich Switzerland
| | - P. Brink
- Jagersro Equine ATG Clinic Jagersro, Malmo Sweden
| | - O. Simon
- Equine Clinic De Morette Asse Belgium
| | - M. Kummer
- Equine Department Vetsuisse Faculty University of Zurich ZurichSwitzerland
| | - A. E. Fürst
- Equine Department Vetsuisse Faculty University of Zurich ZurichSwitzerland
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Jackson MA, Ohlerth S, Fürst AE. Use of an aiming device and computed tomography for assisted debridement of subchondral cystic lesions in the limbs of horses. Vet Surg 2018; 48:O15-O24. [DOI: 10.1111/vsu.13112] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 08/09/2018] [Accepted: 09/04/2018] [Indexed: 11/30/2022]
Affiliation(s)
| | - Stefanie Ohlerth
- Clinic of Diagnostic Imaging, Department of Clinical Diagnostics and Services, Vetsuisse FacultyUniversity of Zurich Zurich Switzerland
| | - Anton E. Fürst
- Equine Department, Vetsuisse FacultyUniversity of Zurich Zurich Switzerland
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McLellan J. Science-in-brief: Bisphosphonate use in the racehorse: Safe or unsafe? Equine Vet J 2018; 49:404-407. [PMID: 28603949 DOI: 10.1111/evj.12682] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- J McLellan
- Florida Equine Veterinary Associates, Ocala, Florida, USA
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Hargreaves L, Anderson JDC, Fleck S, Dixon JJ. Diagnostic investigation of an unusually large osseous cyst-like lesion of the radial carpal bone. EQUINE VET EDUC 2018. [DOI: 10.1111/eve.12951] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - J. D. C. Anderson
- The Surgery; Bishopton Equine Veterinary Services; Ripon North Yorkshire UK
| | - S. Fleck
- The Surgery; Bishopton Equine Veterinary Services; Ripon North Yorkshire UK
| | - J. J. Dixon
- Rainbow Equine Hospital; Malton North Yorkshire UK
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Frazer LL, Santschi EM, Fischer KJ. The impact of subchondral bone cysts on local bone stresses in the medial femoral condyle of the equine stifle joint. Med Eng Phys 2017; 48:158-167. [DOI: 10.1016/j.medengphy.2017.06.019] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2016] [Revised: 06/06/2017] [Accepted: 06/14/2017] [Indexed: 11/24/2022]
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Ortved KF. Surgical Management of Osteochondrosis in Foals. Vet Clin North Am Equine Pract 2017; 33:379-396. [DOI: 10.1016/j.cveq.2017.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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Roquet I, Lane Easter J, Coomer RPC, Ezquerra LJ, Marsh CA, Trostle SS, Santschi EM. Treatment of subchondral lucencies in the medial proximal radius with a bone screw in 8 horses. Vet Surg 2017; 46:478-485. [DOI: 10.1111/vsu.12643] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2016] [Accepted: 07/13/2016] [Indexed: 11/27/2022]
Affiliation(s)
- Imma Roquet
- Department of Equine Surgery; Universidad de Extremadura; Caceres Spain
| | | | | | - Luis J. Ezquerra
- Department of Equine Surgery; Universidad de Extremadura; Caceres Spain
| | - Chad A. Marsh
- Equine Sports Medicine and Surgery; Weatherford Texas
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Bonilla AG, Bertone AL, Brokken MT, Santschi EM. Concurrent or sequential tibial subchondral cystic lesions in 4 horses with medial femoral condyle subchondral cystic lesions. J Am Vet Med Assoc 2016; 249:1313-1318. [DOI: 10.2460/javma.249.11.1313] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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OSTEOCHONDROSIS IN THE DISTAL FEMURS OF AN ADULT RETICULATED GIRAFFE (GIRAFFA CAMELOPARDALIS RETICULATA): MACROSCOPIC, RADIOLOGIC, AND HISTOLOGIC FINDINGS. J Zoo Wildl Med 2016; 47:359-63. [PMID: 27010303 DOI: 10.1638/2015-0076.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
An adult male reticulated giraffe (Giraffa camelopardalis reticulata) was presented for postmortem examination. During radiologic examination of the hindlimbs, osseous cyst-like lesions were detected in both medial femoral condyles. These lesions were subsequently examined macroscopically and histologically. The gross appearance suggested a diagnosis of bilateral osteochondrosis that was confirmed with histopathologic examination. This finding has not previously been reported in giraffes. Macroscopic visualization of the major limb joints, including the femorotibial joints, is therefore encouraged in future postmortem examinations of giraffes (Giraffa camelopardalis), and further assessment of clinical significance is required.
