Trotter Gw

Early events in cartilage repair after subchondral bone microfracture.

The current study investigated healing of large full-thickness articular cartilage defects during the first 8 weeks with and without penetration of the subchondral bone using microfracture in an established equine model of cartilage healing. Chondral defects in the weightbearing portion of the medial femoral condyle were made bilaterally; one defect in each horse was microfractured whereas the contralateral leg served as the control. The expression of cartilage extracellular matrix components (Types I and II collagen and aggrecan) was evaluated using histologic techniques, reverse transcription coupled polymerase chain reaction, in situ hybridization, and immunohistochemistry. This study confirms an increase in Type II collagen mRNA expression in repair tissue as early as 6 weeks after microfracture. Although other matrix mRNA and protein levels changed in concentration and tissue location over the course of the study, no significant differences were seen in microfractured defects. Although the microfracture techniques appear to improve clinical functionality, volume of repair tissue, and augment Type II collagen content, aggrecan content is less than ideal. Therefore, methods to enhance key matrix components such as aggrecan after microfracture may additionally improve repair tissue observed after the procedure.

Development of subchondral cystic lesions after articular cartilage and subchondral bone damage in young horses

The objective of this study was to determine if damage to the articular cartilage alone or articular cartilage plus subchondral bone of the distal medial femoral condyle of young, exercised horses resulted in the formation of subchondral cystic lesions. Twelve Quarter Horses (age 1-2 years), free of clinical and radiographic signs of osteochondrosis and lameness were used. In 6 horses (Group 1), a 15 times 1 mm linear full thickness defect in the articular cartilage was made arthroscopically on the weightbearing surface of the distal aspect of the medial femoral condyle. In the other 6 horses (Group 2), a 15 times 3 mm full thickness elliptical cartilage defect was made, followed by burring a 5 mm diameter, 4 mm deep hole into the subchondral bone. Three weeks after surgery, all horses were hand walked and trotted for 2 weeks and then exercised for 6 min daily, 5 days a week for the next 14 weeks on a treadmill. They were then turned onto a small paddock for 6 weeks (6 months total). The development of subchondral cystic lesions was determined using radiography. Bone activity in the femoral condyle was monitored with nuclear scintigraphy. All horses that developed subchondral cystic lesions radiographically were subjected to euthanasia for gross and histological examination of the lesions. No subchondral cystic lesions and no clinical abnormalities were detected in the horses in Group 1. Subchondral cystic lesions developed radiographically in 5 of 6 horses in (Group 2). Scintigraphic findings of horses with subchondral cystic lesions were inconsistent. Histological examination of lesions revealed variable quantities of fibrous connective tissue, fibrocartilage and bone, with evidence of bone remodelling adjacent to the subchondral cystic lesion. The results suggest that damage to articular cartilage plus subchondral bone, but not articular cartilage alone, of the distal medial femoral condyle may lead to the development of subchondral cystic lesions. These findings indicate that all subchondral cystic lesions in horses may not be osteochondrosis-type lesions and that trauma to weightbearing articular surfaces of young horses may be a predisposing factor.

Arthroscopic injection of corticosteroids into the fibrous tissue of subchondral cystic lesions of the medial femoral condyle in horses: A retrospective study of 52 cases (2001–2006)

REASONS FOR PERFORMING STUDY There are no published results of subchondral cystic lesions (SCLs) in the medial femoral condyle (MFC) treated with arthroscopic injection of corticosteroids into the lining of the cyst. OBJECTIVES 1) To determine the success rate for treatment of SCLs in the MFC with arthroscopic injection of the fibrous tissue of the cyst with corticosteroids. 2) To identify any factors that may predict outcome. HYPOTHESES Injection of the fibrous tissue of SCLs of the MFC with corticosteroids utilising arthroscopic guidance yields a similar or higher chance for intended performance than does arthroscopic debridement as previously reported; this technique will be effective for treating SCLs in older horses. METHODS Horses with clinical and radiographic evidence of a SCL in the MFC were injected with corticosteroids under arthroscopic guidance, and case records and radiographs were reviewed retrospectively. A telephone survey of referring veterinarians, owners and trainers was conducted. RESULTS Thirty-five of 52 (67%) cases were classified as successful involving 73 SCLs of which 56 (77%) were classified as successful. There was no significant association between age group (age<or=3 years vs. >3 years) and outcome, or cyst configuration and outcome. Significantly more unilateral SCLs (28/31 [90%] SCLs) were classified as successful than bilateral (28/42: 67%). There were significant differences in outcome based on the surgeon operating the case and an association between pre-existing radiographic findings of osteophytes and negative outcome. CONCLUSIONS Injection of SCLs utilising arthroscopic guidance is an effective alternative method of surgical treatment of SCL. POTENTIAL RELEVANCE This technique offers a similar chance of success as has been reported with debridement and may allow for a shorter period of convalescence. If unsuccessful, the option remains to debride the cyst in a second surgery.

