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Arthrodesis of the equine distal tarsal joints by perforated stainless steel cylinders.

Perforated stainless steel cylinders filled with autogenous cancellous bone were implanted in the distal tarsal joints of four horses. Graft cell survival was poor two weeks after surgery in one horse. In two horses, at 10 months there was partial arthrodesis of the joints with incorporation of the implants into the osseous union. The implants were filled with vascularised woven bone. These two horses were sound nine months after surgery. One horse fractured its third tarsal bone and was still positive to a hock flexion test 12 months after surgery.

Angiography↗

Development of an equine nuclear medicine facility for gamma camera imaging.

A nuclear medicine facility constructed specifically for the application of a gamma camera system to the radioisotope imaging of bone, pulmonary circulation and ventilation in the horse is described. The gamma camera was previously used for human nuclear medicine, and a support for the gamma camera head was specifically designed for this work. Imaging protocols are suggested and the necessary materials for bone and lung studies are described. Images of bone and lung are shown and computer analysis of the data indicated. Imaging times are approximately 1 to 2 mins and typical bone and lung studies can be completed in 20 to 30 mins.

Animals↗

The role of the reciprocal apparatus in the hind limb of the horse investigated by a modified CODA-3 opto-electronic kinematic analysis system.

The function of the reciprocal apparatus in the hind limb of the horse was studied by kinematic gait analysis. For recording purposes a modified opto-electronic CODA-3 kinematic analysis system was used. The raw kinematic data were corrected for skin displacement artifacts by use of recently developed correction models. It was concluded that contradictory findings about the coupling of tarsal and stifle joints by the reciprocal apparatus, when comparing in vitro and in vivo studies, can be fully attributed to artifacts due to the movement of the skin markers over the underlying bony structures, occurring in the in vivo experiments.

Animals↗

Osteochondritis dissecans of the tarsocrural joint: results of treatment with arthroscopic surgery.

The technique and results of arthroscopic surgery for the treatment of osteochondritis dissecans in 318 tarsocrural joints in 225 horses are reported. Of the 225 horses, 154 were racehorses or intended for racing. Arthroscopic surgery was an effective technique for treating osteochondritis dissecans of the tarsocrural joint. The overall functional ability and cosmetic appearance of the limbs were excellent. Post surgical follow-up information was obtained for 183 horses, of which 140 (76.5 per cent) raced successfully or performed their intended use following surgery. Of the remaining 43, 11 were considered to still have a tarsocrural joint problem, 19 developed other problems precluding successful performance, eight were considered poor racehorses without any lameness problems identified, three were killed because of septic arthritis and two died from other causes. There was no significant effect of age, sex or limb involvement on the outcome. The size of the intermediate ridge lesions had no effect on prognosis but the presence of degenerative or erosive changes in the articular cartilage significantly decreased the prognosis. The synovial effusion resolved in 117/131 racehorse joints (89.3 per cent) and 64 of 86 non-racehorse joints (74.4 per cent) with follow-up. The outcome for synovial fluid resolution was significantly inferior for lesions of the lateral trochlear ridge of the talus or medial malleolus of the tibia compared to distal intermediate ridge lesions. There was no significant relationship between resolution of effusion and successful performance outcome.

Animals↗

Fusion of the distal intertarsal and tarsometatarsal joints in the horse using intraarticular sodium monoiodoacetate.

Six normal horses received 3 intra-articular injections of sodium monoiodoacetate (MIA) in the distal intertarsal (DIT) and tarsometatarsal (TMT) joints of one hindlimb. Injections were at three week intervals, and post injection pain was controlled with routine administration of phenylbutazone for five days following each injection. All horses underwent a gradually increasing exercise programme consisting of walking and trotting beginning one week after the first injection and continuing for 24 weeks. All treated joints showed increasingly severe radiographic evidence of degenerative joint disease with time. Clinical signs were mild or absent during exercise. All treated joints showed radiographic and histological evidence of fusion 24 weeks after the first injection. Amount of radiographic fusion ranged from 54.49 per cent to 88.64 per cent of the joint space. Histologically, the joint space that appeared radiographically fused was filled mainly with woven and lamellar bone. Fibrocartilage and fibrous tissue was seen frequently in the transition between fused and unfused areas. Articular cartilage in unfused areas was thin, fibrillated, hypocellular and histochemically showed diminished proteoglycan content. Existing joint space was filled with fibrin and necrotic, acellular chondroid matrix. We conclude that MIA will produce fusion of the DIT and TMT joints of normal horses in 24 weeks, and may offer a relatively easy, inexpensive and non-invasive treatment for distal tarsal osteoarthritis in the horse.