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Mair TS, Sherlock CE, Blunden A. Clinical and low field magnetic resonance imaging features of osseous cyst-like lesions of the proximal sesamoid bones in seven horses. EQUINE VET EDUC 2016. [DOI: 10.1111/eve.12558] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Affiliation(s)
- T. S. Mair
- Bell Equine Veterinary Clinic; Maidstone Kent UK
| | | | - A. Blunden
- Animal Health Trust; Lanwades Park; Kentford Suffolk UK
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Williams JM, Santschi EM. Pathological fracture through a subchondral bone cyst in the proximal phalanx of a horse. EQUINE VET EDUC 2015. [DOI: 10.1111/eve.12431] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- J. M. Williams
- Department of Large Animal Medicine; College of Veterinary Medicine; University of Georgia; Athens USA
| | - E. M. Santschi
- Department of Clinical Sciences; College of Veterinary Medicine; Kansas State University; Manhattan USA
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34
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Olstad K, Østevik L, Carlson CS, Ekman S. Osteochondrosis Can Lead to Formation of Pseudocysts and True Cysts in the Subchondral Bone of Horses. Vet Pathol 2014; 52:862-72. [DOI: 10.1177/0300985814559399] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Osteochondrosis arises as a result of focal failure of the blood supply to growth cartilage. The current aim was to examine the pathogenesis of pseudocysts and true cysts in subchondral bone following failure of the blood supply to the articular-epiphyseal cartilage complex in horses. Cases were recruited based on identification of lesions ( n = 17) that were considered likely to progress to or to represent pseudocysts or true cysts in epiphyseal bone in histological sections and included 10 horses ranging in age from 48 days to 5 years old. Cases comprised 3 warmbloods, 3 Standardbreds, 1 Quarter horse and 1 Arabian with spontaneous lesions and 2 Fjord ponies with experimentally induced lesions. Seven lesions consisted of areas of ischemic chondronecrosis and were compatible with pseudocysts. Two lesions were located at intermediate depth in epiphyseal growth cartilage, 2 lesions were located in the ossification front, 2 lesions were located in epiphyseal bone and 1 lesion was located in the metaphyseal growth plate (physis). Ten lesions contained dilated blood vessels and were compatible with true cysts. In 2 lesions the dilated blood vessels were located within the lumina of failed cartilage canals. In the 8 remaining lesions areas of ischemic chondronecrosis were associated with granulation tissue in the subjacent bone and dilated vessels were located within this granulation tissue. Failure of the blood supply and ischemic chondronecrosis can lead to formation of pseudocysts or dilatation of blood vessels and formation of true cysts in the epiphyseal bone of horses.
