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Lin ST, Bolas NM, Sargan DR, Restif O, Peter VG, Pokora R, Patrick H, Foote AK, Murray RC. Comparison of cone-beam and fan-beam computed tomography and low-field magnetic resonance imaging for detection of proximal phalanx dorsoproximal osteochondral defects. Equine Vet J 2024; 56:484-493. [PMID: 37488678 DOI: 10.1111/evj.13973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 06/28/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Dorsoproximal osteochondral defects commonly affect the proximal phalanx, but information about diagnosis on computed tomography (CT) and magnetic resonance imaging (MRI) is limited. OBJECTIVES To assess CT and MRI diagnoses of osteochondral defects, describe the lesions and compare sensitivity and specificity of the modalities using macroscopic pathology as gold standard. STUDY DESIGN Cross-sectional study. METHODS Thirty-five equine cadaver limbs underwent standing cone-beam CT (CBCT), fan-beam CT (FBCT), low-field MRI and pathological examination. CT and MR images were examined for proximal phalanx dorsomedial and dorsolateral eminence osteochondral defects. Defect dimensions were measured. Imaging diagnoses and measurements were compared with macroscopic examination. RESULTS Fifty-six defects were seen over 70 potential locations. On CBCT and FBCT, osteochondral defects appeared as subchondral irregularity/saucer-shaped defects. On MRI, osteochondral defects were a combination of articular cartilage defect on dorsal images and subchondral flattening/irregularity on sagittal images. Subchondral thickening and osseous short tau inversion recovery hyperintensity were found concurrent with osteochondral defects. Compared with pathological examination, the sensitivity and specificity of diagnosis were 86% (95% confidence interval [95% CI] 75%-93%) and 64% (95% CI 38%-85%) for FBCT; 64% (95% CI 51%-76%) and 71% (95% CI 46%-90%) for CBCT; and 52% (95% CI 39%-65%) and 71% (95% CI 46%-90%) for MRI. Sensitivity of all modalities increased with defect size. Macroscopic defect dimensions were strongly correlated with CBCT (r = 0.76, p < 0.001) and moderately correlated with FBCT and MRI (r = 0.65, p < 0.001). Macroscopic measurements were significantly greater than all imaging modality dimensions (p < 0.001), potentially because macroscopy included articular cartilage pathology. MAIN LIMITATIONS Influence of motion artefact could not be assessed. CONCLUSIONS Osteochondral defects could be visualised using both CT and MRI with sensitivity increasing with defect size. Diagnostic performance was best using FBCT, followed by CBCT then MRI, but CBCT-measured defect size best correlated with macroscopic examination. MRI provided useful information on fluid signal associated with defects, which could represent active pathology.
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Affiliation(s)
- Szu-Ting Lin
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | | | - David R Sargan
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Olivier Restif
- Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Vanessa G Peter
- Rossdales Equine Hospital and Diagnostic Centre, Suffolk, UK
| | - Rachel Pokora
- Rossdales Equine Hospital and Diagnostic Centre, Suffolk, UK
| | | | | | - Rachel C Murray
- Rossdales Equine Hospital and Diagnostic Centre, Suffolk, UK
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2
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Ciamillo SA, Wulster KB, Gassert TM, Richardson DW, Brown KA, Stefanovski D, Ortved KF. Prospective, longitudinal assessment of subchondral bone morphology and pathology using standing, cone-beam computed tomography in fetlock joints of 2-year-old Thoroughbred racehorses in their first year of training. Equine Vet J 2024. [PMID: 38247205 DOI: 10.1111/evj.14048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 11/30/2023] [Indexed: 01/23/2024]
Abstract
BACKGROUND Catastrophic injuries of the fetlock joints occur in Thoroughbred racehorses and are preceded by stress-induced bone injury. Early detection of subchondral bone injury is essential to prevent irreversible damage or bone failure. OBJECTIVES To investigate the use of standing, robotic cone-beam computed tomography (CBCT) for assessing longitudinal changes in subchondral bone morphology and pathology of the fetlock joints associated with race training in young Thoroughbreds. STUDY DESIGN Observational cohort study. METHODS Forty-one 2-year-old Thoroughbred racehorses were recruited prior to the start of race training. Standing CBCT and radiographs of all 4 metacarpo-/metatarsophalangeal (MCP/MTP) joints were obtained at 0, 6 and 12 months. Hyperdensity, as an estimate of subchondral bone sclerosis, was measured in the distal third metacarpal (MC3)/metatarsal (MT3) bone and proximal phalanx (P1) at each time point on computed tomography. CBCTs were examined for subchondral bone pathology consisting of areas of hypodensity within regions of hyperdensity. RESULTS Subchondral bone sclerosis increased significantly over time in the medial and lateral MC3/MT3 condyles and in the medial and lateral parasagittal grooves of MC3/MT3. The presence of subchondral bone pathology increased significantly over time in the medial and lateral palmar condyles of MC3/MT3, the lateral parasagittal groove, the medial dorsal condyle and the medial and lateral ridges of P1. MAIN LIMITATIONS There was attrition of horses due to relocation, change in ownership, and retirement from racing. Husbandry, training regimens and racing schedules were not controlled for in the study. CONCLUSIONS Standing CBCT is an efficient and effective screening tool for assessing subchondral bone morphology and identifying pathology of the fetlock joint in young Thoroughbred racehorses. CBCT may facilitate early detection of bone pathology allowing for timely intervention and prevention of more serious injuries.
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Affiliation(s)
- Sarah A Ciamillo
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Kathryn B Wulster
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Taryn M Gassert
- Sports Medicine Associates of Chester County, Cochranville, Pennsylvania, USA
| | - Dean W Richardson
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Kara A Brown
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Darko Stefanovski
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA
| | - Kyla F Ortved
- Department of Clinical Studies-New Bolton Center, University of Pennsylvania, Kennett Square, Pennsylvania, USA
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Goldkuhl JEC, Zablotski Y, Sill V, Jahn W, Lorenz I, Brunk J, Gerlach K, Troillet A. Evaluation of cartilage injury in horses with osteochondral fragments in the metacarpo-/metatarsophalangeal joint: A study on 823 arthroscopies. Equine Vet J 2024; 56:89-98. [PMID: 36922161 DOI: 10.1111/evj.13937] [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: 06/15/2022] [Accepted: 03/09/2023] [Indexed: 03/17/2023]
Abstract
BACKGROUND Osteochondral fragment removal is commonly performed but there are little scientific data supporting this procedure in the absence of clinical signs. More information is needed to facilitate clinical decision-making regarding fragment removal of the metacarpo-/metatarsophalangeal joint. OBJECTIVES To assess prevalence of cartilage injury in the equine metacarpo-/metatarsophalangeal joint and its association to fragment size, location, age and lameness. STUDY DESIGN Retrospective observational study. METHODS Clinical records, including radiographs of 823 metacarpo-/metatarsophalangeal joints (640 horses) that underwent arthroscopic fragment removal, were reviewed. Fragment size, intra-articular fragment location and cartilage injury score were recorded. Presence of synovitis was retrospectively evaluated in 157 joints. Kruskal-Wallis and Mann-Whitney tests were used for group comparisons, and Dunn's post hoc test was applied for multiple comparisons. Linear regression analysis was used to assess strength of association between age and mean cartilage score. Univariable regression analysis was performed and variables with p < 0.2 were used in the final mixed-effects multivariable model to which backwards stepwise selection was applied. Significance level was p < 0.05. RESULTS Cartilage injury was present in 28.8% (95% CI = 25.8-32.0) of joints. Lameness was not associated with fragment location or fragment size. Fragment size was not associated with cartilage injury. Age (OR = 1.35, 95% CI = 1.22-1.48, p < 0.001) and lameness (OR = 5.03, 95% CI = 2.27-11.68, p < 0.001) were associated with cartilage injury as well as fragment location (palmar/plantar, OR = 0.22, 95% CI = 0.13-0.38, p < 0.001), with dorsal fragments being more likely to be associated with cartilage lesions than palmar/plantar fragments. There was a significant association between age and mean cartilage score (b = 0.18, 95% CI = 0.14-0.22, p < 0.001). MAIN LIMITATIONS The series included a heterogenous group of horses of different breed, sex, age and use. Data were collected retrospectively and could, in parts, not be fully evaluated. CONCLUSIONS Early fragment removal, especially in joints with dorsal fragmentation, can be beneficial to avoid future cartilage injuries in equine athletes.
