Epidemiology of race-day distal limb fracture in flat racing Thoroughbreds in Great Britain (2000-2013)

Influence of microarchitecture on stressed volume and mechanical fatigue behaviour of equine subchondral bone

Fractures of the equine metacarpophalangeal (MCP) joint are among the most common and fatal injuries experienced by racehorses. These bone injuries are a direct result of repetitive, high intensity loading of the skeleton during racing and training and there is consensus that they represent a mechanical fatigue phenomenon. Existing work has found the fatigue life of bone to be strongly determined by bone microarchitecture and the resulting stressed volume (i.e., the volume of bone stressed above assumed yield). The purpose of this study was to quantify the influence of bone microarchitecture on the mechanical fatigue behaviour of equine subchondral bone from the MCP joint across a wide variety of sample types. Forty-eight subchondral bone samples were prepared from the third metacarpal (MC3) and proximal phalanx (P1) of 8 horses and subsequently imaged using high resolution micro-computed tomography (μCT) to quantify microarchitectural features of interest, including bone volume fraction, tissue mineral density, pore size, pore spacing, and pore number. Samples were cyclically loaded in compression to a stress of 70 MPa, and fatigue life was defined as the number of cycles until failure. Finite element models were created from the μCT images and used to quantify stressed volume. Based on the expected log point-wise predictive density, stressed volume was a strong predictor of fatigue life in both the MC3 and P1. A regional analysis indicated fatigue life was more strongly associated with bone volume fraction in the superficial (r2 = 0.32, p < 0.001) and middle (r2 = 0.70, p < 0.001) regions of the subchondral bone, indicating the prominent role that the cortical plate played in the fatigue resistance of equine subchondral bone. By improving our understanding of the variance in fatigue life measurements, this research helps clarify the underlying mechanisms of the mechanical fatigue process and provides a basic understanding of subchondral bone injuries in the equine fetlock joint.

Fractures in Thoroughbred racing and the potential for pre-race identification of horses at risk

Risk rates for and predisposing factors to fractures occurring in Thoroughbred racing that have been published in peer reviewed journals are documented. The potential for currently available techniques to identify horses at increased risk for fracture is discussed on the bases of principles, practicalities, advantages, disadvantages and current data. All are reviewed in light of justifiable decision making and importance of fractures to horseracing's social license.

Differences in bone turnover markers and injury risks between local and international horses: A Victorian Spring Racing Carnival study

BACKGROUND

Musculoskeletal injuries (MSI) are common in racehorses and have been of increasing concern in horses travelling internationally to compete. Understanding the differences in bone turnover between local horses and international horses following long-distance air transportation may inform MSI prevention strategies.

OBJECTIVES

To understand the differences in bone turnover markers and risk of MSI between local horses and international horses following long-distance air transportation.

STUDY DESIGN

Prospective cohort.

METHODS

The concentrations of bone turnover markers (OCN and CTXI), markers of stress (cortisol), inflammation (serum amyloid A) and circadian rhythm (melatonin), and bisphosphonates were determined in blood samples collected twice (14-17 days apart), from horses following international travel (n = 69), and from local horses (n = 79). The associations between markers, long-distance travel and MSI were determined using multivariable generalised linear regression models.

RESULTS

Within 3-5 days post-transport, concentrations of cortisol in international horses were higher than those of local horses (main effect, Coef. 0.39; 95% CI 0.24, 0.54; p < 0.001) but they decreased and were not different to those of local horses at the second timepoint (interaction effect, Coef. -0.27; 95% CI -0.46, -0.07; p = 0.007). After adjusting for age and sex, OCN and CTXI were not significantly different between international and local horses; however, OCN was lower in international horses at timepoint 2 (interaction effect, Coef. -0.16; 95% CI -0.31, -0.01; p = 0.043). The prevalence of MSI was higher in the international (26%; 95% CI 16, 38%) compared with local horses (8%; 95% CI 3, 16%; p < 0.001), with all severe MSI sustained by the international horses. At the second timepoint compared with the first timepoint post-transport, cortisol remained high or increased (interaction effect, Coef. 0.43; 95% CI 0.24, 0.61; p < 0.001) and OCN increased (interaction effect, Coef. 0.26; 95% CI 0.08, 0.44; p = 0.006) in the horses that sustained severe MSI.

MAIN LIMITATIONS

Horse population and racing career parameters differed between groups. Bone turnover markers have low sensitivity to detect local bone changes.