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Affiliation(s)
- K. Olstad
- Norwegian School of Veterinary Science, Oslo, Norway
| | - L. Østevik
- Norwegian School of Veterinary Science, Oslo, Norway
| | | | - S. Ekman
- Swedish University of Agricultural Sciences, Uppsala, Sweden
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Bonilla AG, Williams JM, Litsky AS, Santschi EM. Ex VivoEquine Medial Tibial Plateau Contact Pressure With an Intact Medial Femoral Condyle, With a Medial Femoral Condylar Defect, and After Placement of a Transcondylar Screw Through the Condylar Defect. Vet Surg 2014; 44:289-96. [DOI: 10.1111/j.1532-950x.2014.12242.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 06/01/2014] [Indexed: 11/27/2022]
Affiliation(s)
- Alvaro G. Bonilla
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; The Ohio State University; Columbus Ohio
| | - Jarred M. Williams
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; The Ohio State University; Columbus Ohio
- Departments of Orthopedics and Biomedical Engineering; Colleges of Medicine and Engineering; The Ohio State University; Columbus Ohio
| | - Alan S. Litsky
- Departments of Orthopedics and Biomedical Engineering; Colleges of Medicine and Engineering; The Ohio State University; Columbus Ohio
| | - Elizabeth M. Santschi
- Department of Veterinary Clinical Sciences; College of Veterinary Medicine; The Ohio State University; Columbus Ohio
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36
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Soto SA, Chiappe Barbará A. Bisphosphonates: Pharmacology and Clinical Approach to Their Use in Equine Osteoarticular Diseases. J Equine Vet Sci 2014. [DOI: 10.1016/j.jevs.2014.01.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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37
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Santschi EM, Williams JM, Morgan JW, Johnson CR, Bertone AL, Juzwiak JS. Preliminary Investigation of the Treatment of Equine Medial Femoral Condylar Subchondral Cystic Lesions With a Transcondylar Screw. Vet Surg 2014; 44:281-8. [DOI: 10.1111/j.1532-950x.2014.12199.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2013] [Accepted: 03/01/2014] [Indexed: 11/30/2022]
Affiliation(s)
| | - Jarred M. Williams
- Department of Veterinary Clinical Sciences; Ohio State University; Columbus Ohio
| | | | | | - Alicia L. Bertone
- Department of Veterinary Clinical Sciences; Ohio State University; Columbus Ohio
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38
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Greet T. The first recorded subchondral cyst-like lesion of a proximal sesamoid bone. EQUINE VET EDUC 2014. [DOI: 10.1111/eve.12144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- T. Greet
- Rossdales Equine Hospital; Newmarket Suffolk UK
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39
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Unicameral Bone Cyst in the Proximal Humerus with Secondary Infection in an 18-Month-Old Foal. Case Rep Vet Med 2014. [DOI: 10.1155/2014/708613] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
An 18-month-old warmblood filly was 4/5 lame on the front right limb at referral and showed severe swelling of the right shoulder region and pain during manipulation of the shoulder region. Radiography revealed a roundish 5 × 7 cm radiolucent area with defined borders within the greater tubercle and the presence of a fracture of the lateral tubercle associated with the cyst. Cellular blood count was 27,500 WBC/μL and serum biochemical analyses revealed fibrinogen of 855 mg/dL. The fractured bone was removed surgically; the cyst debrided and filled with autologous cancellous bone graft. Three and five weeks after surgery the filly was reoperated on because of an osseous sequestrum and a periostal defect on the distal dorsolateral aspect of the pastern of the right hind limb and a septic synovitis of the DFTS of the left hind limb. Fifteen month after surgery the filly was not lame and was introduced to training. Unicameral bone cysts (UBC) are well described lesions, often associated to pathologic fracture in the proximal humerus of children but, until present, no scientific report exists of UBC in the foal. The prompt surgical management had a favorable outcome.