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Affiliation(s)
| | - Yury Zablotski
- Clinic for Horses at the Centre for Clinical Veterinary Medicine, Faculty of Veterinary Medicine, Ludwig Maximilians University, Munich, Germany
| | - Volker Sill
- Pferdeklinik Bargteheide, Bargteheide, Germany
| | - Werner Jahn
- Pferdeklinik Bargteheide, Bargteheide, Germany
| | - Ina Lorenz
- Pferdeklinik Bargteheide, Bargteheide, Germany
| | - Jan Brunk
- Pferdeklinik Bargteheide, Bargteheide, Germany
| | - Kerstin Gerlach
- Department for Horses, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
| | - Antonia Troillet
- Department for Horses, Faculty of Veterinary Medicine, University of Leipzig, Leipzig, Germany
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4
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Van Cauter R, Serteyn D, Lejeune JP, Rousset A, Caudron I. Evaluation of the appearance of osteochondrosis lesions by two radiographic examinations in sport horses aged from 12 to 36 months. PLoS One 2023; 18:e0286213. [PMID: 37220101 DOI: 10.1371/journal.pone.0286213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 05/10/2023] [Indexed: 05/25/2023] Open
Abstract
Osteochondrosis is a developmental orthopedic disease characterized by a defect of enchondral ossification. This pathological condition develops and evolves during growth and is influenced by various factors, in particular genetic and environmental. However, little research has been conducted on the dynamic of this condition in horses after the age of 12 months. The retrospective study presented here investigates changes in osteochondrosis lesions through two standardized radiographic examinations carried out on young Walloon sport horses after one year of age (mean age at first and second examination was 407 (±41) and 680 (±117) days respectively). Each examination, analyzed independently by three veterinarians, included latero-medial views of the fetlocks, hocks, stifles, plantarolateral-dorsomedial hocks view and additional radiograph if the operator deemed it necessary. Each joint site was graded as healthy, osteochondrosis (OC) or osteochondrosis dissecans (OCD) affected. A group of 58 horses was studied, among them 20 presented one or more osteochondrosis lesions for a total of 36 lesions present during at least one examination. In this population, 4 animals (6.9%) presented osteochondrosis during only one examination (2 at the first examination and 2 at the second one). Moreover, it was possible to demonstrate the appearance, disappearance and more generally the evolution of 9/36 lesions (25%) within the different joints. The results of the study suggest that, although substantial main limitations, osteochondrosis lesions can evolve after the age of 12 months in sport horses. Knowing this is useful in helping to decide the appropriate radiographic diagnosis timing and management.
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Affiliation(s)
- Raphaël Van Cauter
- Centre Européen du Cheval, Mont-le-Soie, Vielsalm, Belgium
- Département des Sciences Cliniques des Équidés, Chirurgie et Orthopédie, FARAH, Université de Liège, Liège, Belgium
| | - Didier Serteyn
- Centre Européen du Cheval, Mont-le-Soie, Vielsalm, Belgium
- Département des Sciences Cliniques des Équidés, Chirurgie et Orthopédie, FARAH, Université de Liège, Liège, Belgium
| | - Jean-Philippe Lejeune
- Centre Européen du Cheval, Mont-le-Soie, Vielsalm, Belgium
- Département des Sciences Cliniques des Équidés, Chirurgie et Orthopédie, FARAH, Université de Liège, Liège, Belgium
| | - Alycia Rousset
- Centre Européen du Cheval, Mont-le-Soie, Vielsalm, Belgium
| | - Isabelle Caudron
- Centre Européen du Cheval, Mont-le-Soie, Vielsalm, Belgium
- Département des Sciences Cliniques des Équidés, Chirurgie et Orthopédie, FARAH, Université de Liège, Liège, Belgium
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Barton CK, Sandow CB, Rodgerson DH. Arthroscopic removal of osteochondral fragments located within the condylar fossa of the third metacarpus/metatarsus in Thoroughbred yearlings. Vet Surg 2022; 51:914-919. [PMID: 35524683 DOI: 10.1111/vsu.13824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 02/21/2022] [Accepted: 04/15/2022] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe an arthroscopic technique for the removal of osteochondral fragments located within the condylar fossa of the third metacarpal/tarsal bone. STUDY DESIGN Retrospective study. ANIMALS Thoroughbred yearlings (n = 11). METHODS Osteochondral fragments located within the condylar fossa of the third metacarpal/tarsal bone identified during presale radiographic examination were removed via arthroscopy, assisted with ultrasonography in select cases. Complete fragment removal was confirmed by intraoperative radiography. RESULTS Fragments were successfully removed using rongeurs following dissection of soft tissue attachments using a bipolar radiofrequency probe. No postoperative complications occurred. CONCLUSIONS An ipsilateral arthroscopic and instrument portal coupled with ultrasound assistance and a radiofrequency probe allowed for successful removal of fragments located within the condylar fossa of the third metacarpal/tarsal bone. The technique allowed for the removal of the unstable osteochondral fragment and associated physical debris. CLINICAL SIGNIFICANCE The described surgical technique enables the removal of osteochondral fragments located within the condylar fossa of the third metacarpal/tarsal bone with minimal disruption to the surrounding soft tissues.
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Affiliation(s)
| | - Cole B Sandow
- Hagyard Equine Medical Institute, Lexington, Kentucky, USA
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Plevin S, McLellan J. Comparison of ultrasonography and radiography with arthroscopy for diagnosis of dorsoproximal osteochondral fragmentation of the proximal phalanx in 56 Thoroughbred racehorses. Equine Vet J 2021; 54:649-661. [PMID: 34420230 DOI: 10.1111/evj.13497] [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: 07/30/2020] [Revised: 06/08/2021] [Accepted: 07/12/2021] [Indexed: 11/27/2022]
Abstract
BACKGROUND Osteochondral fragmentation of the proximal phalanx (DPP1 fragment) is a common finding in the racehorse. Whilst radiographic assessment has been reported to lack diagnostic sensitivity, ultrasonographic examination has been documented to be extremely sensitive for identification of bone fragments in the metacarpophalangeal joint. OBJECTIVES To determine the sensitivity and specificity of ultrasonography as an imaging modality for diagnosis of DPP1 fragmentation and to compare it with radiography in the Thoroughbred racehorse. STUDY DESIGN Retrospective cohort study. METHODS Medical records (radiographs and ultrasonographic examinations) of 56 Thoroughbred racehorses in training (average age 26.4 months [SD ±5.9]) with a history of forelimb fetlock joint effusion and arthroscopically confirmed DPP1 fragmentation were evaluated. Inter-observer agreement was calculated between three blinded reviewers for both ultrasonographic and radiographic findings. Median values were used for statistical analyses. Ultrasonographic and radiographic identification of DPP1 fragmentation was considered correct if in agreement with arthroscopic findings. The McNemar test was used to compare correct proportions between radiography and ultrasonography. Analyses were performed to evaluate correct identification of presence of fragment(s), location of fragment(s) and presence and location of fragment(s) within the joints, with values P < .05 considered significant. RESULTS Eighty-one fetlock joints from 56 Thoroughbreds were evaluated. In total, 99 individual DPP1 fragments were confirmed arthroscopically. Ultrasonography was shown to have high levels of sensitivity (94%, 95% CI 89%-99%) and specificity (97%, 95% CI 92%-100%) for identification of DPP1 fragments, with transverse ultrasonographic images being more sensitive than sagittal ultrasonography (P = .001). Ultrasonography was also shown in this population to have significantly greater sensitivity than radiography (47%, 95% CI 37%-56%) (P < .001). CONCLUSIONS Ultrasonography is an extremely sensitive and specific imaging modality for evaluation of DPP1 fragmentation, with transverse ultrasonographic imaging being the most sensitive technique. Radiographic evaluation was less sensitive than ultrasonography in this study.
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Affiliation(s)
- Sarah Plevin
- Florida Equine Veterinary Associates, Ocala, FL, USA
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7
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Potenza KN, Huggons NA, Jones ARE, Rosanowski SM, McIlwraith CW. Comparing racing performance following arthroscopic surgery of metacarpophalangeal/metatarsophalangeal and carpal joints in Thoroughbred racehorses rehabilitated using conventional and underwater treadmill therapies. Vet Rec 2020; 187:355. [PMID: 32967934 DOI: 10.1136/vr.105745] [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: 10/15/2019] [Revised: 05/12/2020] [Accepted: 05/28/2020] [Indexed: 11/03/2022]
Abstract
BACKGROUND Rehabilitation of horses using underwater treadmill therapy has been shown to improve joint range of motion, joint mobility, stride length and proprioceptive parameters with experimental studies. However, studies investigating the prognosis and return to function following rehabilitation are lacking. METHODS A retrospective study of Thoroughbred racehorses treated with arthroscopic surgery for osteochondral fragments of the metacarpophalangeal (MCP) or metatarsophalangeal (MTP) joints or carpal joints undergoing conventional rehabilitation or underwater treadmill assisted rehabilitation at the same facility were included. The objective of the current study was to investigate if underwater treadmill assisted rehabilitation following arthroscopy in the Thoroughbred racehorse was positively associated with returning to racing, time to return to racing and postoperative racing performance including Beyer Speed Figures. RESULTS Surgery was performed on 165 horses on 174 surgical occasions; 70 (40.2 per cent) underwent underwater treadmill rehabilitation, with the remainder undergoing conventional rehabilitation. The time to return to racing was a median of 227 (IQR 185-281) days and 239 (IQR 205-303) days for underwater treadmill and conventional rehabilitation, respectively (P=0.16). Of the horses that raced presurgery, 83 per cent (58/70) of underwater treadmill rehabilitated horses and 61 per cent (63/104) of horses undergoing conventional rehabilitation returned to racing following surgery (P=0.02). CONCLUSION Underwater treadmill rehabilitation is superior in returning a Thoroughbred racehorse to racing following arthroscopic surgery of the carpus and/or MCP/MTP joints.