Animals↗

Racing performance of standardbreds after conservative and surgical treatment for tarsocrural osteochondrosis.

A retrospective study of 114 Standardbred horses diagnosed with osteochondrosis (OC) of the cranial intermediate ridge of the distal tibia was carried out, and their subsequent race records were compared with 456 control horses. Each OC-affected horse was compared with 4 horses randomly selected from a list of horses matched to it by year of birth, sex and sire. The horses with OC were treated by arthroscopic removal of osteochondral fragments (N = 58) or managed conservatively (N = 56). The clinical presentation of these two groups was similar, although joint effusion was a more common presenting sign in the group that received surgical treatment. There was no association between presence of lameness and the type of treatment used. Data from the race records of treated and control horses (including the number of starts, lifetime earnings and record racing times) were compared. Overall, horses treated for OC had significantly fewer starts than, but earnings similar to, those in the control group. However, when stratification by sex was performed, females with OC made fewer starts and had lower earnings than did their control group. There was no significant difference in record time between OC-affected horses and controls. These results indicate that horses treated for osteochondrosis of the cranial intermediate ridge of the distal tibia performed as well as matched controls.

Age Factors↗

The role of computed tomography in evaluation of subchondral osseous lesions in seven horses with chronic synovitis.

Seven horses with severe, persistent lameness of sudden onset were evaluated with scintigraphy and/or computed tomography. The lameness was localised to the front fetlock joint in 2 horses and to the tibiotarsal joint in 5 horses. Five of the horses had a history of intra-articular injections of the involved joint prior to presentation. All horses had effusion of the affected joint and were positive to flexion tests. Intraarticular anaesthesia eliminated or improved the lameness in 4 cases and a nerve conduction block proximal to the affected joint improved the lameness in another. Cytology examination of fluid from affected joints identified normal joint fluid (one horse) or elevations in nucleated cell counts of 0.9 x 10(9)/l-36.8 x 10(9)/l and total protein 20-42 g/l (6 horses). The joint fluid of 2 of these horses cultured positive for bacteria. Initial radiographs were either normal (4 cases) or the changes seen were not sufficient to explain the degree of lameness. In the 6 cases where scintigraphy was performed, intense focal isotope uptake was found in the suspected region, which corresponded to the proximal portion of the first phalanx (2 cases), distal tibia (2 cases), or talus (3 cases). Computed tomography (CT) was performed because occult fracture or osteomyelitis was suspected; and knowledge of the precise anatomical location of the lesion was considered necessary to assess the need for surgery and to plan the surgical approach. Hypodense focal lesions with hyperdense haloes were found in the subchondral bone deep to the sagittal groove of the first phalanx (P1) (2 cases) in the cochlea of the distal tibia (2 cases), and in the intertrochlear portion of the talus (3 cases). Communication between the lesion and the joint space was demonstrated by CT in 5 cases. Post mortem examination of one case revealed synovitis and a chronic bone abscess (Brodie's abscess) communicating with the joint space.

Animals↗

The significance of routine radiographic findings with respect to subsequent racing performance and longevity in standardbred trotters.

A retrospective cohort study was made of the racing performance of trotters which had been subjected routinely to radiography before they started training and racing. Sixty-one per cent (148) of the 243 horses, foaled in 3 consecutive years, had one or more abnormal findings categorised into 5 relevant groups based on radiography, of which osteochondrosis (OCD) was the most specific diagnosis. Parameters used to reflect racing performance were: proportion of horses starting in races, number of starts per year, earnings per year, earnings per start and racing longevity. No significant association between the presence or type of radiological abnormalities and the subsequent performance and longevity could be found. Horses with multiple lesions, however, had a tendency to lower earnings and poorer survival than horses with single lesions.

Animals↗

Kinematic comparison of the leading and trailing fore- and hindlimbs at the canter.

