Incidence of osteochondrosis (dissecans) in Dutch warmblood horses presented for pre-purchase examination

Substantial variability exists in the interpretation of survey radiographs among equine veterinarians

BACKGROUND

Radiographs are a common diagnostic tool utilised during pre-purchase examinations, yet differences surround their interpretation among equine veterinarians.

OBJECTIVES

(1) To determine veterinarians' subjective impressions of a spectrum of radiographic abnormalities regarding suitability for purchase; (2) To determine how veterinarians' years in practice, primary discipline or board certification status influence their subjective impression of radiographic abnormalities, and (3) To determine how horses' discipline, current level of work (working at intended level vs. future prospect) and buyer intent (sell vs. retain ownership) influence veterinarians' subsequent recommendation.

STUDY DESIGN

Worldwide electronic survey of veterinary professionals.

METHODS

Four radiographic series of navicular bones, tarsi, and stifles, representing varying degrees of pathological change (normal, mild, moderate and marked) were presented. Respondents (n = 211) graded their level of concern from 1 (no concern) to 10 (very concerned) based on the radiographs and case scenarios presented.

RESULTS

Overall, as the grade of pathological change increased for each anatomical location, so did the level of veterinarian concern, but a wide range of answers were submitted for all grades of pathology. Board certified practitioners had a higher level of concern over marked radiographic changes of the navicular bone for both western performance and English sport horses as well as prospect horses (mean = 7.2 vs. 6.1; P = 0.009; 95% CI for difference = [0.3, 2.0]). Board certified respondents had a lower level of concern over marked radiographic changes of the tarsus regardless of the performance status of the horse (mean = 7.1 vs. 8.0; P = 0.008; 95% CI for difference = [-1.5, -0.2]). Western performance horse practitioners had a lower level of concern over mild radiographic changes of the tarsus regardless of the performance status of the horse (mean = 3.3 vs. 4.2; P = 0.009; 95% CI for difference = [-1.6, -0.2]).

MAIN LIMITATIONS

Only one example of each pathological grade per anatomical region was presented.

CONCLUSIONS

On survey radiographs, the perceived clinical relevance of radiographic abnormalities among equine practitioners differs widely, making purchase recommendations highly variable.

Evaluation of the appearance of osteochondrosis lesions by two radiographic examinations in sport horses aged from 12 to 36 months

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.

Ultrasound screening protocol for osteochondrosis at selected predilection sites in thoroughbred yearlings

BACKGROUND

Osteochondrosis is a common condition of young horses where there is a failure of endochondral ossification, usually at predisposed sites. The estimated prevalence of osteochondrosis is 33-44%, with radiographic screening of yearlings being used to identify lesions. Radiography has two major limitations: poor sensitivity in detecting cartilaginous lesions and secondly, the exposure of the horse and personnel to ionising radiation. Ultrasonography allows imaging of the articular cartilage and subchondral bone margins and has been shown to be more sensitive in identifying osteochondrosis lesions. However, the ultrasonographic technique for examining joints is operator dependant, resulting in highly variable examinations, thus affecting its reliability and reproducibility as a screening test.

RESULTS

A prospective observational clinical population study was undertaken involving twenty-two clinically normal weanling thoroughbred horses on-farm, describing a detailed protocol of the ultrasonographic examination technique for on-farm screening of common sites of osteochondral disease in the young horse, namely the carpal, metacarpophalangeal, stifle, tarsal and metatarsophalangeal joints.

CONCLUSION

Two veterinary practitioners used the technique to illustrate the repeatability of the protocol. The step-by-step protocol provides a valuable, reliable, repeatable technique for veterinary professionals performing screening ultrasound in the field.