Effects of glucosamine hydrochloride and chondroitin sulphate, alone and in combination, on normal and interleukin-1 conditioned equine articular cartilage explant metabolism

REASONS FOR PERFORMING STUDY Clinical trials in human and veterinary literature have documented the benefits of oral nutraceutical joint supplements containing glucosamine (GU) and chondroitin sulphate (CS) to treat mild to moderate osteoarthritis, but the effects of these components have not yet been conclusively determined. OBJECTIVES To assess varying dosages of GU and CS on normal and interleukin-1alpha (IL-1) conditioned equine cartilage explants and rationalise the use of these products. HYPOTHESIS Treatment would not be detrimental to cartilage metabolism and higher dosages and the combination of GU and CS would be more beneficial than lower dosages and. GU or CS alone. METHODS Articular cartilage explants collected from the femoral trochlea and condyles were cultured in normal and IL-1 conditioned media. Treatment groups included 0, 12.5, 25,125 and 250 microg/ml concentrations of GU alone, CS alone, or GU+CS in combination. Glycosaminoglycan (GAG) synthesis and total GAG content in the explants and media were analysed. RESULTS There were no detrimental effects of GU, CS or GU+CS on cartilage metabolism. High dosages of GU+CS reduced total GAG release into the media (degradation). CONCLUSIONS Our results suggests that GU+CS may prevent cartilage GAG degradation. POTENTIAL RELEVANCE The combination of GU and CS may be more effective in preventing or treating osteoarthritis in horses than either product alone.

Effects of dosage titration of methylprednisolone acetate and triamcinolone acetonide on interleukin‐1‐conditioned equine articular cartilage explants in vitro

REASONS FOR PERFORMING STUDY Osteoarthritis is a frequent sequela of joint disease, especially with severe injuries or if attempts at therapy are unsuccessful. Negative and positive effects of corticosteroid treatment of articular cartilage have been demonstrated by in vitro and in vivo studies. OBJECTIVES To assess the metabolic effects of varying dosages of methylprednisolone acetate (MPA) and triamcinolone acetonide (TA) on interleukin-1alpha (IL-1) conditioned equine cartilage explants. Our hypothesis was that lower dosages of corticosteroids would be less detrimental to cartilage metabolism than higher dosages. TA would be less detrimental to cartilage metabolism than MPA. METHODS Treatment groups included articular cartilage explants with no IL-1 (control), IL-1 alone, and IL-1 plus 10, 5, 1 and 0.5 mg/ml MPA or 1.2, 0.6, 0.12 and 0.06 mg/ml TA. Explants were labelled with 35SO4 prior to the beginning and end of the experiment to assess glycosaminoglycan (GAG) degradation and synthesis, respectively. Total GAG content in media and explants and total cartilage DNA were also analysed. RESULTS MPA and TA reduced GAG synthesis compared to control and IL-1 alone. The highest dosage of MPA (10 mg/ml) reduced GAG synthesis less than lower dosages of MPA and all dosages of TA. Compared to IL-1 alone, all dosages of TA and lower dosages of MPA increased GAG degradation. MPA at 10 mg/ml reduced GAG degradation. Both MPA and TA increased media GAG content compared to control and IL-1 explants. Total cartilage GAGs were unchanged with MPA, but reduced with TA, compared with IL-1 alone. Total cartilage DNA was decreased with MPA and increased with TA compared to IL-1 and control explants. CONCLUSIONS MPA and TA did not counteract the negative effects of IL-1 and did not maintain cartilage metabolism at control levels. Lower dosages of MPA and TA were not less detrimental to cartilage metabolism than higher dosages. TA did not appear to be less harmful than MPA on cartilage metabolism. The results of this study differ from the findings of comparable in vivo studies. POTENTIAL RELEVANCE The low numbers of horses used in this study limits extrapolation of these findings to the equine population; however, this study also questions the clinical relevance of this in vitro model.

