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Radiographic evolution of the forelimb digit in Ardenner horses from weaning to 28 months of age and its clinical significance.

Ossification of collateral cartilages is a common radiographic finding in draught horses and indication of a high frequency of interphalangeal osteo-arthropathy have been found in Ardenner horses. This study first aimed at following the evolution of the digits of the forelimbs on radiographic images in a group of 32 Ardenner horses from weaning to 852 +/- 19 days and, secondly, at evaluating the clinical significance of the observed radiographic changes. At 250 +/- 21 days, only 23% of the horses presented a small separate ossification centre of collateral cartilages above the level of the distal sesamoid bone or at the level of the proximal half of the middle phalanx. At 852 +/- 19 days, 100% of the horses presented an ossification of collateral cartilages but at different stages and grades. The presence and the extent of the ossification of the lateral cartilages were not significantly associated with lameness. Phalanges changes appeared at the average age of 1 year and they were represented by entheseophytes on the dorsal surface of the middle and distal phalanges. The frequency of affected horses increased with age as well as the size of the entheseophytes. This may reflect mechanical stresses applied to the interphalangeal joints. A significant association with the presence of lameness was pointed out. The presence and the severity of phalanges changes could be of importance, in combination with a clinical examination, in improving the selection of horses able to assume work and/or leisure activities.

Aging↗

Stress protection afforded by a cast on plate fixation of the distal forelimb in the horse in vitro.

Six forelimb specimens from three adult horses had the fetlock joint fused by application of a dorsal plate and by a screw placed in lag fashion through the metacarpus to each proximal sesamoid bone. Five specimens were instrumented on the central dorsal surface of the plate with a single rosette strain gage, and the plate of the sixth specimen was instrumented with four longitudinally oriented single-axis strain gages. The specimens were loaded axially in compression to 4,000 N in a cast (test 1), in a cast with a heel block (test 2), and uncast (test 3). The principal angle of strain in all specimens, in all tests, closely approximated the vertical axis at loads < 1,000 N. The principal angle in uncast specimens was significantly different at loads > 1,000 N than the cast specimens (P < .05). At loads > 3,000 N, the principal angle in test 3 closely approximated the horizontal axis, indicating a change from tension to compression on the dorsal surface of the plate, whereas the principal angle of the cast specimens was unchanged. Specimens in a cast (tests 1 and 2) suffered less surface deformation than did uncast specimens (test 3). Therefore, the cast changed the direction and extent of bending at the point of fixation, and thereby decreased the deformation of the plate. This effect would lead to greater fatigue life of the implant in the cast specimens compared with the uncast specimens.

Animals↗

Popliteal tendon transposition for stabilization of the cranial cruciate ligament deficient stifle joint in dogs: an experimental study.

Popliteal tendon transposition was performed in five dogs with surgically induced cranial cruciate ligament rupture. After a lateral approach to the stifle joint, the popliteal tendon was severed distal to the sesamoid bone and transposed cranially onto the tibial crest to mimic the sagittal orientation of the cranial cruciate ligament. The origin of the popliteal tendon on the lateral femoral condyle was preserved. Lameness was not clinically detectable 2 months after surgery. At 6 months postoperatively, there was minimal radiographic and histopathologic evidence of degenerative joint disease in the stifle joints that had underwent surgery. There was no gross or microscopic evidence of meniscal damage found at necropsy 6 months after surgery. Biomechanical studies are warranted before recommending the procedure.

Animals↗

Ultrasonography of the podotrochlear apparatus in the horse using a transcuneal approach: technique and reference images.

The purpose of this paper is to describe the technique for ultrasonographic examination of the podotrochlear apparatus in the horse using a transcuneal approach. In this study, ultrasound scans were performed in 3 normal cadaver limbs and 5 sound horses and images were compared to anatomic sections to establish the normal ultrasonographic anatomy of the podotrochlear apparatus. Detailed description of transverse and sagittal reference ultrasonographic images of this region is provided. This new imaging technique allows the assessment of the distal sesamoid bone flexor surface, the distal portion of the deep digital flexor tendon, the impar distal sesamoidean ligament, and the entheses of the distal phalanx.

Animals↗

Ultrasonography of the solar aspect of the distal phalanx in the horse.