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Affiliation(s)
- Korin N Potenza
- San Luis Rey Equine Hospital, Bonsall, California, USA .,Trifecta Equine Athletic Center, Bonsall, California, USA
| | | | | | | | - C Wayne McIlwraith
- Gail Holmes Equine Orthopedic Research Center, Department of Clinical Sciences, Colorado State University, Fort Collins, Colorado, USA.,Equine Medical Center, Cypress, California, USA
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8
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Elzer EJ, Bramlage LR. Arthroscopic debridement of short frontal plane proximal phalanx fractures preserves racing performance. Equine Vet J 2020; 53:267-276. [PMID: 32367546 DOI: 10.1111/evj.13275] [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: 10/30/2019] [Revised: 04/15/2020] [Accepted: 04/24/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Outcomes have been reported for a limited number of short frontal plane fractures of the proximal phalanx following nonsurgical treatment and internal fixation. OBJECTIVES To describe a new approach, arthroscopic debridement, of short frontal plane fractures of the proximal phalanx in flat-racing Thoroughbreds and post-operative racing outcome. STUDY DESIGN Retrospective case-control study. METHODS Medical records of 81 Thoroughbred racehorses treated with arthroscopic debridement for frontal plane fractures of the proximal phalanx were reviewed. Diagnostic images and operative reports were used to characterise lesions and a technique for arthroscopic treatment was described. Post injury racing career length, starts, earnings and race quality are compared with matched controls. RESULTS Of 81 treated horses, 74 (91%) raced post-operatively. Treated horses had fewer post-operative starts compared with controls (median 12, 95% CI 9-16 vs median 19, 95% CI 15-23; P < .001), but there was no difference in post-operative earnings (median $51 465, 95% CI $39 868-$85 423 vs median $68 017, 95% CI $54 247-$87 870, P = .7) or career length (median 7 quarters, 95% CI 5-8 vs median 9 quarters, 95% CI 8-10, P = .1). MAIN LIMITATIONS Retrospective studies prevent prospective control of sampling bias and limit selection of matched controls. CONCLUSIONS Treatment of frontal plane fractures of the proximal phalanx by arthroscopic debridement results in racing performance comparable to uninjured controls with respect to longevity and earnings.
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Bertoni L, Jacquet-Guibon S, Branly T, Legendre F, Desancé M, Mespoulhes C, Melin M, Hartmann DJ, Schmutz A, Denoix JM, Galéra P, Demoor M, Audigié F. An experimentally induced osteoarthritis model in horses performed on both metacarpophalangeal and metatarsophalangeal joints: Technical, clinical, imaging, biochemical, macroscopic and microscopic characterization. PLoS One 2020; 15:e0235251. [PMID: 32584901 PMCID: PMC7316256 DOI: 10.1371/journal.pone.0235251] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 06/12/2020] [Indexed: 12/13/2022] Open
Abstract
Osteoarthritis is a common cause of pain and economic loss in both humans and horses. The horse is recognized as a suitable model for human osteoarthritis, because the thickness, structure, and mechanical properties of equine articular cartilage are highly comparable to those of humans. Although a number of equine experimental osteoarthritis models have been described in the literature, these cases generally involve the induction of osteoarthritis in just one joint of each animal. This approach necessitates the involvement of large numbers of horses to obtain reliable data and thus limits the use of this animal model, for both economic and ethical reasons. This study adapts an established equine model of post-traumatic osteoarthritis to induce osteoarthritis-associated lesions in all 4 fetlock joints of the same horse in order to reduce the number of animals involved and avoid individual variability, thus obtaining a more reliable method to evaluate treatment efficacy in future studies. The objectives are to assess the feasibility of the procedure, evaluate variability of the lesions according to interindividual and operated-limb position and describe the spontaneous evolution of osteoarthritis-associated pathological changes over a twelve-week period. The procedure was well tolerated by all 8 experimental horses and successfully induced mild osteoarthritis-associated changes in the four fetlock joints of each horse. Observations were carried out using clinical, radiographic, ultrasonographic, and magnetic resonance imaging methods as well as biochemical analyses of synovial fluid and postmortem microscopic and macroscopic evaluations of the joints. No significant differences were found in the progression of osteoarthritis-associated changes between horses or between the different limbs, with the exception of higher synovial effusion in hind fetlocks compared to front fetlocks and higher radiographic scores for left fetlocks compared to the right. This model thus appears to be a reliable means to evaluate the efficacy of new treatments in horses, and may be of interest for translational studies in human medicine.
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Affiliation(s)
- Lélia Bertoni
- CIRALE, USC 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
- * E-mail:
| | | | | | | | | | - Céline Mespoulhes
- Clinique Equine, Ecole Nationale Vétérinaire d’Alfort, UPEC, Maisons-Alfort, France
| | | | | | - Amandine Schmutz
- CWD-VetLab, USC 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - Jean-Marie Denoix
- CIRALE, USC 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | | | | | - Fabrice Audigié
- CIRALE, USC 957, BPLC, INRA, Ecole Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
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10
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Ramzan PHL, Wylie CE. Career outcome of Thoroughbred racehorses with metacarpo/metatarsophalangeal joint dorsal chip fracture managed nonsurgically and surgically: A retrospective cohort study. Equine Vet J 2020; 52:823-831. [PMID: 32118304 DOI: 10.1111/evj.13253] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 11/27/2019] [Accepted: 02/04/2020] [Indexed: 11/30/2022]
Abstract
BACKGROUND Arthroscopy has been advocated as the treatment of choice for dorsal osteochondral chip fracture of the metacarpo/metatarsophalangeal (MCP/MTP) joint. However, there is no published research on racing performance outcomes of horses with this pathology managed nonsurgically. OBJECTIVES To compare racing career outcomes of Thoroughbred racehorses with nonsurgically (non-SX) or surgically (SX) managed MCP/MTP dorsal osteochondral chip fracture alongside a cohort of horses with no dorsal osteochondral chip fracture (unexposed). STUDY DESIGN Retrospective cohort study conducted between 2006 and 2014. METHODS Radiographs of Thoroughbred racehorses were reviewed to identify MCP/MTP dorsal osteochondral chip fractures. Unexposed horses under the care of the same practice were recruited randomly from training records. Racing outcomes were analysed using survival analysis and logistic, linear and negative binomial regression techniques. RESULTS Dorsal osteochondral chip fractures were identified in 98 (70 non-SX, 28 SX) horses and compared with 648 unexposed horses. There was no significant difference among non-SX, SX, and unexposed horses in respect of total career starts, or likelihood of ever winning, placing, or earning money in a race (P > .05). SX horses had a significantly higher rate of wins/start than non-SX horses (rate ratio 1.6, CI 1.1-2.4, P = .02) and unexposed horses (rate ratio 1.9, CI 1.3-2.8, P = .001). Total career earnings for the SX horses were 4.1 times that of the unexposed horses (95% CI 1.2-14.5, P = .03), although total career earnings did not differ significantly between non-SX and unexposed horses (P = .8). MAIN LIMITATIONS Retrospective observational study where management technique was not randomised or blinded. Small number of surgically managed horses and potential selection bias for surgical management. CONCLUSIONS Nonsurgical management of this injury appears to be a valid management choice given that it was not associated with significant effects on racing career performance relative to a large unexposed cohort in this study population.