The canter is a 3 beat asymmetrical gait with a difference in timing between left and right limbs. To evaluate intralimb asymmetry at the canter, a group of 24 Dutch Warmbloods was evaluated on a treadmill (7 m/s) using a modified CODA-3 optoelectronic gait analysis system. Thirteen horses cantered in the left lead ('leading limb' group) and 11 in the right lead ('trailing limb' group) during left forelimb recordings, while 11 horses were at the left and 13 were at the right lead during left hindlimb recordings. Kinematic differences between horses from the 'leading limb' and 'trailing limb' group were statistically evaluated at a significance level of P<0.05. Stride, stance and swing duration were similar between the 2 groups. The pelvis rotation, angle of maximal protraction and total range of maximal pro- and retraction were larger in the 'leading limb' group, while the scapula rotation, and the angle of maximal retraction were larger in the 'trailing limb' group. The elbow and hip joints were more flexed at impact, at maximal extension and at maximal flexion of the leading limb, whereas the stifle joint was more extended at impact. Furthermore, the leading tarsal joint was more maximally flexed in stance and swing phase, whereas the carpal joint was more flexed only in the swing phase of the leading limb. However, during the stance phase the maximal fetlock extension of the trailing fore- and hindlimbs were significantly larger. Apparently, horses move at the canter with a more protracted leading limb by more flexing the elbow, carpal, hip and tarsal joints. In the trailing limb, however, the scapula is more rotated, and the tarsal and fetlock joints are more loaded. In conclusion, the difference in interlimb timing between left and right limbs at canter also leads to an asymmetry in intralimb coordination of these limbs.

Analysis of Variance↗

Enostosis-like lesions in the long bones of 10 horses: scintigraphic and radiographic features.

Ten horses admitted for lameness evaluation including bone scintigraphy had enostosis-like lesions, described scintigraphically as focal or multifocal areas of intense increased radioisotope uptake within the medullary cavity of one or more long bones, and radiographically as one or multiple round to irregularly shaped radiopacities within the medullary cavity, often in close proximity to the nutrient foramen. There were 6 Thoroughbreds, one male, one female and 4 geldings, 3 Standardbreds, all geldings and one Appaloosa gelding; age 3-10 years. Enostosis-like lesions were seen in the tibia (5 horses), radius (3 horses), humerus (one horse) and third metatarsal bone (MT-III) (4 horses). The number of affected bones in each horse was 1-3. Of 16 affected limbs, there were 9 hindlimbs and 7 forelimbs. Enostosis-like lesions were considered a possible cause of lameness in 5 horses, but were considered incidental findings in the other horses. Lesions thought to cause lameness were seen in the tibia (2 horses), MT-III (one horse) and in the radius (4 horses). Lameness resolved after horses were rested (2-6 months) and given nonsteroidal anti-inflammatory drugs (4 horses). Follow-up scintigraphic examination in 3 horses (2, 6 and 9 months later, respectively) revealed normal radioisotope uptake in the affected areas.

Animals↗

The effects of partial thyroidectomy on the development of the equine fetus.

A syndrome of congenital hypothyroidism and dysmaturity has been an important cause of reproductive loss and foal mortality in western Canada. The cause and pathogenesis of this syndrome is under investigation. One issue to be addressed is whether all the anomalies present in affected foals are produced concurrently by the same agent, or if affected foals are primarily hypothyroid in utero which induces the associated lesions. This study was designed to document the effects of fetal thyroidectomy, at about 215 days of gestation, on the growth and development of the equine fetus and to compare the anomalies present to those reported in the spontaneously occurring syndrome of foals in western Canada. Two sham-operated controls and 4 partially thyroidectomised foals were carried to term following surgery. Sham-operated control foals were normally developed. Partially thyroidectomised foals were hypothyroid; had hyperplastic thyroid gland remnants; abnormal behaviour and locomotor skills; and numerous, marked deficiencies in their skeletal development. The anomalies present in partially thyroidectomised foals were comparable to those reported in congenitally hypothyroid neonates of other species, including human infants, and were similar to those described in congenitally hypothyroid and dysmature foals reported in western Canada.

Animals↗

Gross, histological and histomorphometric features of the navicular bone and related structures in the horse.