CONCLUSIONS

Most horses showed minimal effects of long-distance air transport within 2 weeks relative to local horses as assessed by stress and bone turnover markers. Screening for persistent high cortisol and evidence of net bone formation after long-distance air transportation may help to identify racehorses at high risk of catastrophic MSI.

Classification of racehorse limb radiographs using deep convolutional neural networks

Purpose

To assess the capability of deep convolutional neural networks to classify anatomical location and projection from a series of 48 standard views of racehorse limbs.

Materials and methods

Radiographs (N = 9504) of horse limbs from image sets made for veterinary inspections by 10 independent veterinary clinics were used to train, validate and test (116, 40 and 42 radiographs, respectively) six deep learning architectures available as part of the open source machine learning framework PyTorch. The deep learning architectures with the best top-1 accuracy had the batch size further investigated.

Results

Top-1 accuracy of six deep learning architectures ranged from 0.737 to 0.841. Top-1 accuracy of the best deep learning architecture (ResNet-34) ranged from 0.809 to 0.878, depending on batch size. ResNet-34 (batch size = 8) achieved the highest top-1 accuracy (0.878) and the majority (91.8%) of misclassification was due to laterality error. Class activation maps indicated that joint morphology, not side markers or other non-anatomical image regions, drove the model decision.

Conclusions

Deep convolutional neural networks can classify equine pre-import radiographs into the 48 standard views including moderate discrimination of laterality, independent of side marker presence.

The Reporting of Racehorse Fatalities in New Zealand Thoroughbred Flat Racing in the 2011/12-2021/22 Seasons

Race day fatalities as a consequence of catastrophic musculoskeletal injury and cardiac failure are both a welfare concern and provide a challenge for the social perceptions of equine welfare within the racing industry. To reduce race day fatalities, the risk factors under New Zealand racing conditions need to be identified. The aim of this study was to examine race and horse-level risk factors for fatalities in New Zealand Thoroughbred flat racing using retrospective race day data from the 2011/12-2021/22 racing seasons. Horse and race-level factors associated with a suspected cardiac failure and fatal fracture were identified by merging fatality data with the master race dataset for the corresponding seasons. Most fatalities were associated with fatal fracture (0.4 per 1000 starts, 95% CI 0.4-0.5). Horses which raced over distances > 1600 m were 1.7 times (95% CI 1.2-2.5) more likely to sustain a fatal fracture than horses racing ≤ 1600 m. Male horses and firmer track conditions were also associated with an increase in the risk of fatal fracture. Horses aged 5 years and older were 2.1 (95% CI 1.1-4.6) times more likely to suffer a suspected cardiac failure than younger horses. Changes in the industry reporting system improved the level of detail provided for fatalities, enabling the identification of specific risk factors.

Race-Level Reporting of Incidents Using the New Online System During Two Seasons (2019/2020-2020/2021) of Harness Racing in New Zealand

After establishing a baseline of stipendiary stewards' reporting using the paper-based system in the 2015/16 and 2016/17 seasons of harness racing, it is important to examine if the implementation of an online system has altered frequency and descriptors used for clinical outcomes. The objective of this study was to describe the race level injury and reporting outcomes, and horse- and race-level variables associated with the rate of the reporting of these outcomes during the 2019/20 and2020/21 harness racing seasons in New Zealand. The introduction of the online system was associated with few (0.01%) miscoding events associated with horse identification. There was a shift in the frequency of reporting non-incident examinations, possibly due to better definition and prompts within the online system. The coding category, no observable abnormalities detected (NOAD) had the greatest number of entries, reflecting that the majority of examinations were associated with general screening rather than adverse events occurring during warm-up or the race. The frequency of recordings for most clinical findings was consistent between the old paper-based system and the new online system. The incidence of musculoskeletal fractures remained low (0.12 per 1,000 starts, 95%CI = 0.05-0.28). The online system has the potential to provide a useful tool to prospectively monitor the reporting of injuries and conditions associated with harness racing in New Zealand.