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Affiliation(s)
| | - Claire E Wylie
- Rossdales LLP, Beaufort Cottage Stables, Newmarket, Suffolk, UK
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11
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Ramzan PHL, Wylie CE. Nonsurgical and surgical management of metacarpo/metatarsophalangeal joint dorsal chip fracture in the Thoroughbred racehorse. Equine Vet J 2019; 52:399-403. [PMID: 31515837 DOI: 10.1111/evj.13185] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Accepted: 08/26/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Arthroscopy is considered the treatment of choice for dorsal osteochondral chip fractures of the metacarpo/metatarsophalangeal (MCP/MTP) joints in the racehorse; however, there is no published research on non-surgical management of this injury. OBJECTIVES To compare clinical features, intra-articular medication use and return to racing in Thoroughbred racehorses with non-surgically (non-SX) or surgically (SX) managed MCP/MTP dorsal chip fracture. STUDY DESIGN Retrospective observational study conducted between 2006 and 2014. METHODS Radiographs of Thoroughbred racehorses were reviewed to identify MCP/MTP dorsal osteochondral chip fractures. Clinical and intra-articular medication data were obtained from veterinary records, and return to racing data from a public online resource. RESULTS A total of 98 MCP/MTP horses with dorsal chip fractures were identified (70 non-SX, 28 SX). Median age was 2 years (range 2-7 years). Osteochondral chip fractures predominantly involved the forelimbs (n = 92, 93.9%) and the majority were considered by the treating clinician to be clinically active (n = 85, 86.7%). Significantly more SX horses had a reported ongoing problem associated with the affected joint than non-SX horses (P = 0.002), however there was no significant difference between non-SX and SX horses in the number of intra-articular medications of affected joint per month of follow-up (P = 0.22). The proportion of horses racing post-diagnosis was not significantly different between non-SX (55/70; 78.6%, 95% CI 69.0, 88.2%) and SX horses (24/28; 85.7%, 95% CI 72.8, 98.73%) (P = 0.57). Median time to first start following diagnosis for non-SX (106 days, range 1-326) was significantly shorter than for SX horses (203 days, range 9-559) (P = 0.002). MAIN LIMITATIONS Management technique was not randomised or blinded, with few surgically managed horses. CONCLUSIONS The results contribute to the current evidence base used to guide management of osteochondral chip fractures of the MCP/MTP joints in the racehorse, and indicate that non-surgical management may be a valid treatment option for some injuries.
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Affiliation(s)
- P H L Ramzan
- Rossdales LLP, Beaufort Cottage Stables, Newmarket, Suffolk, UK
| | - C E Wylie
- Rossdales LLP, Beaufort Cottage Stables, Newmarket, Suffolk, UK
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Osteoarticular radiographic findings of the distal forelimbs in Tbourida Horses. Heliyon 2019; 5:e02514. [PMID: 31687602 PMCID: PMC6819765 DOI: 10.1016/j.heliyon.2019.e02514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Revised: 09/01/2019] [Accepted: 09/19/2019] [Indexed: 11/29/2022] Open
Abstract
Tbourida is a traditional Moroccan equestrian sport in which 15 horses gallop 200 m in a line while riders fire into the sky with muskets. The stop is the finale and representative demands of this equestrian event. Such particular sudden stop after a fast gallop requires a hyperextension of the metacarpophalangeal joint. Indeed, it is well known that Tbourida show predisposes horses to different injuries of the hard and soft tissues of the distal forelimbs. Yet, there is a paucity of research that examined such lesions. The aim of the present study was to investigate for the first time the type and the prevalence of osteoarticular findings in the distal forelimbs of Tbourida horses using radiographic images. The study was conducted on 127 Tbourida horses aged between 2.5 and 15 years old with 6-year-old horses being the most affected. Data analysis showed that 93,7% of horses exhibit degenerative joint lesions of the fetlock, 86,6% showed ossification of the ungual cartilage, 78,7% had enthesophytes associated with the deep digital flexor tendons, 81,1% had enthesophytes associated with the suspensory ligament branches, and 19,6% showed a particular exostosis on the first phalanx. This large number of lesions reflects how this sport is difficult for horses and also argues that animals are suffering from a lack of welfare and care in their husbandry management.
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Kieffer PJ, Aceto H, Stefanovski D, Parente EJ. Using quarterly earnings to assess racing performance in 66 thoroughbreds after transendoscopic laser surgery for treatment of epiglottic entrapment. Vet Surg 2018; 47:605-613. [DOI: 10.1111/vsu.12907] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Revised: 12/05/2017] [Accepted: 12/12/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Philip J. Kieffer
- Department of Clinical Studies; University of Pennsylvania School of Veterinary Medicine New Bolton Center; Kennett Square Pennsylvania
| | - Helen Aceto
- Department of Clinical Studies; University of Pennsylvania School of Veterinary Medicine New Bolton Center; Kennett Square Pennsylvania
| | - Darko Stefanovski
- Department of Clinical Studies; University of Pennsylvania School of Veterinary Medicine New Bolton Center; Kennett Square Pennsylvania
| | - Eric J. Parente
- Department of Clinical Studies; University of Pennsylvania School of Veterinary Medicine New Bolton Center; Kennett Square Pennsylvania
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Walsh R, Smith MRW, Wright IM. Frequency distribution of osteochondral fragmentation of the dorsoproximal articular surface of the proximal phalanx in racing Thoroughbreds in the
UK. Equine Vet J 2018; 50:624-628. [DOI: 10.1111/evj.12795] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Accepted: 12/02/2017] [Indexed: 10/18/2022]
Affiliation(s)
- R. Walsh
- Newmarket Equine Hospital Newmarket Suffolk UK
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Miyakoshi D, Senba H, Shikichi M, Maeda M, Shibata R, Misumi K. A retrospective study of radiographic abnormalities in the repositories for Thoroughbreds at yearling sales in Japan. J Vet Med Sci 2017; 79:1807-1814. [PMID: 28993565 PMCID: PMC5709557 DOI: 10.1292/jvms.16-0425] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
This study aimed to evaluate whether radiographic abnormalities at yearling sales were associated with the failure to start racing at 2–3 years of age. Radiographic abnormalities in the carpal (n=852), tarsal (n=976),
metacarpophalangeal (n=1,055), and metatarsophalangeal joints (n=1,031) from 1,082 horses, recorded at yearling sale, were reviewed. Eighty-two horses (7.6%) failed to start racing. Radiographic abnormalities such as wedged or
collapsed tarsal bones, irregular lucency of a sagittal ridge at the distal aspect of the distal third metatarsal bone, and proximal dorsal fragmentation of the first phalanx in metatarsophalangeal joints were associated with
failure to start racing in these horses. In the follow-up survey of 12 horses with one or more these radiographic abnormalities, the horses failed to start racing due to reasons unrelated to these radiographic abnormalities such
as pelvic fractures (2 horses), fracture of a distal phalanx (1 horse), cervical stenotic myelopathy and proximal sesamoid fracture (1 horse), superficial digital flexor tendonitis (2 horses), laryngeal hemiplegia (1 horse),
economic problems (2 horses) and unknown causes (3 horses). Although radiographic abnormalities at yearling sales can be associated with failure to start racing at 2–3 years of age, these radiographically detected abnormalities
might not necessarily cause that failure.
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Affiliation(s)
- Daisuke Miyakoshi
- Hidaka Horse Breeders Association, 175-2 Shizunai Kamimori Shinhidaka-cho, Hokkaido 056-0002, Japan
| | - Hiroyuki Senba
- The Japan Bloodhorse Breeders' Association, 517 Shizunai Tahara Shinhidaka-cho, Hokkaido 056-0144, Japan
| | - Mitsumori Shikichi
- Hidaka Horse Breeders Association, 175-2 Shizunai Kamimori Shinhidaka-cho, Hokkaido 056-0002, Japan
| | - Masaya Maeda
- Hidaka Horse Breeders Association, 175-2 Shizunai Kamimori Shinhidaka-cho, Hokkaido 056-0002, Japan
| | - Ryo Shibata
- Hidaka Horse Breeders Association, 175-2 Shizunai Kamimori Shinhidaka-cho, Hokkaido 056-0002, Japan
| | - Kazuhiro Misumi
- Faculty of Veterinary Medicine, Kagoshima University, 1-21-24 Korimoto, Kagoshima 890-0065, Japan
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Wright IM, Minshall GJ. Short frontal plane fractures involving the dorsoproximal articular surface of the proximal phalanx: Description of the injury and a technique for repair. Equine Vet J 2017; 50:54-59. [DOI: 10.1111/evj.12722] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 07/09/2017] [Indexed: 11/29/2022]
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James O, Payne R, Bathe A, Greet T, Wylie C. Arthroscopy of the Dorsal and Plantar Pouches of the Tarsocrural Joint for the Treatment of Osteochondritis Dissecans in the Horse: Clinical Features and Follow-Up. Vet Surg 2016; 45:1049-1055. [DOI: 10.1111/vsu.12560] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2015] [Accepted: 06/28/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Oliver James
- Royal (Dick) School of Veterinary Studies; The University of Edinburgh, Dick Vet Equine; Edinburgh United Kingdom
- Rossdales Equine Hospital; Newmarket, Suffolk United Kingdom
| | - Richard Payne
- Rossdales Equine Hospital; Newmarket, Suffolk United Kingdom
| | - Andrew Bathe
- Rossdales Equine Hospital; Newmarket, Suffolk United Kingdom
| | - Tim Greet
- Rossdales Equine Hospital; Newmarket, Suffolk United Kingdom
| | - Claire Wylie
- Rossdales Equine Hospital; Newmarket, Suffolk United Kingdom
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McCarty CA, Thomason JJ, Gordon KD, Burkhart TA, Milner JS, Holdsworth DW. Finite-Element Analysis of Bone Stresses on Primary Impact in a Large-Animal Model: The Distal End of the Equine Third Metacarpal. PLoS One 2016; 11:e0159541. [PMID: 27459189 PMCID: PMC4961423 DOI: 10.1371/journal.pone.0159541] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2015] [Accepted: 07/05/2016] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To assess whether the transient stresses of foot impact with the ground are similar to those found during midstance loading and if the location of high stress correlate with the sites most commonly associated with mechanically induced osteoarthritis (OA). We compared impact stresses in subchondral bone between two subject-specific, three-dimensional, finite-element models of the equine metacarpophalangeal (MCP) joint-one with advanced OA and one healthy, and with similar published data on the stresses that occur at midstance. METHODS Two right MCP joints (third metacarpal and proximal phalanx) were scanned using micro-computed tomography (μCT). Images were segmented, and meshed using modified 10-node quadratic tetrahedral elements. Bone material properties were assigned based on the bone density. An impact velocity of 3.55 m/s was applied to each model and contact pressures and stress distribution were calculated for each. In a separate iteration, the third metacarpal was loaded statically. A sampling grid of 160 equidistant points was superimposed over selected slices, and average peak stresses were calculated for 6 anatomical regions. Within-region maximal peak and average von Mises stresses were compared between healthy and OA bones in both midstance and impact loading. RESULTS Average impact stresses across all regions, in both locations (palmar and dorsal) were greater in the OA model. Highest impact stresses were located in the dorsal medial condyle in the healthy (12.8 MPa) and OA (14.1MPa) models, and were lowest in the palmar medial and lateral parasagittal grooves in the healthy (5.94 MPa) and OA (7.07 MPa) models. The healthy static model had higher peak (up to 49.7% greater) and average (up to 38.6% greater) stresses in both locations and across all regions compared to the OA static model. CONCLUSIONS Under simulated footfall a trot, loading on the dorsal aspect of the third metacarpal at impact created stresses similar to those found during midstance. The high accelerations that occur under impact loading are likely responsible for creating the high stresses, as opposed to midstance loading where the high stresses are the result of high mass loading. Although the stress magnitudes were found to be similar among the two loading conditions, the location of the high stress loading occurred in sites that are not typically associated with osteoarthritic changes.