Osteochondritis dissecans (OCD) in Horses - Molecular Background of its Pathogenesis and Perspectives for Progenitor Stem Cell Therapy

Osteochondrosis (osteochondrosis dissecans; OCD) is a disease syndrome of growing cartilage related to different clinical entities such as epiphysitis, subchondral cysts and angular carpal deformities, which occurs in growing animals of all species, including horses. Nowadays, these disorders are affecting increasing numbers of young horses worldwide. As a complex multifactorial disease, OCD is initiated when failure in cartilage canals because of existing ischemia, chondrocyte biogenesis impairment as well as biochemical and genetic disruptions occur. Recently, particular attention have been accorded to the definition of possible relations between OCD and some metabolic disorders; in this way, implication of mitochondrial dysfunctions, endoplasmic reticulum disruptions, oxidative stress or endocrinological affections are among the most considered axes for future researches. As one of the most frequent cause of impaired orthopaedic potential, which may result in a sharp decrease in athletic performances of the affected animals, and lead to the occurrence of complications such as joint fragility and laminitis, OCD remains as one of the primary causes of considerable economic losses in all sections of the equine industry. It would therefore be important to provide more information on the exact pathophysiological mechanism(s) underlying early OC(D) lesions, in order to implement innovative strategies involving the use of progenitor stem cells, which are considered nowadays as a promising approach to regenerative medicine, with the potential to treat numerous orthopaedic disorders, including osteo-degenerative diseases, for prevention and reduction of incidence of the disease, not only in horses, but also in human medicine, as the equine model is already widely accepted by the scientific community and approved by the FDA, for the research and application of cellular therapies in the treatment of human conditions.

Diagnostic needle arthroscopy of the tarsocrural joint in standing sedated horses

OBJECTIVE

To develop and assess a needle arthroscopic technique to diagnose conditions of the tarsocrural joint (TCj) in standing sedated horses.

STUDY DESIGN

Experimental study.

SAMPLE POPULATION

Six cadaveric hind limbs (phase 1) and six healthy horses (Phase 2).

METHODS

In phase 1, each TCj was examined with a 1.2-mm-needle arthroscope. Suitability of the needle arthroscope and degree of joint visualization with traditional arthroscopic approaches were assessed. In phase 2, the feasibility of the procedure was assessed in six standing healthy horses. A custom-made splint and base were developed to maintain joint flexion during the procedure.

RESULTS

Thorough evaluation of the dorsal intra-articular structures of the TCj via dorsomedial and dorsolateral approaches was possible in both phases. The procedure was feasible, quickly performed, and well tolerated by all horses. Complications consisted of moderate movement (2/6 horses) and hemarthrosis (3/6 horses).

CONCLUSION

Diagnostic standing needle arthroscopy of the TCj allowed thorough evaluation of the dorsal aspect of the joint while avoiding the cost and risks associated with general anesthesia. Inadvertent puncture of the dorsomedial vasculature with the cannula and obturator led to significant hemarthrosis.

CLINICAL IMPACT

Needle arthroscopy of the TCj offers an alternative diagnostic tool when traditional imaging techniques (radiography and ultrasonography) are unrewarding or nondiagnostic. The technique is conceived mainly for diagnostic purposes, but its use during short interventions warrants investigation.

Is Sclerostin Glycoprotein a Suitable Biomarker for Equine Osteochondrosis?

Osteochondrosis (OC) disease appears to be multifactorial in origin, including skeletal growth rates, nutrition, endocrinological factors, exercise, biomechanics, and other environmental factors. Endocrinological and metabolic factors seem to have an important role in the pathogeny of OC like the Wnt signaling pathway. One of the regulators in the Wnt signaling pathway is the sclerostin glycoprotein. The aim of this study was to investigate the sclerostin blood concentration according to the evolution of the disease, the environment, and the age but also its use as a possible biomarker for OC disease. Relation between age and sclerostin concentrations was calculated by a linear regression. A relation was found between age and sclerostin concentrations, but also a significant relation between age and the sclerostin concentrations was observed for two subgroups (OC affected and healthy). Evolution of the disease related to the sclerostin concentration was assessed with two logistic regressions (risk of developing OC and recovery of existing lesions), but not any significance was found. In conclusion, these results show that, despite the possible link of sclerostin with the OC pathogenesis through the Wnt pathway, circulating levels of this glycoprotein shall not be used as a biomarker for the disease. Besides, more studies are needed to fully understand the functions of sclerostin in the equine specie since it may play an important role in bone homeostasis.