Ultrasonographic examinations were performed on the solar aspect of the distal phalanx of 10 feet of five normal live horses (Group 1), 22 feet of seven normal cadavers (Group 2), and nine feet of five horses with pathology of the dorsal solar aspect of the distal phalanx (Group 3). Lateromedial radiographs of the distal phalanx were made in all groups, and in Group 2, digits were sagitally sectioned after imaging. The ultrasonographic and radiographic appearance of the sagittal solar aspect of the distal phalanx was described. Measurements of the distance between the sole and the distal tip of the distal phalanx (A), the solar aspect of the apex of the frog and the distal phalanx (B), and the body of the frog's surface and flexor surface of the distal sesamoid bone (C) were made ultrasonographically, radiographically, and on the sectioned cadaver specimens. There was no statistical difference between the radiographic, ultrasonographic, and direct cadaver measurements in A and C. In B, there was a statistical difference between the radiographic, ultrasonographic, and cadaver measurements-most likely as a result of the difference in trimming of the frog apex. Ultrasonographic and radiographic examination of the nine feet of the five horses in Group 3 were performed and the abnormalities described. Color flow and power Doppler ultrasonography were performed on the normal sagittal solar distal phalanx, on the impar distal sesamoidean ligament, and at the insertion of the deep digital flexor tendon on the facies flexoria of the distal phalanx. Power Doppler in these horses showed blood flow at 0.16-0.48 kHz at the tip of the distal phalanx and at 0.16 kHz at the deep digital flexor tendon insertion and in the impar distal sesamoidean ligament. Using color flow Doppler in normal horses mean blood flows ranged from 1.8 to 5.4 cm/s at the tip of the distal phalanx and 1.8-2.0 cm/s at the deep digital flexor tendon insertion and in the impar distal sesamoidean ligament.

Animals↗

Causes of death in racehorses over a 2 year period.

Necropsies were performed on 496 horses that had a fatal injury or illness at a California racetrack during the period February 20th 1990 to March 1st 1992. The primary cause of death was categorised by breed, activity at time of injury or illness and organ system affected. Most of the submissions were Thoroughbred horses (432) and Quarter Horses (46). Most of the injuries occurred while racing (42%) and in training sessions (39%); with fewer non-exercise (12%) and accident (7%) related injuries or illnesses. Musculoskeletal injuries accounted for 83% of the Thoroughbred and 80% of the Quarter Horse submissions. The Thoroughbred horses incurred 306 fractures with 263 in the limbs and 90% of those in the forelimbs. The proximal sesamoid bone(s), third metacarpal bone and humerus were the most common bones fractured in Thoroughbred horses and Quarter Horses. Other major causes of death included respiratory, digestive and multi-organ system disorders.

Age Factors↗

Radiographic features of the hand in diffuse idiopathic skeletal hyperostosis (DISH): comparison with normal subjects and acromegalic patients.

Radiographs of the hands of 25 men and 9 women with diffuse idiopathic skeletal hyperostosis (DISH) were compared with age- and sex-matched controls and acromegalic patients. Characteristics of DISH included broadening and "arrowheading" of the distal phalangeal tufts, enlarged sesamoid bones, increased cortical width of tubular bones, prominent enthesopathy in the proximal phalanges, exostoses (particularly at the metacarpophalangeal heads), and new bone in the joint capsule. There was no consistent change in soft-tissue measurements or cartilage width between DISH and control patients. Acromegaly could be differentiated from DISH by the relative lack of enthesopathy, marked soft-tissue changes, and increased cartilage width. Any metabolic factor responsible for the changes in DISH apparently acts primarily on the enthesis and bone but has little effect on soft-tissue or cartilage growth.

Acromegaly↗

New aspects of the tolerance of the antiseptic povidone-iodine in different ex vivo models.

Investigating new possibilities for the application of 1% (v/v) iodophors, povidone-iodine (PVP-I) was better tolerated in the HET-CAM or explant test than 1% (w/v) silver nitrate or tetracycline. After application to the eye, at least 2.6% of used iodine were adsorbed. Therefore PVP-I is more effective than silver nitrate or erythromycin, meaning a possible alternative for the prevention of ophthalmia neonatorum. PVP-I is more active against methicillin-resistant Staphylococcus aureus (MRSA) in a human ex vivo skin model, which results in a complete eradication of S. aureus in the nasal cavity of volunteers after 2 daily applications and will be better tolerated by human nasal cilial epithelium than chlorhexidine. Having the same clinical tolerance as mupirocin, PVP-I is a useful alternative for the antiseptic therapy of germ carriers of MRSA. The synthesis of proteoglycans in articular cartilage of bovine sesamoid bones was increased after application of 5% (v/v) PVP-I without any increase in catabolism revealing possibilities for the use as irrigation solution in the joint.