Concurrent or sequential development of medial meniscal and subchondral cystic lesions within the medial femorotibial joint in horses (1996–2006)

UNLABELLED Summary Reasons for performing study: Medial meniscal injuries and subchondral cystic lesions (SCL) are known to occur independently within the medial femorotibial (MFT) joint in horses. However, there are no reports of a potential clinical relationship between these 2 types of lesions. OBJECTIVES To: 1) document the concurrent presence or sequential development of medial meniscal and SCL of the medial femoral condyle within the MFT joint; and 2) determine the prognosis with both types of lesions. METHODS Retrospective case series of horses with both a medial meniscal and SCL of the medial femoral condyle identified concurrently or sequentially by radiography, arthroscopy or post mortem examination. Case records and radiographs were reviewed, and a telephone survey of referring veterinarians, owners and trainers was conducted. RESULTS Twenty-one horses (9.1% of all horses undergoing MFT joint arthroscopy) were identified to have both a medial meniscal injury and SCL of the medial femoral condyle. Thirteen horses had both abnormalities identified concurrently, 6 developed a meniscal lesion subsequent to SCL debridement, and 2 developed a SCL subsequent to a medial meniscal injury. Only 4/19 horses were classified as successful and returned to their intended use. The severity of the meniscal injury was significantly associated with the severity of lameness but not with outcome. CONCLUSIONS A low percentage of horses may develop both a meniscal injury and SCL of the medial femoral condyle within the MFT joint and have a poor prognosis. POTENTIAL RELEVANCE Trauma to the MFT joint may lead to both meniscal and subchondral bone damage of the medial femoral condyle that may be recognised concurrently or sequentially.

Natural balance trimming and shoeing: its theory and application

The principles and techniques of natural balance trimming and shoeing are designed to optimize the efficiency and function of the foot. The basic guidelines have evolved in part from wild horse hoof imprint studies done in 1986 through 1987 and first presented in 1995. Further research has contributed to these principles and guidelines to make them applicable to domestic horses.

Advances in Equine Arthroscopy

Surgical procedures completed under arthroscopic guidance have become commonplace in many equine practices and have largely replaced surgery using arthrotomy incisions. With a limited amount of equipment, numerous diagnostic and surgical procedures can be completed. Surgeons need to become familiar with regional and intraarticular (intrasynovial) anatomy to ensure that proper surgical approaches are used, access to the lesion will be realized, and potential complications will be minimized. Specialized motorized instruments and surgical lasers are now available and may be useful in the treatment of selected clinical cases.

Surgery for Abnormal Vulvar and Perineal Conformation in the Mare

Reproductive failure in mares can present a challenge to the attending veterinarian. Although many causes of failure to conceive or to carry to term may be easy to diagnose and treat effectively, others may be difficult. In some cases, more than one problem will be present, and both medical therapy and surgical intervention will be required to achieve a successful outcome. Pneumovagina and its sequelae remain a common cause of reproductive failure in mares. Depending on the case involved, different surgical techniques may be required to correct the problem.

Principles of Early Wound Management

The unique personality of horses, combined with their environmental surroundings and the way they are used, makes them prone to a variety of injuries. As such, large animal practitioners are frequently called to examine and treat wounds on horses. Effective and proper treatment is predicated upon a reasonable knowledge of wound healing and how wound healing can be manipulated in a favorable fashion. The optimal end result includes return of full function, cosmetic healing, a short recovery period, and minimal cost to the owner. Not all of these goals are achievable in every case, but they should be kept in mind when treating all cases.