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Affiliation(s)
- Cristin A. McCarty
- Department of Biomedical Science, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
- * E-mail:
| | - Jeffrey J. Thomason
- Department of Biomedical Science, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada
| | - Karen D. Gordon
- Department of Biomedical Engineering, School of Engineering, University of Guelph, Guelph, Ontario, Canada
| | - Timothy A. Burkhart
- Department of Mechanical and Materials Engineering, School of Engineering, Western University, London, Ontario, Canada
| | - Jaques S. Milner
- Department of Mechanical and Materials Engineering, School of Engineering, Western University, London, Ontario, Canada
| | - David W. Holdsworth
- Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Surgery, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
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Hauspie S, Vanderperren K, Gielen I, Pardon B, Kromhout K, Martens A, Saunders JH. Magnetic Resonance Imaging of the Dorsal Proximal Synovial Plica of the Equine Metacarpo-/Metatarsophalangeal Joint. Anat Histol Embryol 2014; 45:19-27. [DOI: 10.1111/ahe.12166] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2014] [Accepted: 11/04/2014] [Indexed: 11/26/2022]
Affiliation(s)
- S. Hauspie
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; B-9820 Merelbeke Belgium
| | - K. Vanderperren
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; B-9820 Merelbeke Belgium
| | - I. Gielen
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; B-9820 Merelbeke Belgium
| | - B. Pardon
- Department of Internal Medicine and Clinical Biology of Large Animals; Faculty of Veterinary Medicine; Ghent University; B-9820 Merelbeke Belgium
| | - K. Kromhout
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; B-9820 Merelbeke Belgium
| | - A. Martens
- Department of Surgery and Anaesthesiology; Faculty of Veterinary Medicine; Ghent University; B-9820 Merelbeke Belgium
| | - J. H. Saunders
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; B-9820 Merelbeke Belgium
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Evaluation of a subject-specific finite-element model of the equine metacarpophalangeal joint under physiological load. J Biomech 2014; 47:65-73. [DOI: 10.1016/j.jbiomech.2013.10.001] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Revised: 10/08/2013] [Accepted: 10/08/2013] [Indexed: 11/19/2022]
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Boyce MK, Trumble TN, Carlson CS, Groschen DM, Merritt KA, Brown MP. Non-terminal animal model of post-traumatic osteoarthritis induced by acute joint injury. Osteoarthritis Cartilage 2013; 21:746-55. [PMID: 23467035 PMCID: PMC3624059 DOI: 10.1016/j.joca.2013.02.653] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Revised: 02/12/2013] [Accepted: 02/21/2013] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Develop a non-terminal animal model of acute joint injury that demonstrates clinical and morphological evidence of early post-traumatic osteoarthritis (PTOA). METHODS An osteochondral (OC) fragment was created arthroscopically in one metacarpophalangeal (MCP) joint of 11 horses and the contralateral joint was sham operated. Eleven additional horses served as unoperated controls. Every 2 weeks, force plate analysis, flexion response, joint circumference, and synovial effusion scores were recorded. At weeks 0 and 16, radiographs (all horses) and arthroscopic videos (OC injured and sham joints) were graded. At week 16, synovium and cartilage biopsies were taken arthroscopically from OC injured and sham joints for histologic evaluation and the OC fragment was removed. RESULTS OC fragments were successfully created and horses were free of clinical lameness after fragment removal. Forelimb gait asymmetry was observed at week 2 (P = 0.0012), while joint circumference (P < 0.0001) and effusion scores (P < 0.0001) were increased in injured limbs compared to baseline from weeks 2 to 16. Positive flexion response of injured limbs was noted at multiple time points. Capsular enthesophytes were seen radiographically in injured limbs. Articular cartilage damage was demonstrated arthroscopically as mild wear-lines and histologically as superficial zone chondrocyte death accompanied by mild proliferation. Synovial hyperemia and fibrosis were present at the site of OC injury. CONCLUSION Acute OC injury to the MCP joint resulted in clinical, imaging, and histologic changes in cartilage and synovium characteristic of early PTOA. This model will be useful for defining biomarkers of early osteoarthritis and for monitoring response to therapy and surgery.
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Affiliation(s)
- Mary K. Boyce
- Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, MN
| | - Troy N. Trumble
- Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, MN
| | - Cathy S. Carlson
- Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, MN
| | - Donna M. Groschen
- Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, St. Paul, MN
| | - Kelly A. Merritt
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
| | - Murray P. Brown
- Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL
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Singer E, Garcia T, Stover S. How do metacarpophalangeal joint extension, collateromotion and axial rotation influence dorsal surface strains of the equine proximal phalanx at different loads in vitro? J Biomech 2013; 46:738-44. [DOI: 10.1016/j.jbiomech.2012.11.028] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2012] [Revised: 10/19/2012] [Accepted: 11/10/2012] [Indexed: 10/27/2022]
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McIlwraith CW, Frisbie DD, Kawcak CE. The horse as a model of naturally occurring osteoarthritis. Bone Joint Res 2012; 1:297-309. [PMID: 23610661 PMCID: PMC3626203 DOI: 10.1302/2046-3758.111.2000132] [Citation(s) in RCA: 174] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2012] [Accepted: 09/24/2012] [Indexed: 01/15/2023] Open
Abstract
Osteoarthritis (OA) is an important cause of
pain, disability and economic loss in humans, and is similarly important in
the horse. Recent knowledge on post-traumatic OA has suggested opportunities
for early intervention, but it is difficult to identify the appropriate
time of these interventions. The horse provides two useful mechanisms
to answer these questions: 1) extensive experience with clinical
OA in horses; and 2) use of a consistently predictable model of
OA that can help study early pathobiological events, define targets
for therapeutic intervention and then test these putative therapies.
This paper summarises the syndromes of clinical OA in horses including
pathogenesis, diagnosis and treatment, and details controlled studies
of various treatment options using an equine model of clinical OA.
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Affiliation(s)
- C W McIlwraith
- Orthopaedic Research Center, Colorado State University, 300 West Drake Road, Fort Collins, Colorado 80523, USA
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Kim W, Kawcak CE, McIlwraith CW, Firth EC, Broom ND. Histologic and histomorphometric evaluation of midcarpal joint defects in Thoroughbreds raised with and without early conditioning exercise. Am J Vet Res 2012; 73:498-507. [PMID: 22452496 DOI: 10.2460/ajvr.73.4.498] [Citation(s) in RCA: 7] [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 describe and measure histologic features of midcarpal joint cartilage defects in Thoroughbreds and evaluate the influence of early conditioning exercise on defect development. SAMPLE 24 midcarpal joints from twelve 18-month-old Thoroughbreds. PROCEDURES Midcarpal joints from 12 horses (6 exercised spontaneously at pasture only and 6 given additional conditioning exercise beginning at a mean age of 3 weeks were evaluated. Gross cartilage defects were assessed histologically. Third and radial carpal bones were categorized with regard to the presence or absence of calcified cartilage (CC) abnormalities at the dorsoproximal and dorsodistal articular surfaces, respectively; histomorphometric assessment and statistical analysis were conducted for the third carpal bone. RESULTS Number and severity of defects did not appear different between exercise groups. Nine third or radial carpal bones had thickened CC with microcracks, matrix and osteochondral junction changes, and increased vascularity, without histologic changes in the hyaline cartilage. Third carpal bones with CC abnormalities had significantly thicker CC (452 vs 228 μm) than did those without CC abnormalities in the evaluated region. However, in the same region, there were no significant differences in hyaline cartilage thickness (681 vs 603 μm), vascular channel area in the subchondral bone (624,894 vs 490,320 μm(2)), or number of vascular channels (15.9 vs 18.0). CONCLUSIONS AND CLINICAL RELEVANCE Early exercise did not appear to influence the distribution or severity of cartilage defects in the midcarpal joint. Calcified cartilage abnormalities beneath the undisrupted hyaline cartilage in the dorsoproximal aspect of the third carpal bone may represent the first changes in the pathogenesis of midcarpal osteochondral disease.