Allantois↗

Clinical results of modified Mitchell's osteotomy for hallux valgus augmented with oblique lesser metatarsal osteotomy.

PURPOSE: To evaluate postoperative results of modified Mitchell's osteotomy and its combination with oblique metatarsal osteotomy for the treatment of hallux valgus. METHODS: A total of 93 feet of 53 patients (2 men and 51 women) with hallux valgus underwent modified Mitchell's osteotomy and were followed up for at least 5 years. Patients' age ranged from 17 to 83 years, and the duration of follow-up ranged from 5 years one month to 18 years 4 months. Modified Mitchell's osteotomy was performed on 53 feet in 31 patients (group A), whereas modified Mitchell's osteotomy augmented with oblique lesser metatarsal osteotomy was performed to the remaining 40 feet in 22 patients (group B). Postoperative results were assessed using a clinical assessment system developed by the Tokyo Medical University based on 5 categories: pain in the first metatarsophalangeal, deformity of the metatarsophalangeal, plantar callosity and/or metatarsalgia of lesser metatarsals, the use of commercially available shoes, and local inflammatory symptoms. RESULTS: Mean total score improved from 3.8 to 7.9 on a 10-point scale. Scores for 2 categories--plantar callosity and/or metatarsalgia and the use commercially available shoes--were significantly higher in group B at postoperative 5 years. Before surgery, at postoperative 3 weeks, and at postoperative 5 years, respectively, the mean hallux valgus angles were 34.2, 12.0, and 17.1 degrees; mean M1-M2 angles were 16.7, 7.4, and 8.7 degrees; mean M1-M5 angles were 34.9, 25.8, and 26.6 degrees; and mean sesamoid bone shifts were 8.7 mm, 4.3 mm, and 5.9 mm. CONCLUSION: Modified Mitchell's osteotomy shortens the length of the first metatarsal bone and thus relieves tension in soft tissues such as the adductor hallucis. Nonetheless, the procedure can induce metatarsophalangeal joint malalignment and metatarsalgia, and plantar callosity may develop or persist after surgery. Combining oblique metatarsal osteotomy of the lesser metatarsal bones is useful in patients with uneven metatarsal bone lengths and metatarsophalangeal joint malalignment.

Adolescent↗

A comparison of Keller's arthroplasty and distal metatarsal osteotomy in the treatment of adult hallux valgus.

A prospective trial is reported which compares distal osteotomy of the first metatarsal with Keller's arthroplasty in the treatment of adult hallux valgus. A total of 33 patients attended for review at least three years after operation. Symptomatic improvement, as assessed by patient satisfaction, pain relief, cosmetic improvement and restoration of function, was similar in the two groups. Objective measurement showed that the range of movement of the metatarsophalangeal joint was better maintained after osteotomy, as was the relationship of the sesamoid bones to the head of the first metatarsal. Correction of the valgus deformity also was significantly better in the patients who underwent osteotomy and in these patients the first intermetatarsal angle was reduced to within normal limits. There was no evidence that initial degenerative changes or subluxation at the metatarsophalangeal joint compromised a successful result from osteotomy.

Adult↗

Outbreaks of pythiosis in two flocks of sheep in northeastern Brazil.

Two outbreaks of cutaneous pythiosis caused by Pythium insidiosum were diagnosed in two herds of crossbred hair wool sheep of different ages in the semiarid region of Northeastern Brazil. In one herd of 120 sheep, 40 were affected. The other outbreak affected six sheep out of 80. Local swellings with ulcerative lesions were observed in the limbs and abdominal and prescapular regions. Three sheep were necropsied. Two of them had lung metastasis characterized by multifocal nodules measuring 0.5-2 cm. In one animal, the prescapular lymph node was also affected. In another, the cutaneous lesion extended to the sesamoid bone. Microscopically, there were multifocal granulomas with intralesional P. insidiosum hyphae and Splendore-Hoeppli material surrounding the hyphae. The diagnosis was based on the histologic lesions, immunohistochemical identification, and culture of the etiologic agent. One sheep treated with potassium iodide recovered. Standing in swampy water for long periods in a warm aquatic environment seems to be the reason for the high prevalence of the disease.