Biomechanical and Microstructural Properties of Subchondral Bone From Three Metacarpophalangeal Joint Sites in Thoroughbred Racehorses

Fatigue-induced subchondral bone (SCB) injury is common in racehorses. Understanding how subchondral microstructure and microdamage influence mechanical properties is important for developing injury prevention strategies. Mechanical properties of the disto-palmar third metacarpal condyle (MCIII) correlate poorly with microstructure, and it is unknown whether the properties of other sites within the metacarpophalangeal (fetlock) joint are similarly complex. We aimed to investigate the mechanical and structural properties of equine SCB from specimens with minimal evidence of macroscopic disease. Three sites within the metacarpophalangeal joint were examined: the disto-palmar MCIII, disto-dorsal MCIII, and proximal sesamoid bone. Two regions of interest within the SCB were compared, a 2 mm superficial and an underlying 2 mm deep layer. Cartilage-bone specimens underwent micro-computed tomography, then cyclic compression for 100 cycles at 2 Hz. Disto-dorsal MCIII specimens were loaded to 30 MPa (n = 10), while disto-palmar MCIII (n = 10) and proximal sesamoid (n = 10) specimens were loaded to 40 MPa. Digital image correlation determined local strains. Specimens were stained with lead-uranyl acetate for volumetric microdamage quantification. The dorsal MCIII SCB had lower bone volume fraction (BVTV), bone mineral density (BMD), and stiffness compared to the palmar MCIII and sesamoid bone (p < 0.05). Superficial SCB had higher BVTV and lower BMD than deeper SCB (p < 0.05), except at the palmar MCIII site where there was no difference in BVTV between depths (p = 0.419). At all sites, the deep bone was stiffer (p < 0.001), although the superficial to deep gradient was smaller in the dorsal MCIII. Hysteresis (energy loss) was greater superficially in palmar MCIII and sesamoid (p < 0.001), but not dorsal MCIII specimens (p = 0.118). The stiffness increased with cyclic loading in total cartilage-bone specimens (p < 0.001), but not in superficial and deep layers of the bone, whereas hysteresis decreased with the cycle for all sites and layers (p < 0.001). Superficial equine SCB is uniformly less stiff than deeper bone despite non-uniform differences in bone density and damage levels. The more compliant superficial layer has an important role in energy dissipation, but whether this is a specific adaptation or a result of microdamage accumulation is not clear.

Factors associated with completion of Fédération Équestre Internationale endurance rides (2012-2019): Modelling success to promote welfare-oriented decisions in the equestrian sport of endurance

Endurance riding is a popular equestrian sport organised at the international level by the Fédération Équestre Internationale (FEI). The sport involves prolonged exercise at speed over significant distances, which puts a substantial load on equine athletes' musculoskeletal systems and metabolism and contributes to the risk of injuries and other veterinary problems. The FEI employs a system of in-ride veterinary inspections aimed at early detection of such problems and elimination of horses unfit to continue in the ride. To date, risk factors for elimination due to irregular gait or metabolic problems have been the primary focus of scientific enquiry. The present study is the first large-scale multivariable study to report factors associated with the positive outcome of endurance rides - their successful completion. This retrospective observational cohort study used data from the FEI's Global Endurance Database. The study cohort included 74,629 starts made by 21,346 unique horses in one-day international-level competitions held worldwide between July 2012 and December 2019. Forty-one potential factors identified based on previous studies and a priori hypotheses were considered in the analysis. Univariable and multivariable logistic regression analyses were performed to investigate associations between ride completion and predictor variables and their interactions. The study identified 19 factors and four interactions associated with an increased or decreased likelihood of successful ride completion. High competition frequency (fewer days over mandatory out of competition period; Wald χ² 71.35, P-value <0.0001), fast riding speed (236.57, <0.0001), upward changes in competition level and riding speed between two successive rides (103.59, <0.0001 and 87.60, <0.0001) were associated with a decrease in the likelihood of ride completion. These factors can be effectively regulated by appropriate rules and considered by athletes when planning competition schedules, preparing ride strategies, or indeed during the ride itself. Other identified factors, including horse and rider age, sex, completions and eliminations history, contribute to an estimate of the likelihood that a particular combination completes a ride and thus can aid veterinarians at veterinary inspections as additional inputs supporting their decision-making when assessing horses' fitness to continue in the competition. The study's main limitation is an absence of data on national-level rides. Such data and data on training and veterinary histories remain difficult to access and were unavailable for the analysis. The present study's results demonstrate that shifting the focus to modelling the positive outcome is a valuable approach offering evidence-based recommendations for good horsemanship, better-informed veterinary inspections, and welfare-oriented rules.