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Affiliation(s)
- Woong Kim
- Tissue Mechanics Laboratory, Department of Chemical and Materials Engineering, Faculty of Engineering, University of Auckland, Auckland 1142, New Zealand
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The OARSI histopathology initiative - recommendations for histological assessments of osteoarthritis in the horse. Osteoarthritis Cartilage 2010; 18 Suppl 3:S93-105. [PMID: 20864027 DOI: 10.1016/j.joca.2010.05.031] [Citation(s) in RCA: 125] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2010] [Accepted: 05/05/2010] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Equine models of osteoarthritis (OA) have been used to investigate pathogenic pathways of OA and evaluate therapeutic candidates for naturally occurring equine OA which is a significant clinical disease in the horse. This review focuses on the macroscopic and microscopic criteria for assessing naturally occurring OA in the equine metacarpophalangeal joint as well as the osteochondral fragment-exercise model of OA in the equine middle carpal joint. METHODS A review was conducted of all published OA studies using horses and the most common macroscopic and microscopic scoring systems were summarized. Recommendations regarding methods of OA assessment in the horse have been made based on published studies. RESULTS A modified Mankin scoring system is recommended for semi-quantitative histological assessment of OA in horses due to its already widespread use and similarity to other scoring systems. Recommendations are also provided for histological scoring of synovitis and macroscopic lesions of OA as well as changes in the calcified cartilage and subchondral bone of naturally occurring OA. CONCLUSIONS The proposed system for assessment of equine articular tissues provides a useful method to quantify OA change. It is believed that addition of quantitative tracing onto plastic and macroscopic measurement as recently described would be an improvement for overall assessment of articular cartilage change.
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Clinical and imaging features of suspected prodromal fracture of the proximal phalanx in three Thoroughbred racehorses. Equine Vet J 2010; 42:164-9. [DOI: 10.2746/042516409x478695] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Brommer H, van Weeren PR, Brama PAJ, Barneveld A. Quantification and age-related distribution of articular cartilage degeneration in the equine fetlock joint. Equine Vet J 2010; 35:697-701. [PMID: 14649362 DOI: 10.2746/042516403775696357] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY The equine fetlock joint has the largest number of traumatic and degenerative lesions of all joints of the appendicular skeleton. OBJECTIVE To gain insight into the distribution of cartilage degeneration across the articular surface in relation to age in order better to understand the dynamic nature and progression of osteoarthritis (OA). HYPOTHESIS That there would be a specific age-related distribution pattern of cartilage degeneration in the equine metacarpophalangeal joint. METHODS The proximal articular cartilage surfaces of the first phalanges (P1) of 73 slaughter horses (age range 0.4-23 years) with different stages of osteoarthritis were scored semiquantitatively on a 0 to 5 scale and also assessed quantitatively using the cartilage degeneration index (CDI(P1)), which ranges from 0 to 100%. Furthermore, CDI values were determined for special areas of interest; medial dorsal surface (CDI(mds)), lateral dorsal surface (CDI(lds)), medial central fovea (CDI(mcf)) and lateral central fovea (CDI(lcf)). Correlations were calculated for CDI(P1) values and CDI values at the specific areas of interest with macroscopic scores and with age. RESULTS There was a high correlation between the semiquantitative macroscopic score and the quantitative CDI(P1) values (r = 0.92; P < 0.001). A macroscopic score of 0 (i.e. no obvious cartilage degeneration) corresponded with a CDI(P1) mean +/- s.e. value of 25 +/- 2.8% and a macroscopic score of 5 (i.e. severe cartilage degeneration in localised areas) with a mean +/- s.e. value of 38.1 +/- 7.9%. There was a moderate but highly significant correlation between the CDI(P1) value and the age of the horses (r = 0.41; P < 0.001). Highest CDI values were calculated for the medial dorsal surface (from 10.6 +/- 2.8% at macroscopic Grade 0 to 63.1 +/- 8.4% at Grade 5). At the lateral dorsal surface, these values were 5.9 +/- 1.4% and 47.2 +/- 10.4%, respectively. The CDI(mcf) and CDI(lcf) were significantly lower (P < 0.05) than the CDI(mds) and CDI(lds) at all grades. The CDI(mcf) ranged from 1.0 +/- 2.9% at Grade 0 to 43.7 +/- 9.1% at Grade 5; laterally, these values were 1.5 +/- 2.6% and 15.2 +/- 6.2%, respectively. CONCLUSIONS CDI grading increased from lateral to medial and from central to dorsal. This specific distribution pattern confirms the heterogeneous nature of the OA process and strongly supports an important role for biomechanical loading, superimposed on age-related changes, in the spread of the disorder over the joint. POTENTIAL RELEVANCE Knowledge of the development of OA across the articular surface is essential for understanding the dynamic nature and progression of the disease and can form a basis for improvements in diagnostic and therapeutic approaches to degenerative joint disease.
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Affiliation(s)
- H Brommer
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 12, 3584 CM Utrecht, The Netherlands
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Diagnostic imaging of the equine fetlock region using radiography and ultrasonography. Part 2: The bony disorders. Vet J 2009; 181:123-36. [DOI: 10.1016/j.tvjl.2008.01.017] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2007] [Revised: 01/26/2008] [Accepted: 01/31/2008] [Indexed: 11/21/2022]
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Vanderperren K, Martens AM, Declercq J, Duchateau L, Saunders JH. Comparison of ultrasonography versus radiography for the diagnosis of dorsal fragmentation of the metacarpophalangeal or metatarsophalangeal joint in horses. J Am Vet Med Assoc 2009; 235:70-5. [DOI: 10.2460/javma.235.1.70] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kim W, Kawcak CE, McIlwraith CW, Firth EC, McArdle BH, Broom ND. Influence of early conditioning exercise on the development of gross cartilage defects and swelling behavior of cartilage extracellular matrix in the equine midcarpal joint. Am J Vet Res 2009; 70:589-98. [PMID: 19405897 DOI: 10.2460/ajvr.70.5.589] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To investigate the influence of early conditioning exercise on the development of gross cartilage defects and swelling behavior of cartilage extracellular matrix (ECM) in the midcarpal joint of horses. ANIMALS 12 Thoroughbreds. PROCEDURES 6 horses underwent early conditioning exercise from birth to 18 months of age (CONDEX group), and 6 horses were used as control animals (PASTEX group). The horses were euthanized at 18 months of age, and the midcarpal joints were harvested. Gross defects of the cartilage surface were classified and mapped. Opposing surfaces of the third and radial carpal bones were used to quantify swelling behavior of the cartilage ECM. RESULTS A wide range of gross defects was detected in the cartilage on the opposing surfaces of the bones of the midcarpal joint; however, there was no significant difference between the CONDEX and PASTEX groups. Similarly, no significant difference in swelling behavior of the cartilage ECM was evident between the CONDEX and PASTEX groups. CONCLUSIONS AND CLINICAL RELEVANCE In the study reported here, we did not detect negative influences of early conditioning exercise on the prevalence of gross defects in cartilage of the midcarpal joint or the quality of the cartilage ECM as defined by swelling behavior. These results suggested that early conditioning exercise may be used without negative consequences for the midcarpal joint and the cartilage ECM of the third and radial carpal bones.