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40
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41
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Denoix JM, Jeffcott L, McIlwraith C, van Weeren P. A review of terminology for equine juvenile osteochondral conditions (JOCC) based on anatomical and functional considerations. Vet J 2013; 197:29-35. [DOI: 10.1016/j.tvjl.2013.03.038] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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42
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Beccar Varela AM, Patipa LA, Eggleston RB. Subchondral bone cyst of the apical portion of the proximal sesamoid bone as a cause of severe lameness in a Warmblood filly. EQUINE VET EDUC 2012. [DOI: 10.1111/eve.12006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - L. A. Patipa
- Reid and Associates Equine Medicine and Surgery; Florida USA
| | - R. B. Eggleston
- Department of Large Animal Medicine; College of Veterinary Medicine, University of Georgia; Georgia USA
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Hurtig MB, Buschmann MD, Fortier LA, Hoemann CD, Hunziker EB, Jurvelin JS, Mainil-Varlet P, McIlwraith CW, Sah RL, Whiteside RA. Preclinical Studies for Cartilage Repair: Recommendations from the International Cartilage Repair Society. Cartilage 2011; 2:137-52. [PMID: 26069576 PMCID: PMC4300779 DOI: 10.1177/1947603511401905] [Citation(s) in RCA: 104] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Investigational devices for articular cartilage repair or replacement are considered to be significant risk devices by regulatory bodies. Therefore animal models are needed to provide proof of efficacy and safety prior to clinical testing. The financial commitment and regulatory steps needed to bring a new technology to clinical use can be major obstacles, so the implementation of highly predictive animal models is a pressing issue. Until recently, a reductionist approach using acute chondral defects in immature laboratory species, particularly the rabbit, was considered adequate; however, if successful and timely translation from animal models to regulatory approval and clinical use is the goal, a step-wise development using laboratory animals for screening and early development work followed by larger species such as the goat, sheep and horse for late development and pivotal studies is recommended. Such animals must have fully organized and mature cartilage. Both acute and chronic chondral defects can be used but the later are more like the lesions found in patients and may be more predictive. Quantitative and qualitative outcome measures such as macroscopic appearance, histology, biochemistry, functional imaging, and biomechanical testing of cartilage, provide reliable data to support investment decisions and subsequent applications to regulatory bodies for clinical trials. No one model or species can be considered ideal for pivotal studies, but the larger animal species are recommended for pivotal studies. Larger species such as the horse, goat and pig also allow arthroscopic delivery, and press-fit or sutured implant fixation in thick cartilage as well as second look arthroscopies and biopsy procedures.
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44
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45
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Sparks HD, Nixon AJ, Bogenrief DS. Reattachment of the articular cartilage component of type 1 subchondral cystic lesions of the medial femoral condyle with polydioxanone pins in 3 horses. J Am Vet Med Assoc 2011; 238:636-40. [DOI: 10.2460/javma.238.5.636] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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46
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Olstad K, Ytrehus B, Ekman S, Carlson CS, Dolvik NI. Early Lesions of Articular Osteochondrosis in the Distal Femur of Foals. Vet Pathol 2011; 48:1165-75. [DOI: 10.1177/0300985811398250] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Failure of the cartilage canal blood supply to epiphyseal growth cartilage has been implicated in the pathogenesis of articular osteochondrosis in horses and other animal species. In a previous study of the developmental pattern of the blood supply in the tarsus of foals, early lesions of osteochondrosis were consistently found in regions where the cartilage canal vessels traversed the chondro-osseous junction. The developmental pattern of blood vessels has also been described in the distal femoral epiphysis; however, the group of foals examined in that study did not have lesions of osteochondrosis in this location. Therefore, the relationship between the occurrence of early lesions of osteochondrosis and the developmental pattern of the blood supply to epiphyseal growth cartilage in this site in foals has not been examined. Distal femora were collected from 30 fetuses and foals (up to 11 months old) submitted for postmortem examination. Sections from the lateral trochlear ridge and medial femoral condyle of both hind limbs were examined histologically. Sixteen cartilage lesions were found in 7 of the 30 fetuses and foals. All lesions contained evidence of cartilage canal necrosis and ischemic chondronecrosis. The lesions were located in regions where cartilage canal vessels traversed the chondro-osseous junction, as previously observed in the tarsus. The location and morphology of lesions indicated that a subclinical stage of ischemic chondronecrosis existed that preceded and predisposed to the development of osteochondrosis dissecans and subchondral bone cysts.