Influence of seating styles on head and pelvic vertical movement symmetry in horses ridden at trot

Detailed knowledge of how a rider’s seating style and riding on a circle influences the movement symmetry of the horse’s head and pelvis may aid rider and trainer in an early recognition of low grade lameness. Such knowledge is also important during both subjective and objective lameness evaluations in the ridden horse in a clinical setting. In this study, inertial sensors were used to assess how different rider seating styles may influence head and pelvic movement symmetry in horses trotting in a straight line and on the circle in both directions. A total of 26 horses were subjected to 15 different conditions at trot: three unridden conditions and 12 ridden conditions where the rider performed three different seating styles (rising trot, sitting trot and two point seat). Rising trot induced systematic changes in movement symmetry of the horses. The most prominent effect was decreased pelvic rise that occurred as the rider was actively rising up in the stirrups, thus creating a downward momentum counteracting the horses push off. This mimics a push off lameness in the hindlimb that is in stance when the rider sits down in the saddle during the rising trot. On the circle, the asymmetries induced by rising trot on the correct diagonal counteracted the circle induced asymmetries, rendering the horse more symmetrical. This finding offers an explanation to the equestrian tradition of rising on the ‘correct diagonal.’ In horses with small pre-existing movement asymmetries, the asymmetry induced by rising trot, as well as the circular track, attenuated or reduced the horse’s baseline asymmetry, depending on the sitting diagonal and direction on the circle. A push off hindlimb lameness would be expected to increase when the rider sits during the lame hindlimb stance whereas an impact hindlimb lameness would be expected to decrease. These findings suggest that the rising trot may be useful for identifying the type of lameness during subjective lameness assessment of hindlimb lameness. This theory needs to be studied further in clinically lame horses.

Outcome after arthroscopic treatment of lateral femoral trochlear ridge osteochondrosis in sport horses

Objectives: To determine the short- and long-term outcome for sport horses after arthroscopic treatment of osteochondrosis of the lateral trochlear ridge of the femur.

Methods: A retrospective study was performed using the medical records of horses intended for use as English sport horses. Outcome was obtained through telephone questionnaire.

Results: Thirty-seven horses, mainly Warmbloods, underwent arthroscopic surgery for treatment of lateral femoral trochlear ridge osteochondrosis. Short-term outcome revealed that 27 of 37 horses had no complications. Seven horses had postoperative lameness and effusion which eventually resolved in four horses. Long-term outcome was available for 29 horses, of which 19 were performing to full expectations. Five horses were athletic but at a lower level than expected, and five horses were unable to be used. The depth of the lesion was significantly associated with short-term complications of effusion and lameness. The depth and length of the lesion were not associated with the long-term outcome, but involvement of structures other than the lateral trochlear ridge (patella, medial trochlear ridge) was associated with a worse prognosis.

Clinical significance: The prognosis for sport horses following stifle arthroscopy for lateral trochlear ridge is similar to that reported in other studies and lesions at other sites within the stifle joint.

Impact of feeding and housing on the development of osteochondrosis in foals-A longitudinal study

Osteochondrosis dissecans (OCD) is a developmental orthopedic disease caused by a failure of the endochondral ossification in epiphyseal plates and joint cartilage. This trouble may induce the presence of osteochondral fragments in the articulation, fissures or subchondral bone cysts in the growth cartilage. Occurrence of osteochondrosis is influenced by a complex interaction of different factors. Among these, the effect of the housing and the feeding of the foals during their first months of life, have been described as risk factors for the development of osteochondrosis. The aim of this study was to investigate the evolution of OCD lesions with a longitudinal study in 204 young foals from 6 to 18 months in comparison to the type of feeding and the type of housing conditions. These factors and OCD status were obtained by a questionnaire and radiological examination, respectively. This allowed dividing the foals into four groups according to the initial OCD status and the evolution of the condition. As a result, we found that foals fed with concentrates show a higher probability to develop OCD lesions (p=0.06), while foals not receiving concentrates, had a higher probability to heal from existing OCD lesions (p=0.001). This study supports the theory that management factors such as feeding or housing may influence the evolution of the osteochondrosis disease.