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Affiliation(s)
- Woong Kim
- Biomaterials Laboratory, Department of Chemical and Materials Engineering, Faculty of Engineering, University of Auckland, Auckland 1142, New Zealand
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Brommer H, Laasanen MS, Brama PAJ, van Weeren PR, Helminen HJ, Jurvelin JS. Functional consequences of cartilage degeneration in the equine metacarpophalangeal joint: quantitative assessment of cartilage stiffness. Equine Vet J 2005; 37:462-7. [PMID: 16163950 DOI: 10.2746/042516405774480012] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY No quantitative data currently exist on the relationship of the occurrence of cartilage degeneration and changes in site-specific biomechanical properties in the metacarpophalangeal (MCP) joint in the horse. OBJECTIVES To gain insight into the biomechanical consequences of cartilage deterioration at 2 differently loaded sites on the proximal articular surface of the proximal phalanx (P1). HYPOTHESIS Static and dynamic stiffness of articular cartilage decreases significantly in degenerated cartilage. METHODS Cartilage degeneration index (CDI) values were measured at the lateral dorsal margin (Site 1), lateral central fovea (Site 2) and entire joint surface of P1 (CDIP1) in 30 horses. Group 1 contained joints without (CDIP1 values <25 %, n = 22) and Group 2 joints with (CDIP1 values >25 %, n = 8) signs of cartilage degeneration. Cartilage thickness at Sites 1 and 2 was measured using ultrasonic and needle-probe techniques. Osteochondral plugs were drilled out from Sites 1 and 2 and subsequently tested biomechanically in indentation geometry. Young's modulus at equilibrium and dynamic modulus were determined. RESULTS Cartilage thickness values were not significantly different between the 2 groups and sites. Young's modulus at Site 1 was significantly higher in Group 1 than in Group 2; at Site 2, the difference was not significant. Dynamic modulus values were significantly higher in Group 1 than in Group 2 at both sites. CONCLUSIONS Degenerative cartilage changes are clearly related to loss of stiffness of the tissue. Absolute changes in cartilage integrity in terms of CDI are greatest at the joint margin, but concomitant changes are also present at the centre, with a comparable decrease of the biomechanical moduli at the 2 sites. Therefore, significant cartilage degradation at the joint margin not only reflects local deterioration of biomechanical properties, but is also indicative of the functional quality in the centre. POTENTIAL RELEVANCE These findings may be important for improving prognostication and developing preventative measures.
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Affiliation(s)
- H Brommer
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 12, 3584 CM, Utrecht, The Netherlands
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Brommer H, Brama PAJ, Barneveld A, van Weeren PR. Differences in the topographical distribution of articular cartilage degeneration between equine metacarpo- and metatarsophalangeal joints. Equine Vet J 2004; 36:506-10. [PMID: 15460075 DOI: 10.2746/0425164044877369] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
REASONS FOR PERFORMING STUDY The equine metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints, although having virtually the same geometrical appearance, differ in the prevalence of joint pathologies, such as osteochondral fragmentation, and in biomechanical behaviour. The recently developed cartilage degeneration index (CDI) technique offers a possibility to assess quantitatively differences in cartilage degeneration between these joints and to compare these with known differences in biomechanics and clinical observations. OBJECTIVES To compare the topographical distribution of articular cartilage degeneration across the proximal articular surface of the proximal phalanx (P1) in the equine fore- and hindlimb. METHODS In 24 distal hindlimbs from 24 horses, articular cartilage degeneration of the proximal articular surface of P1 was quantified using the CDI. Overall CDI value (CDI(P1)) and CDI values of 6 areas of interest were determined: the medial dorsal surface (mds), lateral dorsal surface (lds), medial central fovea (mcf), lateral central fovea (lcf), medial plantar surface (mps) and lateral plantar surface (lps). The joints were divided into 4 equally sized groups of increasing CDI(P1) values. From an existing CDI database of MCP joints, 24 joints were selected with matching CDI(P1) values to the MTP joints and CDI values for the same areas of interest were determined. RESULTS In both the MCP and MTP joints, highest CDI values were determined at the dorsal articular surfaces. Values were not significantly different between fore- and hindlimbs. In contrast to the MCP joint, CDI values at the plantar joint margin were significantly higher compared to CDI values in the central sites in the MTP joint. CDI values for the plantar surfaces of P1 were significantly higher than those for the palmar surfaces in the forelimb in joints with advanced stages of OA; and values for the central regions of P1 were significantly lower in the hindlimb compared with the forelimb in joints with severe OA. CONCLUSIONS In both fore- and hindlimbs, initial cartilage degeneration started at the dorsal articular margin of P1. There was a major difference in the spread of cartilage degeneration; in the forelimb both the central and palmar parts are about equally involved, whereas in the hindlimb the plantar parts were significantly more and the central parts significantly less involved. These differences can be linked to differences in biomechanical loading reported elsewhere. POTENTIAL RELEVANCE This study supports the hypothesis that differences in biokinematics between fore- and hindlimbs are associated with differences in the development of cartilage degeneration and other joint pathologies such as osteochondral fragmentation in the MCP and MTP joints. This information is indispensable for a better understanding of the dynamic nature and progression of these joint disorders and may be of help when monitoring the effects of therapeutic interventions and preventative measures.
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Affiliation(s)
- H Brommer
- Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 12, 3584 CM, Utrecht, The Netherlands
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van der Harst MR, Brama PAJ, van de Lest CHA, Kiers GH, DeGroot J, van Weeren PR. An integral biochemical analysis of the main constituents of articular cartilage, subchondral and trabecular bone. Osteoarthritis Cartilage 2004; 12:752-61. [PMID: 15325642 DOI: 10.1016/j.joca.2004.05.004] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2003] [Accepted: 05/08/2004] [Indexed: 02/02/2023]
Abstract
OBJECTIVE In articular joints, the forces generated by locomotion are absorbed by the whole of cartilage, subchondral bone and underlying trabecular bone. The objective of this study is to test the hypothesis that regional differences in joint loading are related to clear and interrelated differences in the composition of the extracellular matrix (ECM) of all three weight-bearing constituents. METHOD Cartilage, subchondral- and trabecular bone samples from two differently loaded sites (site 1, dorsal joint margin; site 2, central area) of the proximal articular surface of 30 macroscopically normal equine first phalanxes were collected. Collagen content, cross-linking (pentosidine, hydroxylysylpyridinoline (HP), lysylpyridinoline (LP)) hydroxylation, and denaturation, as well as glycosaminoglycan (GAG) and DNA content were measured in all three tissues. In addition, bone mineral density (BMD), the percentage of ash and the mineral composition (calcium, magnesium and phosphorus) were determined in the bony samples. RESULTS For pentosidine cross-links there was an expected correlation with age. Denatured collagen content was significantly higher in cartilage at site 1 than at site 2 and was higher in trabecular bone compared to subchondral bone, with no site differences. There were significant site differences in hydroxylysine (Hyl) concentration and HP cross-links in cartilage that were paralleled in one or both of the bony layers. In subchondral bone there was a positive correlation between total (HP+LP) cross-links and Ca content. For Ca and other minerals there were corresponding site differences in both bony layers. CONCLUSIONS It is concluded that there are distinct differences in distribution of the major biochemical components over both sites in all three layers. These differences show similar patterns in cartilage, subchondral bone and trabecular bone, stressing the functional unity of these tissues. Overall, differences could be interpreted as adaptations to a considerably higher cumulative loading over time at site 2, requiring stiffer tissue. Turnover is higher in trabecular bone than in subchondral bone. In cartilage, the dorsal site 1 appears to suffer more tissue damage.
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Affiliation(s)
- Mark R van der Harst
- Faculty of Veterinary Medicine, Department of Equine Sciences, Utrecht University, The Netherlands.
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McIlwraith CW. Arthroscopic surgery for osteochondral chip fragments and other lesions not requiring internal fixation in the carpal and fetlock joints of the equine athlete: What have we learned in 20 years? ACTA ACUST UNITED AC 2002. [DOI: 10.1053/ctep.2002.35589] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Elce YA, Richardson DW. Arthroscopic removal of dorsoproximal chip fractures of the proximal phalanx in standing horses. Vet Surg 2002; 31:195-200. [PMID: 11994846 DOI: 10.1053/jvet.2002.32393] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To report a technique for, and outcome after, arthroscopic removal of dorsoproximal chip fractures of a proximal phalanx in standing horses. STUDY DESIGN Retrospective study. ANIMALS OR SAMPLE POPULATION A total of 104 horses, 1 to 13 years of age, with a dorsoproximal chip fracture of a proximal phalanx. METHODS Horses were restrained in standing stocks and sedated with intravenous xylazine, detomidine, or a combination of both drugs. Local analgesia was achieved with 2% mepivacaine administered intra-articularly and by subcutaneous infiltration in a crescent-shaped block dorsal to the fetlock. Sterile drapes were placed on the surgical field, and impervious drapes were used on the hoof and floor. Arthroscopic portals were created in the dorsal pouch of the metacarpophalangeal or metatarsophalangeal joints to remove chip fractures. Statistical analysis was performed on race records for all Thoroughbred racehorses and compared with previously published studies. Operative and hospitalization times were compared with those of the general hospital population, and risks associated with general anesthesia were examined. RESULTS No major operative or postoperative complications occurred. Ninety-one percent of racehorses raced after surgery with 78% returning to race at the same or higher level. CONCLUSION Standing arthroscopic surgery can be performed successfully to remove dorsoproximal chip fractures of the proximal phalanx. CLINICAL RELEVANCE Standing arthroscopic surgery is a valid alternative treatment for experienced surgeons to avoid the expense and potential risks associated with general anesthesia.