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Affiliation(s)
- K. Olstad
- Norwegian School of Veterinary Science, Oslo, Norway
| | - B. Ytrehus
- National Veterinary Institute, Oslo, Norway
| | - S. Ekman
- Swedish University of Agricultural Sciences, Uppsala, Sweden
| | | | - N. I. Dolvik
- Norwegian School of Veterinary Science, Oslo, Norway
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Briston L, Dudhia J, Lees P. Age-related differences in prostaglandin E2 synthesis by equine cartilage explants and synoviocytes. J Vet Pharmacol Ther 2010; 33:268-76. [PMID: 20557444 DOI: 10.1111/j.1365-2885.2009.01131.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Time- and concentration-related actions of lipopolysaccharide (LPS) on the synthesis of prostaglandin E(2) (PGE(2)) were investigated in cartilage explants and synoviocytes harvested from 3 age groups of horses, all with clinically normal joint function: group A <10 years; group B 11-20 years and group C >20 years. Cartilage explants from group A horses were least and those from group C were most sensitive to LPS. Significant increases in PGE(2) concentration (P <or= 0.01) were obtained in group C horses in response to LPS concentrations of 1.0 microg/mL (and higher) after exposure for 24, 36 and 48 h, whereas explants from group A horses failed to respond to LPS at concentrations up to 100 microg/mL after exposure times up to 48 h. In contrast, synoviocytes from group A horses were most and those from group C horses were least sensitive to LPS stimulation. Synoviocytes from group A horses responded to LPS concentrations of 1 microg/mL (and higher) with significantly increased concentrations of PGE(2) at 24 and 36 h. Significant but numerically smaller increases in PGE(2) concentration were induced by LPS in synoviocytes from groups B and C. As the effects of high PGE(2) concentrations are catabolic for cartilage, these observations suggest that both synoviocytes and chondrocytes might exert roles in the degenerative changes which occur in cartilage in horses with osteoarthritis.
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Affiliation(s)
- L Briston
- Department of Veterinary Basic Sciences, Royal Veterinary College, Hawkshead Campus, Hatfield, Hertfordshire, UK
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48
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Byron CR, Barger AM, Stewart AA, Pondenis HC, Fan TM. In vitro expression of receptor activator of nuclear factor-kappaB ligand and osteoprotegerin in cultured equine articular cells. Am J Vet Res 2010; 71:615-22. [PMID: 20513175 DOI: 10.2460/ajvr.71.6.615] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine concentrations of receptor activator of nuclear factor-kappaB ligand (RANKL) and osteoprotegerin (OPG) in equine chondrocytes and synoviocytes and to quantify changes in the OPG:RANKL ratio in response to exogenous factors. SAMPLE POPULATION Samples of articular cartilage and synovium with grossly normal appearance obtained from metacarpophalangeal and metatarsophalangeal joints of 5 adult (1- to 8-year-old) horses. PROCEDURES Cell cultures of chondrocytes and synoviocytes were incubated with human recombinant interleukin-1beta (hrIL-1beta; 10 ng/mL), lipopolysaccharide (LPS; 10 microg/mL), or dexamethasone (100nM) for 48 hours. Negative control cultures received no treatment. Cells and spent media were assayed for RANKL and OPG concentrations by use of western blot and immunocytochemical analyses. Spent media were also assayed for OPG concentration by use of an ELISA. RESULTS RANKL and OPG were expressed in equine chondrocytes and synoviocytes in vitro. Cell-associated RANKL and OPG concentrations were not impacted by exogenous factors. Soluble RANKL release into media was significantly increased by hrIL-1beta in chondrocyte but not in synoviocyte cultures. Soluble OPG release into media was significantly increased by hrIL-1beta and LPS in chondrocyte but not in synoviocyte cultures. The soluble OPG:RANKL ratio was significantly increased by LPS in chondrocyte cultures. Dexamethasone decreased OPG expression in synoviocytes. CONCLUSIONS AND CLINICAL RELEVANCE RANKL and OPG proteins were expressed in equine articular cells. Release of these proteins may affect osteoclastogenesis within adjacent subchondral bone. Thus, RANKL and OPG may have use as biomarkers and treatment targets in horses with joint disease.
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Affiliation(s)
- Christopher R Byron
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine, University of Illinois, Urbana, IL 61801, USA.
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49
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Arthroscopic injection of corticosteroids into the fibrous tissue of subchondral cystic lesions of the medial femoral condyle in horses: A retrospective study of 52 cases (2001-2006). Equine Vet J 2010; 40:461-7. [DOI: 10.2746/042516408x258843] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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50
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Scott M. Musculoskeletal Injuries in Nonracing Quarter Horses. Vet Clin North Am Equine Pract 2008; 24:133-52. [DOI: 10.1016/j.cveq.2007.11.006] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
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