Forelimb navicular bones and associated soft tissues were collected from 3 groups of horses and subjected to pathological examinations. The groups consisted of 38 horses with clinical navicular disease (ND) and 2 control groups, with no history of forelimb lameness, consisting of 25 age-matched mature horses (A-MC) and 9 immature horses (IC). Histological and histomorphometric studies were performed on tissue samples from 10 ND, 10 A-MC and 5 IC horses. Gross changes seen only in ND horses included: full thickness defects in the palmar surface fibrocartilage, palmar cortex erosion, medullary lysis, flexor digitorum profundus tendon (FDPT) surface fibrillation, FDPT core lesions and adhesions between the FDPT and navicular bone. Palmar surface partial thickness fibrocartilage loss and distal border fragmentation were seen with a significantly greater incidence in ND than in A-MC and not observed in IC. Remodelling of the proximal border, FDPT surface colouration, palmar surface fibrocartilage colouration and proximal border entheseous bone were identified in ND and A-MC but not in IC. Mid-ridge synovial fossae and horizontal depressions in the palmar surface were identified in all groups. Histologically palmar fibrocartilage thinning and loss were associated with reduced palmar fibrocartilage cell density and chondrocyte cluster formation. Palmar fibrocartilage fibrillation, palmar cortical bone defects, fibromyxoid stromal change in the medulla, medullary pseudocyst formation and entheseous new bone formation were all seen in ND. The adjacent FDPT showed fibrillation, tag formation and degeneration of the dorsal surface. Necrotic foci were also present within the body of the tendon. Although not always present, medullary bone pseudocysts, separate mineralised foci and most changes on the dorsal surface of the FDPT were specific to ND. Bone histomorphometric parameters were compared among groups. Cross-sectional area reduced from the sagittal ridge to the medial and lateral margins of each navicular bone. IC navicular bones had a smaller subchondral area, subchondral bone volume and a greater osteoid volume than in the AC, indicating that these differences were age-related. In ND the medullary area was decreased but the trabecular bone volume increased. The palmar subchondral area was increased but contained bone with an increased porosity and osteoid volume. Changes occurred from the medial to the lateral margins of the bone in horses with ND indicating remodelling of the bony elements throughout the bone in ND. The histological and histomorphometric changes in the navicular bone and palmar fibrocartilage were considered similar of those found in articular hyaline cartilage and subchondral bone in osteoarthritis.

Animals↗

Endoscopic examination of the tarsal sheath of the lateral digital flexor tendon in horses.

This study was designed to develop a reliable technique for endoscopic examination of the tarsal sheath of the lateral digital flexor tendon of horses. The anatomy of the tendon sheath and associated structures was studied in detail in cadavers before determining portals for the insertion of an arthroscope into the sheath. Approaches into the sheath through the proximal pouch and through the flexor retinaculum, at the level of the sustentaculum tali, were performed and compared in cadavers. The proximal pouch portal permitted visualisation only of the proximal half of the sheath, while the approach through the retinaculum allowed examination of the entire sheath. The normal endoscopic appearance of the tarsal sheath was studied. The endoscopic approach was subsequently used to examine and treat 5 horses with tarsal sheath tenosynovitis, including 2 cases of chronic, traumatic tenosynovitis and 3 of subacute septic tenosynovitis. Four of these horses had fragmentation of the sustentaculum tali. The technique allowed adequate examination of the sheath and debridement of adhesions and lesions within the lumen of the sheath. Fragments dorsal to the medioplantar edge of the sustentaculum tali could not be visualised endoscopically and had to be removed after widening of the wound. All 5 horses survived. Follow-up enquiries (8-31 months) revealed that the horses were all reported to be sound. Four were performing at their previous level of activity, 1 was used for hacking. The 2 cases presented with chronic tenosynovitis had residual sheath distension with no associated loss of function. A prospective study, including longer term follow-up investigation, is currently being performed.

Animals↗

Intra-articular pressure profiles of the cadaveric equine fetlock joint in motion.