Factors Associated with Fatality in Ontario Thoroughbred Racehorses: 2003-2015

Simple Summary

Ontario’s Alcohol and Gaming Commission records equine racing fatalities through its Equine Health Program. This study examines the 695 Thoroughbred occurrences from 2003 to 2015 with the aim of identifying associations. Deaths occurred within 60 days of a horse racing or being entered or qualified to race. Calculated on the most commonly adopted basis, rates for Ontario Thoroughbreds are high—2.94/1000 starts (all fatalities) and 1.96/1000 (breakdowns only), compared with a global industry breakdown range of 0.29–2.36/1000 starts. The study revealed several significant risk factors, including workload, stage of training, age, sex, stage of career, finish position, race field size, and day of week. Among fatalities were groups where combinations of these risk factors were important, such as being a two-year-old male, un-castrated, and in early training. Probability of fatality fell over the study period in response to increasing awareness through existence of the Program and adoption of new regulations, but remains of concern. All identified associations represent aspects of management and industry structure that are amenable to change with a view to reducing fatalities. A link between fatality and cumulative, non-fatal outcomes should also be considered. An overall approach might view associated factors as sources of physical and psychological stress that, acutely and cumulatively, may influence the liability for adverse outcomes in training and racing.

Abstract

Ontario’s Alcohol and Gaming Commission records equine racing fatalities through its Equine Health Program. The present study examined all Thoroughbred fatalities from 2003 to 2015, inclusive, to identify associations. Official records and details of fatalities were combined in multivariable logistic regression modelling of 236,386 race work-events (433 fatalities), and 459,013 workout work-events (252 fatalities). Fatality rates were 2.94/1000 race starts (all fatalities) and 1.96/1000 (breakdowns only) with an overall rate of 2.61% or 26.1 fatalities/1000 horses. Comparison with published reports reveals rates to be high. Musculoskeletal injury was the predominant complaint and there was a high incidence of horses dying suddenly. Liability was high for young horses early in the season with a differential according to sex and whether a male horse was gelded. Horses undertaking repeated workouts had a higher liability and liability was higher in workouts for horses switching from dirt/synthetic to turf racing and for young horses in sprints. Race distance was not significant but high fatality rates in some large field, distance races combined with effects of age and workload identified groups at particular risk. As field size increased, fatality liability increased for early-finishing horses. Findings suggest jockey strategy could be an important factor influencing fatalities. Probability of fatality declined over the study period. Findings indicate that rapid accumulation of workload in animals early in their preparation is likely to be damaging. Fatality fell toward the end of a season and for horses with a long career history of successful performance; however, horses not exhibiting this robustness and staying power represent the population of greatest concern. Associations may be characterised as representing sources of stress, current or cumulative, and identifying at-risk animals on this basis may be as productive as targeting specific, discrete mechanisms suspected to contribute to individual fatalities.

Attrition of Thoroughbred and Standardbred racehorses at New York Racetracks due to exercise and non-exercise related fatalities during the 2016 - 2019 racing seasons

A longitudinal retrospective study was carried out to investigate the attrition of Thoroughbred (TB) and Standardbred (SB) horses racing at New York racetracks during the 2016 to 2019 seasons. The data were collected from the New York State Gaming Commission (NYSGC) Equine Breakdown, Death, Injury and Incident (EBDII), The Jockey Club InCompass Solutions, and The United States Trotting Association Pathway databases. Survival analysis was used to compare the predisposing factors by breed of the horse. The study included 431 horses (360 TB and 71 SB). There was a significant difference between the average incidence of attrition events per start for TB (0.304) and SB (0.035) horses. There was a significant difference in the median age to attrition between TB (4.2 years) and SB (7.5 years) horses. There was also a significant difference between the average number of starts to attrition for TB (13.6) and SB (125.5) horses. Among the causes of attrition events in the two breeds musculoskeletal injuries and medical conditions were significantly higher among TB horses, while sudden death was significantly higher among SB horses. The multivariate analysis showed that the hazard of attrition was affected by the age of the horse, age at first start, whether the horse was intact male, type of activity (racing training or other) and the breed of the horse. SB horses were less likely to experience attrition events in comparison to TB horses.

