Term
| ___% of equine lameness is related to OA. |
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Definition
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Term
| Definition: Osteoarthritis |
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Definition
| -ifnlammatin of a joint involving the articular cartilage and the undrlying subchondral bone |
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Term
| What happens physiologically with osteoarthritis? |
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Definition
-catabolic pathway leading to progressive degeneration and ultimate failure fo the tissue
-inc expression of pro-inflammatory cytokines: interleukin 1beta & tumor necrosis factors alpha
-loss of aggrecan and type II collagen
-inflammation of the synovium can precede the development of OA |
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Term
| What are the two major mechanisms leading to the development of OA? |
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Definition
-abnormal mechanical loads exterted on a normal joint tissue: direc trauma, cumulative microdamage, fatigue related
-normal mechanical loads exerted on an abnormal joint tissues: metabolic tissue degradation, osteochondrosis, flexural or angular deformity, subluxation |
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Term
| What are the clinical signs of OA? |
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Definition
-lameness
-joint effusion
-dec range o fmotion
-painful manipulation
-behavioral problems
-poor performance |
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Term
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Definition
-localize pain: thrught exam, local anesthesia
-synovial fluid abnormalities
-rad evidence |
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Term
| What radiographic features do we see with OA? |
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Definition
-subchondral bone lysis and/or sclerosis
-peri-articular osteophytosis
-joint space narrowing
-osteochondral fragmentation |
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Term
| What are the common sites of OA in the equine forelimb? |
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Definition
-distal interphalangeal joint (DIP, coffin): low ring bone
-proximal interphalangeal joint (PIP, pastern): high ring bone
-metacarpophalangeal joint (MCP., fetlock)
-carpometacarpal joint (CMC)
-intercarpal joint
-radiocarpal joint |
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Term
| What are the common sites of OA in the equine hindlimb? |
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Definition
-proximal interphalangeal joint aka pastern: high ring bone
-tarsometatarsal, distal intertarsal joints: bone spavin
-tarsocrural joint: bog spavin
-stifle, medial femorotibial joint |
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Term
| Which location in the equine hindlimb is most commonly affected by OA? |
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Definition
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Term
| How do we medically manage equine OA? |
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Definition
-systemic meds
-local meds
-nutraceuticals
-innovative therapies
-regenerative therapies |
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Term
| How do we surgically manage equine OA? |
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Definition
-arthroscopy
-facilitated ankylosis
-arthrodesis
-cartilage repair
-cartilage resurfacing |
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Term
| How do we modify activity regarding management of equine OA? |
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Definition
-drop class of performance, less intense activity, lower level of competition
-career change may be indicated
-retirement: breeding, pasture pet |
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Term
| What kinds of systemic meds do we use for medical treatment of equine OA? Why? |
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Definition
-NSAIDS: prevent prostaglandin synthesis at the site of inflammation
-Hyaluronate: suppress proteoglycan degradation by IL1-beta and TNF-alpha
-PSGAGS: condroprotective by reducing proteoglycan breakdown, stim HA synth, endhace pdn fo collagen/proteoglycan
-Pentosan: mod and correction of pathologic imbalances
-Disphosphanates: inhibits osteoclasts
-Stem cell therapy |
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Term
| What are some of the local medications that we use for medical treatment of equine OA? Why? |
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Definition
-Diclofenac: topical NSAID
-Corticosteroids: anti-inflammatory and analgesia
-Hyaluronate (intra-articular_: suppresses IL1-beta and TNF-alpha proteoglycan degradation
-PSGAGs: inc incidence of infection
-Interleukin-1 Rc Antagonist protein (IRAP): inc anti and pro inflammatory cytokines but good outweighs the bad
-Platelet Rich Plasma: helps tissue healing
-Stem cells |
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Term
| What are the types of corticosteroids we use locally for equine OA? |
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Definition
-Triamcinolone aceonide (TMA): intermediate acting, high-motion joints
-Methylprednisolone acetate (MPA): long acting, low motion joints
-Betamethasone acetate
-Isoflupredone acetate |
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Term
| What are some of the oral nutraceuticals that we use for medical treatment of OA? |
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Definition
-Chondrotin sulfate, Glucosamine, HYaluronate, etc
-FDA regs do not apply |
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Term
| Describe diagnostic arthroscopic for equine OA. |