Animals↗

Use of computed tomography angiography to evaluate the vascular anatomy of the distal portion of the forelimb of horses.

OBJECTIVE: To provide a detailed description of the vascular anatomy of the distal portion of the forelimbs of horses by use of computed tomography angiography (CTA). SAMPLE POPULATION: 6 forelimbs of 5 horses and 1 forelimb from an equine cadaver; none of the horses had orthopedic or vascular disease. PROCEDURE: Horses were anesthetized and CTA was conducted on the dependent forelimb. A catheter was inserted in the median artery, and contrast medium was infused at a rate of 3 mL/s. A computed tomography (CT) scanner was used to obtain contiguous slices from the region of the proximal sesamoid bones to the toe. All horses were allowed to recover from anesthesia. To help identify vessel patterns in the distal portion of the forelimb, the median artery and lateral palmar digital vein of a heparinized forelimb obtained from an equine cadaver were infused with red and blue polymethylmethacrylate and the distal portion of that forelimb was then sectioned to correspond to CTA images. RESULTS: Vessel patterns in CTA images matched vascular anatomic structures of the cadaver forelimb and were consistent with published anatomic structures. Major and minor vessels were consistently visible in CTA images of all horses. There were no complications reported in any horses. CONCLUSIONS AND CLINICAL RELEVANCE: Use of CTA provided a highly detailed depiction of the vasculature of the distal portion of the equine forelimb. This was a safe technique and should be useful in the evaluation of the blood supply to the distal portion of the forelimb.

Angiography↗

Evaluation of expected response to selection for orthopedic health and performance traits in Hanoverian Warmblood horses.

OBJECTIVE: To determine whether selection schemes accounting for orthopedic health traits were compatible with breeding progress in performance parameters in Hanoverian Warmblood horses. ANIMALS: 5,928 horses. PROCEDURE: Relative breeding values (RBVs) were predicted for osseous fragments in fetlock (metacarpo- and metatarsophalangeal) and tarsal joints, deforming arthropathy in tarsal joints, and pathologic changes in distal sesamoid bones. Selection schemes were developed on the basis of total indices for radiographic findings (TIR), dressage (TID), and jumping (TIJ). Response to selection was traced over 2 generations of horses for dressage and jumping ability and all-purpose breeding. Development of mean RBVs and mean total indices in sires and prevalences of orthopedic health traits in their offspring were used to assess response to selection. RESULTS: Giving equal weight toTIR andTID, TIJ, or a combined index of 60% TID and 40% TIJ, 43% to 53% of paternal grandsires and 70% to 82% of descending sires passed selection. In each case, RBVs and total indices increased by as much as 9% in selected sires, when compared with all sires, and prevalences of orthopedic health traits in offspring of selected sires decreased relatively by as much as 16%. When selection was exclusively based on TID, TIJ, or TID and TIJ, percentages of selected sires were 44% to 66% in the first and 73% to 84% in the second generation and TID and TIJ increased by 9% to 10% and 19% to 23%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Compared with exclusively performance-based selection, percentages of selected sires changed slightly and breeding progress in TID, TIJ, or TID and TIJ was only slightly decreased; however, prevalences of orthopedic health traits decreased in offspring of TIR-selected sires.

Animals↗

Evaluation of analgesia resulting from extracorporeal shock wave therapy and radial pressure wave therapy in the limbs of horses and sheep.

OBJECTIVE: To identify the duration and potential mechanisms of analgesia following extracorporeal shock wave therapy (ESWT) and radial pressure wave therapy (RPWT) in limbs of horses and sheep. ANIMALS: 6 horses and 30 sheep. PROCEDURE: An electrical stimulus was used to identify the nociceptive threshold for each horse daily for 3 days before treatment (baseline) with ESWT or RPWT, 8 hours after treatment, and at 24-hour intervals for 7 days after treatment. Testing was conducted for the treatment field (midmetacarpus or midmetatarsus) and nerve field (medial and lateral forelimb heel bulbs) distal to a treatment site that included the nerve on the abaxial surface of the proximal sesamoid bone. All 4 limbs of 30 sheep were treated with ESWT, RPWT, or a sham treatment. Two sheep were euthanatized daily and tissue harvested for histologic evaluation of nerves, and concentrations of substance P and calcitonin gene-related peptide were measured in the skin and periosteum. RESULTS: Values did not differ significantly between baseline and after treatment for the treatment field or nerve field sensation. There was a large difference in the slope when data for horses were plotted for the first 3 days after treatment, compared with the slope for days 4 to 7 after treatment. No differences were found in neuropeptide concentrations after treatment of the sheep, but there was an inflammatory response in the treated nerves. CONCLUSIONS AND CLINICAL RELEVANCE: A small cutaneous analgesic effect may exist at the treatment site for approximately 3 days after ESWT or RPWT in horses.