Training Young Horses: The Science behind the Benefits

Simple Summary

Of common debate among equine professionals and enthusiasts alike, is whether entering race training at two years of age is detrimental or beneficial to the animal’s career and growth. This literature review evaluates epidemiological studies to elucidate that two-year-old horses are not at greater risk of injury compared to older horses. Horses which enter race training at two years of age are, in fact, found to have greater earnings and longer race careers. This review also tackles the impact that exercising an animal at two years of age or younger has on bone, articular cartilage, and tendons. Numerous studies on growing animals have found confinement to be detrimental to normal musculoskeletal growth. However, exercise of dynamic nature in moderate distances, such as that attained with pasture access or prescribed sprints, is beneficial to musculoskeletal development and may prevent injuries when entering race training. Based on scientific evidence, the research cited in this review supports the training and racing of two-year-old horses and advises caution in the use of medications such as corticosteroids.

Abstract

Conflicting research and anecdotal evidence have created disagreement among equestrians as to whether two-year-old horses should be trained and raced. The objective of this literature review is to evaluate epidemiological studies, as well as physiological data on equine bone, articular cartilage, and tendons to better determine the impact of training and racing two-year-old horses. The evaluation of numerous studies on the topic provides evidence that a horse which is trained or raced as a two-year-old has a lower risk of injury and better adapted tissues for the rigors of racing. Unfortunately, the current prolific use of pain-mitigating substances in the racing industry does place horses, including young cohorts, at greater risk of injury, and should be used with caution.

Microstructural properties of the proximal sesamoid bones of Thoroughbred racehorses in training

BACKGROUND

Proximal sesamoid bone fractures are common catastrophic injuries in racehorses. Understanding the response of proximal sesamoid bones to race training can inform fracture prevention strategies.

OBJECTIVES

To describe proximal sesamoid bone microstructure of racehorses and to investigate the associations between microstructure and racing histories.

STUDY DESIGN

Cross-sectional.

METHODS

Proximal sesamoid bones from 63 Thoroughbred racehorses were imaged using micro-computed tomography. Bone volume fraction (BVTV) and bone material density (BMD) of the whole bone and four regions (apical, midbody dorsal, midbody palmar and basilar) were determined. Generalised linear regression models were used to identify the associations between bone parameters and race histories of the horses.

RESULTS

The mean sesamoid BVTV was 0.79 ± 0.08 and BMD was 806.02 ± 24.66 mg HA/ccm. BVTV was greater in medial sesamoids compared with lateral sesamoids (0.80 ± 0.07 vs 0.79 ± 0.08; P < .001) predominantly due to differences in the apical region (medial-0.76 ± 0.08 vs lateral-0.72 ± 0.07; P < .001). BVTV in the midbody dorsal region (0.86 ± 0.06) was greater than other regions (midbody palmar-0.79 ± 0.07, basilar-0.78 ± 0.06 and apical-0.74 ± 0.08; P < .001). BVTV was greater in sesamoids with more microcracks on their articular surface (Coef. 0.005; 95% CI 0.001, 0.009; P = .01), greater extent of bone resorption on their abaxial surface (Grade 2-0.82 ± 0.05 vs Grade 1-0.80 ± 0.05 or Grade 0-0.79 ± 0.06; P = .006), in horses with a low (0.82 ± 0.07) or mid handicap rating (0.78 ± 0.08) compared with high rating (0.76 ± 0.07; P < .001), in 2- to 5-year-old horses (0.81 ± 0.07) compared with younger (0.68 ± 0.08) or older horses (0.77 ± 0.08; P < .001) and in horses that commenced their racing career at less than 4 years of age (0.79 ± 0.08 vs 0.77 ± 0.77; P < .001). BMD was greater in the midbody dorsal (828.6 ± 19.6 mg HA/ccm) compared with other regions (apical-805.8 ± 21.8, midbody palmar-804.7 ± 18.4 and basilar-785.0 ± 17.1; P < .001), in horses with a handicap rating (low-812.1 ± 20.0, mid-821.8 ± 21.3 and high-814.6 ± 19.4) compared with those with no rating (791.08 ± 24.4, P < .001), in females (806.7 ± 22.0) and geldings (812.2 ± 22.4) compared with entires (792.7 ± 26.2; P = .02) and in older horses (<2-year-old-763.7 ± 24.8 vs 2- to 5-year-old-802.7 ± 23.4, and 6- to 12-year-old-817.8 ± 20.0; P = .002).

MAIN LIMITATIONS

Data were cross-sectional.

CONCLUSIONS

Densification of the proximal sesamoid bones is associated with the commencement of racing in younger horses and the presence of bone fatigue-related pathology. Lower sesamoid BVTV was associated with longevity and better performance.