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Definition
-visually evaluate the articular cartilage and intrasynovial ligamentous structures
-prognostication |
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Term
| Describe therapeituc arthroscopic for equine OA. |
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Definition
-removal of OC fragments, debridement of damaged subchondral bone and/or ligamentous structures
-removal of inflammatory cytokines thru alvage
-cartilage resurfacing techniques |
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Term
| What is the purpose behind arthrodesis and facilitated ankylosis techniques for the surgical management of equine OA? |
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Definition
-removal of the diarhrodial articulation +/- stabilization to allow bone fusion
-no motion, nor pain
-commonly applied as a salvage procedure in advanced chronic OA of high-motion joints
-certain low-motion joints can be fused in order to maintain or return horse to performance |
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Term
| What is a tendon? Where does it originate? Where does it insert? |
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Definition
-connective tissues that joing muscle to bone
-origin = muscle
-insertion = bne |
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Term
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Definition
| -inflammation of a tendon |
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Term
| What is a ligament? Where does it originate? where does it insert? |
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Definition
-connective tissues that joing bone to bone
-origin = bone
-insertion = obne |
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Term
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Definition
| -inflammation of a ligament |
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Term
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Definition
| -strain-induced injury to atendon or ligamnet is hte most common orthropedic injury in athlete of any species |
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Term
| In what two ways do tendinopathies occur? Where do each tend to occur? |
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Definition
-Sudden overloading: DDFT, meniscal injury
-Cumulative degeneration: SDFT, suspensory |
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Term
| What are the clinical signs of tendinopathies? |
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Definition
-lameness
-swelling
-heat
-pain on palpation
-synovial effusion
-off feed
-dec in performance |
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Term
| How do we diagnose tendinopahties? |
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Definition
-clinical signs
-US: approx 1 week post injury is best
=MRI |
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Term
| How do we manage tendinopathes? |
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Definition
-rest is essential to allow healing of injured tissues
-stall confinement
-common misconception is that free turnout allows for appropriate rest
-serial US of tendinoapthies should be performed to monitor progress |
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Term
| How do we medically treat equine tendinopathies? |
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Definition
-Systemic meds: NSAIDs, corticosteroids, PSGAGs
-Local meds: dicrofenac, DMSO, topical steroids, etc
-Intra-lesional injection: Hyaluronate, Platelet Rich Plasma, Stem Cell therapy, Novabrace |
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Term
| How do we surgically treat tendinopathies? |
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Definition
-tendon splitting: acute cases with anechoic core lesion, decompression and evacuation of serum to facilitate vascularization
-accesssory ligament or annular ligament desmotomy
-arthroscopic/tenoscopic debridement |
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Term
| What is our major concern with laceration of flexor tendons? How do you fix it? |
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Definition
-weight bearing structures
-should be anatomically apposed if possible (3 loop pulley), support limb in flexion with external coaptation |
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Term
| How do we fix extensor tendon lacerations? |
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Definition
-shoud be apposed when possible but generally heal well without apposition
-splinting may be necessary to aid in ambulation without knuckling |
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Term
| What is ESWT? What is it used for? |
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Definition
-Extracorporeal Shock Wave Therapy
-non-invasive medical procedure that introduces sound waves into target with intention to stimulate healing via microtrauma causes neovascualrization
-used for flexor and extender tendon lacerations |
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Term
| what is low level laser phototherapy? What is it used for? |
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Definition
-laser energy is absorbed by chromophores in mitochondria where it is transformed into biochem E = inc ATP pdn stims tissue-repair mechs
-pain reduction
-used for flexor and extender tendon lacerations |
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Term
| What is acupuncture? What is it used for? |
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Definition
-stimulation of points achieved through insertion of specialized needles into the body
-for flexor and extender tendon lacerations |
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