Analgesia↗

Ex vivo investigation of the use of hydrothermal energy to induce chondrocyte necrosis in articular cartilage of the metacarpophalangeal and metatarsophalangeal joints of horses.

OBJECTIVE: To evaluate the use of hydrothermal ablation of articular cartilage for arthrodesis in horses through investigation of the effects of joint lavage with physiologic saline (0.9% NaCI) solution (80 degrees C) for various treatment times on chondrocyte viability in the articular cartilage of the metacarpophalangeal and metatarsophalangeal joints of cadaveric horse limbs. Sample Population-7 pairs of metacarpophalangeal and 8 pairs of metatarsophalangeal joints from 8 Thoroughbreds. PROCEDURE: The horses were euthanatized for reasons unrelated to musculoskeletal disease. On a random basis, 1 joint of each pair underwent intra-articular lavage for 5, 10, or 15 minutes with heated saline solution (80 degrees C); the other joint underwent sham treatment of similar duration with saline solution at 22 degrees C (control). Cartilage samples from the distal articular surface of metacarpus III (or metatarsus III), the proximal surface of the proximal phalanx, and the lateral and medial proximal sesamoid bones were assessed for chondrocyte viability via confocal microscopy and viability staining following enzymatic digestion. RESULTS: Compared with the control joints, findings of both viability assays indicated that the percentage of sites containing viable chondrocytes in heat-treated joints was decreased. Treatment hazard ratios of 0.048 (confocal microscopy) and 0.2 (digestion assay) were estimated. Histologically, periarticular soft tissues had minimal detrimental effects after heat treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Ex vivo intra-articular lavage with saline solution at 80 degrees C resulted in the death of almost all articular chondrocytes in the joint. This technique may be a satisfactory method for extensive cartilage ablation when performing arthrodesis by minimally invasive techniques.

Animals↗

The effects of loading on the synthesis of biglycan and decorin in intact mature articular cartilage in vitro.

Sesamoid bone cartilage from the metacarpophalangeal joints of 5-year-old cows was cultured intact on its bone support. The incorporation of sulfate increased similarly in experimental cartilage that was subjected to cyclic loading (0.2 MPa, 0.2 Hz) for a week and in control cartilage that was cultured without loading. The synthesis of a population of small macromolecules decreased in the cultured controls, but was maintained at a constant level in the experimental samples. This population was isolated through Sepharose CL-2B chromatography. Subsequent application to Sepharose CL-4B yielded two distinct peaks. One contained protein-free chondroitin sulfate, keratan sulfate, and possibly some dermatan sulfate glycosaminoglycans. The other, more prominent, peak consisted of dermatan sulfate proteoglycans. This peak material was pooled, and applied to a 4-15% SDS-gel. The material was separated into two major bands, which represented biglycan and decorin. They decreased to less than half their day-0 value, in the cultured control. In the loaded cartilage, biglycan synthesis remained constant while decorin synthesis increased. These findings suggest that biglycan and decorin are involved in the adaptation of articular cartilage to variations in loading regime.

Aging↗

Three-dimensional reconstruction of magnetic resonance images of a displaced flexor hallucis longus tendon in hallux valgus.

By using three-dimensional magnetic resonance image reconstruction, lateral displacement of the flexor hallucis longus tendon and sesamoid bones was made clearly visible in a living patient. This finding supports a biomechanical model related to disturbed muscle balance at the first metatarsophalangeal joint, which could play an important role in the pathogenesis of hallux valgus and metatarsus primus varus.

Computer Simulation↗

Hallux hammer toe secondary to pseudomonas osteomyelitis.

The authors present two cases of resultant hallux hammer toe secondary to the definitive treatment of hallux sesamoidal osteomyelitis. Pseudomonas osteomyelitis developed in both cases following puncture wounds to the first metatarsophalangeal joint complex. The authors also review the literature on pseudomonas osteomyelitis secondary to puncture wounds and the development of hallux hammer toe after removal of the involved sesamoid bones.

Adolescent↗