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Affiliation(s)
- Yvonne A Elce
- Department of Clinical Studies, New Bolton Center, University of Pennsylvania, 382 West Street Road, Kennett Square, PA 19348, USA
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Kawcak CE, McIlwraith CW, Norrdin RW, Park RD, James SP. The role of subchondral bone in joint disease: a review. Equine Vet J 2001; 33:120-6. [PMID: 11266060 DOI: 10.1111/j.2042-3306.2001.tb00589.x] [Citation(s) in RCA: 105] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Subchondral bone plays a role in the pathogenesis of osteochondral damage and osteoarthritis in horses and humans. Osteochondral fragmentation and fracture, subchondral bone necrosis and osteoarthritis are common diseases in athletic horses, and subchondral bone is now thought to play an integral role in the pathogenesis of these diseases. There have been numerous research efforts focused on articular cartilage damage and its pathogenesis, yet comparatively little effort focused on subchondral bone pathology or the coordinated disease states of the osteochondral tissues. The purpose of this report is to review the current understanding of osteochondral disease in all species and its application to equine research and practice. It can be concluded from this review that our current understanding of osteochondral disease is based on clinical and pathological sources; and that the lack of information about joint tissue adaptation and disease has hampered objective studies of osteochondral tissues.
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Affiliation(s)
- C E Kawcak
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins 80523, USA
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Colón JL, Bramlage LR, Hance SR, Embertson RM. Qualitative and quantitative documentation of the racing performance of 461 Thoroughbred racehorses after arthroscopic removal of dorsoproximal first phalanx osteochondral fractures (1986-1995). Equine Vet J 2000; 32:475-81. [PMID: 11093620 DOI: 10.2746/042516400777584640] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The purpose of this study was to examine the longevity of postoperative careers and quality of performance of 461 Thoroughbred racehorses after arthroscopic removal of dorsoproximal first phalanx (P1) osteochondral fractures. Six hundred and 59 dorsoproximal P1 chip fractures were removed arthroscopically from 574 joints in 461 horses presented for lameness or decreased performance attributed to the chip fractures. Radiological and arthroscopic examination revealed an average of 1.43 fragment sites/horse, 1.15 fragment sites/joint and 1.25 affected joints/horse. Eighty-nine percent of the horses (411/461) raced after surgery and 82% (377/461) did so at the same or higher class. Fifty horses did not race after surgery. Sixty-eight percent of the horses raced in a Stake or Allowance race postoperatively. Data, previously undocumented, establishes that the quantity and quality of performance is not diminished after arthroscopic treatment of dorsoproximal P1 fragmentation. Surgical removal of chip fractures is a means of preserving the economic value of an injured Thoroughbred, allowing a rapid and successful return to racing at the previous level of racing performance.
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Affiliation(s)
- J L Colón
- Rood & Riddle Equine Hospital, Lexington, Kentucky 40580, USA
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Kawcak CE, McIlwraith CW, Norrdin RW, Park RD, Steyn PS. Clinical effects of exercise on subchondral bone of carpal and metacarpophalangeal joints in horses. Am J Vet Res 2000; 61:1252-8. [PMID: 11039557 DOI: 10.2460/ajvr.2000.61.1252] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine effects of treadmill exercise on subchondral bone of carpal and metacarpophalangeal joints of 2-year-old horses. ANIMALS 12 healthy 2-year-old horses. PROCEDURE Horses were randomly assigned to the control (n = 6) or exercised (6) groups. Horses in the exercised group ran on a high-speed treadmill 5 d/wk for 6 months. Horses in the control group were hand walked for the same amount of time. Results of clinical, radiographic, nuclear scintigraphic, and computed tomographic examinations, and serum and synovial concentrations of biochemical markers of bone metabolism were compared between groups. RESULTS Exercised horses were significantly lamer at the end of the study than control horses. Radionuclide uptake in the metacarpal condyles, but not in the carpal joints, was greater in exercised horses, compared with control horses. Exercised horses also had a higher subchondral bone density in the metacarpal condyles than control horses, but such differences were not detected in the carpal bones. CONCLUSIONS AND CLINICAL RELEVANCE None of the diagnostic techniques evaluated was sufficiently sensitive to detect all osteochondral damage. Computed tomography and computed tomographic osteoabsorptiometry were superior to conventional radiography for detecting small osteochondral fragments. Nuclear scintigraphy was a sensitive indicator of subchondral bone change but lacked specificity for describing lesions and discerning normal bone remodeling from damage. Newer techniques such as computed tomography may help clinicians better diagnose early and subtle joint lesions in horses prior to development of gross joint damage.
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Affiliation(s)
- C E Kawcak
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins 80523, USA
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Southwood LL, McIlwraith CW. Arthroscopic removal of fracture fragments involving a portion of the base of the proximal sesamoid bone in horses: 26 cases (1984-1997). J Am Vet Med Assoc 2000; 217:236-40. [PMID: 10909466 DOI: 10.2460/javma.2000.217.236] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
OBJECTIVE To determine the outcome of horses with basal fractures of the proximal sesamoid bone from which a fracture fragment involving a portion of the base of the bone was removed arthroscopically and to determine whether fragment size was associated with outcome. DESIGN Retrospective study. ANIMALS 26 horses. PROCEDURE Dorsopalmar and axial-abaxial lengths of the fracture fragment were measured on the dorsopalmar and mediolateral radiographic views, respectively, and percentage of the base of the sesamoid bone involved was estimated. Fractures were classified as grade 1 (< or = 25% of the base involved) or grade 2 (> 25% but < 100% of the base involved). Outcome was classified as successful if the horse started at least 2 races or unsuccessful if the horse started only 1 race or failed to return to racing. RESULTS There were 24 racehorses and 2 nonracehorses. Twelve (50%) of the racehorses returned to racing and started at least 2 races. Eight of 14 horses with grade-1 fractures and 4 of 10 horses with grade-2 fractures had a successful outcome. Ten of 16 horses without associated articular disease had successful outcomes, compared with 2 of 8 horses with associated articular disease. However, fragment size and presence of associated articular disease were not significantly associated with outcome. CONCLUSIONS AND CLINICAL RELEVANCE Horses with basal fractures of the proximal sesamoid bone from which a fracture fragment involving a portion of the base of the bone is removed arthroscopically have a fair prognosis for return to racing.
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Affiliation(s)
- L L Southwood
- Equine Orthopaedic Research Laboratory, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins
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Ross WA, Kaneene JB, Caron JP, Gallagher KF, Gardiner JC. Factors influencing recovery from and duration of lameness in Michigan (USA) horses. Prev Vet Med 1999; 40:127-38. [PMID: 10384949 DOI: 10.1016/s0167-5877(99)00028-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The objective of this study was to identify factors that may affect recovery from and duration of a case of lameness in a stratified random sample of Michigan horses. This was done using data from Phase-II of the Michigan equine monitoring system (MEMS Phase-II), the equine health-monitoring study [Kaneene et al., Prev. Vet. Med. 29 (1997b) 277-292; Ross and Kaneene, Prev. Vet. Med. 28 (1996a) 209-224; Ross and Kaneene, Prev. Vet. Med. 29 (1996b) 59-75; Ross et al., Am. J. Vet. Res. 59 (1997) 23-29]. In this study, statistical modelling was conducted to evaluate risk factors affecting recovery from and duration of lameness using multivariable logistic regression and Cox's proportional hazards regression, respectively. Of 357 incident lameness cases reported during MEMS Phase-II, 280 (78.6%) were reported to have recovered. The median duration of a lameness case was 18 days (1st quartile (Q): 1, maximum (Max): 360). A total of 296 of 357 (82.9%) incident lameness cases received some type of treatment. Of 619 total treatments used, 329 (53.2%) were administered, conducted or applied by a veterinarian. Horses experiencing other types of lameness were less likely to recover than those experiencing hoof lameness (odds ratio (OR) = 0.48; 95% CI: 0.25, 0.93). Horses that had participated in exercise-related activities during the study period and prior to the lameness were more likely to recover (OR = 1.91; 95% CI: 1.05, 3.50). Treatment of the lameness was associated with an increased likelihood of recovery (OR = 1.82; 95% CI: 0.97, 3.45). Cases with a veterinarian involved in the diagnosis were associated with a decreased risk of recovery (OR = 0.48; 95% CI: 0.27, 0.84) and a longer duration lameness (HR = 0.58; 95% CI: 0.45, 0.73)--which might indicate that these cases were more complex or severe. Although cases treated for lameness were more likely to recover (OR = 1.82; 95% CI: 1.05, 3.50), treatment was not associated with lameness duration (HR = 0.58; 95% CI: 0.45, 0.73).
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Affiliation(s)
- W A Ross
- Kent County Health Department, Grand Rapids, MI 49503, USA
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Traditional Chinese channel diagnosis, myofascial pain syndrome and metacarpophalangeal joint trauma in the horse. J Equine Vet Sci 1996. [DOI: 10.1016/s0737-0806(96)80031-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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