The study of the influence of motion and initial intra-articular pressure (IAP) on intra-articular pressure profiles in equine cadaver metatarsophalangeal (MTP) joints was undertaken as a prelude to in vivo studies. Eleven equine cadaver MTP joints were submitted to 2 motion frequencies of 5 and 10 cycles/min of flexion and extension, simulating the condition of lower and higher (double) rates of passive motion. These frequencies were applied and pressure profiles generated with initial normal intra-articular pressure (-5 mmHg) and subsequently 30 mmHg intra-articular pressure obtained by injection of previously harvested synovial fluid. The 4 trials performed were 1) normal IAP; 5 cyles/min; 2) normal IAP; 10 cycles/min; 3) IAP at 30 mmHg; 5 cycles/min and 4) IAP at 30 mmHg; 10 cycles/min. The range of joint motion applied (mean +/- s.e.) was 67.6+/-1.61 degrees with an excursion from 12.2+/-1.2 degrees in extension to 56.2+/-2.6 degrees in flexion. Mean pressure recorded in mmHg for the first and last min of each trial, respectively, were 1) -5.7+/-0.9 and -6.3+/-1.1; 2) -5.3+/-1.1 and -6.2+/-1.1; 3) 58.8+/-8.0 and 42.3+/-7.2; 4) 56.6+/-3.7 and 40.3+/-4.6. Statistical analyses showed a trend for difference between the values for the first and last minute in trial 3 (0.05>P<0.1) with P = 0.1 and significant difference (P = 0.02) between the mean IAP of the first and last min in trial 4. The loss of intra-articular pressure associated with time and motion was 10.5, 16.9, 28.1 and 28.9% for trials 1-4, respectively. As initial intraarticular pressure and motion increased, the percent loss of intra-articular pressure increased. The angle of lowest pressure was 12.2+/-1.2 degrees (mean +/- s.e.) in extension in trials 1 and 2. In trials 3 and 4, the lowest pressures were obtained in flexion with the joints at 18.5+/-2.0 degrees (mean +/- s.e.). This demonstrated that the joint angle of least pressure changed as the initial intra-articular pressure changed and there would not be a single angle of least pressure for a given joint. The volume of synovial fluid recovered from the MTP joints in trial 3 compared to 4 (trials in which fluid was injected to attain IAP of 30 mmHg) was not significantly different, supporting a soft tissue compliance change as a cause for the significant loss of intra-articular pressure during the 15 min of trial 4. The pressure profiles generated correlate well with in vivo values and demonstrated consistent pressure profiles. Our conclusions are summarised as follows: 1. Clinically normal equine MTP joints which were frozen and then later thawed were found to have mostly negative baseline intra-articular pressures, as would be expected in living subjects. 2. Alternate pressure profiles of the dorsal and plantar pouch at baseline intra-articular pressure document the presence of pressure forces that would support 'back and forth' fluid movement between joint compartments. This should result in movement of joint fluid during motion, assisting in lubrication and nutrition of articular cartilage. 3. If joint pressure was initially greater than normal (30 mmHg), as occurs in diseased equine MTP joints, joint motion further increased joint capsule relaxation (compliance) and, therefore, reduced intra-articular pressure. 4. Peak intra-articular pressures reached extremely high values (often >100 mmHg) in flexion when initial pressure was 30 mmHg. Joint effusion pressures recorded for clinical MCP joints are frequently 30 mmHg. These IAP values are expected to produce intermittent synovial ischaemia in clinical cases during joint flexion. 5. Additional in vivo studies are necessary to confirm our conclusions from this study and to identify the contributions of fluid absorption and the presence of ischaemia in a vascularised joint.

Animals↗

Effects of 5-lipoxygenase inhibitors on interleukin production by human synovial tissues in organ culture: comparison with interleukin-1-synthesis inhibitors.

Prostaglandins and leukotrienes differentially regulate the production of interleukin-1 (IL-1) in monocytes. It was, therefore, decided to investigate the effects of some 5-lipoxygenase inhibitors compared with standard IL-1 synthesis inhibitors on the production of IL-1 by human synovial tissue explants in organ culture. Human synovial (from hip/knee arthroplasty) or porcine tibio-tarsal joint synovial explants were incubated in organ culture in Dulbecco's Modified Eagle's Medium + 5% foetal calf serum in the presence of the test compounds or solvents (controls), or media alone for 1-5 days. Total bioactive IL-1 was assayed in the medium (following serial dilution or with polyethylene glycol 8000 added in some assays to remove inhibitors) using the D-10 T-cell bioassay. Some assays of interleukins 1 alpha, 1 beta, 6 or 8 were performed by ELISA. Of the 5-lipoxygenase inhibitors investigated, MK-886(3-(1-(4-chlorobenzyl)-3-tert-butyl-thio-5-isopropylindol-2- yl)-2,2 -dimethyl propanoic acid), L-656,224 ((7-chloro-2-[4-methoxypenyl]methyl)-3 -methyl-5-propyl-4-benzofuranol), PF-5901 and tepoxalin were the most potent inhibitors of IL-1 production. While the PF-5901 was effective at 5-30 microM and tepoxalin was effective at 1-10 microM, the others were the most potent having minimal inhibitory activity in the range of 0.01-0.1 microM. The presumed IL-1-synthesis inhibitors, tenidap and IX-207,887, were inactive at concentrations of 30-50 microM. Leukotriene B4 (1-100 ng/mL-1) added to MK-886 (5 microM)-treated cultures reversed the inhibitory effects of the latter on IL-1, confirming the role of 5-lipoxygenase products in the regulation of IL-1 production. Addition of polyethylene glycol 8000 to MI-886-treated cultures eliminated the inhibitory effects of this drug, suggesting that this drug exerts its effects by promoting production of IL-1 inhibitors. MK-886 also inhibited synovial production of two other pleiotrophic cytokines which it regulates, IL-6 and IL-8. The results suggest that some 5-lipoxygenase inhibitors may be usefully employed in regulating production of those interleukins involved in joint cartilage destruction.

Animals↗