Kinematics of the hind limb in trotting horses after induced lameness of the distal intertarsal and tarsometatarsal joints and intra-articular administration of anesthetic

OBJECTIVE: To identify hind limb and pelvic kinematic variables that change in trotting horses after induced lameness of the distal intertarsal and tarsometatarsal joints and after subsequent intra-articular administration of anesthetic. ANIMALS: 8 clinically normal adult horses. PROCEDURE: Kinematic measurements were made before and after transient endotoxin-induced lameness of the distal intertarsal and tarsometatarsal joints and after intra-articular administration of anesthetic. Fourteen displacement and joint angle (metatarsophalangeal [fetlock] and tarsal joints) measurements were made on the right hind limb, sacrum, and the right and left tubera coxae. Kinematic measurements were compared by general linear models, using a repeated measures ANOVA. Post hoc multiple comparisons between treatments were evaluated with a Fisher least squared difference test at alpha = 0.05. RESULTS: After lameness induction, fetlock and tarsal joint extension during stance decreased, fetlock joint flexion and hoof height during swing increased, limb protraction decreased, and vertical excursion of the tubera coxae became more asymmetric. After intra-articular administration of anesthetic, limb protraction returned to the degree seen before lameness, and vertical excursion of the tubera coxae became more symmetric. CONCLUSIONS AND CLINICAL RELEVANCE: Increased length of hind limb protraction and symmetry of tubera coxae vertical excursion are sensitive indicators of improvement in tarsal joint lameness. When evaluating changes in tarsal joint lameness, evaluating the horse from the side (to assess limb protraction) is as important as evaluating from the rear (to assess pelvic symmetry).     

Comparison of three methods for arthrodesis of the distal intertarsal and tarsometatarsal joints in horses

OBJECTIVE: To evaluate the effects of diode laser surgery (LS), surgical drilling (SD), and intraarticular sodium monoiodoacetate (MIA) as methods for fusing the distal intertarsal (DIT) and tarsometatarsal (TMT) joints in horses. STUDY DESIGN: Experimental study. ANIMALS: Adult horses (15) without radiographic signs of osteoarthritis (OA) of the DIT and TMT joints. METHODS: Group 1 (n=3) had LS performed bilaterally on DIT and TMT joints; 1 horse was evaluated for 1 week and 2 horses were evaluated for 2 weeks. Group 2 (n=6) had LS on DIT and TMT joints of 1 tarsus and MIA administration into the contralateral DIT and TMT joints and were evaluated for 6 months. Group 3 (n=6) had LS performed on DIT and TMT joints of 1 tarsus and SD of the contralateral DIT and TMT joints and were evaluated for 12 months. Postoperative comfort, lameness, radiography, microradiography, and histology scores were compared using repeated measures ANOVA, and paired or 2 sample t-tests; significance was set at P<.05. RESULTS: LS caused the least postoperative morbidity. In group 2, horses were less lame in 4 LS-treated limbs and 2 MIA-treated limbs at 6 months when compared with the contralateral limb. In group 3, horses were less lame in 5 LS-treated limbs and 1 SD-treated limb at 6 and 12 months compared with the contralateral limb. On microradiography, 11 MIA joints and 2 LS joints had bone bridging the joint at 6 months whereas 8 SD joints and 5 LS joints had bone bridging at 12 months. Significantly more joint space was bridged by bone in MIA- (51.4%) and SD (46.2%)-treated joints compared with LS joints at 6 (30.6%) and 12 (28.5%) months, respectively (P<.05). CLINICAL RELEVANCE: SD and MIA resulted in more bone bridging of the distal 2 tarsal joints, than LS. However, LS seemingly caused less pain and discomfort to horses in the immediate postoperative period; horses were generally less lame in the LS limb. More laser energy may need to be applied to these joints to promote fusion; however, it may also have beneficial effects beyond fusion. Further research on horses with OA of the distal 2 tarsal joints is needed to determine whether LS can cause soundness without facilitating bony fusion.     

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.     

Surgical arthrodesis for the treatment of osteoarthrosis of the proximal intertarsal, distal intertarsal and tarsometatarsal joints in 30 horses: a comparison of four different techniques

Over a period of seven years, 30 horses were treated by surgical arthrodesis for lameness resulting from osteoarthrosis of the proximal intertarsal, distal intertarsal and tarsometatarsal joints (bone and occult spavin). Twenty-five horses were affected in one hock only and five were affected bilaterally. Four different techniques for achieving arthrodesis were used. Fourteen out of 18 horses (78 per cent) with involvement of the distal intertarsal and tarsometatarsal joints only and six out of 11 horses (55 per cent) in which the proximal intertarsal joint was also involved became sound following surgery. The status of one other horse, with involvement of the proximal intertarsal joint, is not known.     

Three-dimensional kinematics of the distal forelimb in horses trotting on a treadmill and effects of elevation of heel and toe

REASONS FOR PERFORMING STUDY: Comprehensive understanding of the 3-dimensional (3D) kinematics of the distal forelimb and precise knowledge of alterations induced by dorsopalmar foot imbalance remains incomplete because in vivo studies performed with skin markers do not measure the actual movements of the 3 digital joints. OBJECTIVE: To quantify the effects of 6 degree heel or toe wedges on the 3D movements of the 4 distal segments of the forelimb in horses trotting on a treadmill. METHODS: Three healthy horses were equipped with ultrasonic markers fixed surgically to the 4 distal segments of the left forelimb. The 3D movements of these segments were recorded while horses were trotting on a treadmill. Rotations of the digital joints were calculated by use of a joint coordinate system. Data obtained with 6 degree heel or toe wedges were compared to those obtained with flat standard shoes. RESULTS: Use of heel wedges significantly increased maximal flexion and decreased maximal extension of the proximal (PIPJ) and distal (DIPJ) interphalangeal joints. Inverse effects (except for PIPJ maximal extension) were observed with the toe wedges. In both cases, neither flexion-extension of the metacarpophalangeal joint nor extrasagittal motions of the digital joints were statistically different between conditions. CONCLUSIONS: At a slow trot on a treadmill, heel and toe wedges affect the sagittal plane kinematics of the interphalangeal joints. POTENTIAL RELEVANCE: Better understanding of the actual effects of toe and heel wedges on the 3D kinematics of the 3 digital joints may help to improve clinical use of sagittal alteration of hoof balance in the treatment of distal forelimb injuries.     

Effect of induced back pain on gait and performance of trotting horses

Back pain was induced in Standardbred horses by multiple intramuscular injections of a concentrated lactic acid solution into the left longissimus dorsi muscle. The investigation was divided into 2 parts. In Stage 1, 2 trotters were exercised on a treadmill and filmed by high speed cinematography before and after the induction of back pain. No signs of hindlimb lameness were evident and no quantitative changes in the components of the gait resulted, but a noticeable reduction was seen in performance capacity. Stage 2 involved a more intensive clinical and cinematic analysis of 3 horses. In these animals some changes were detected in the stride pattern, but no obvious gait disturbance was produced. The principal effect was stiffness in the thoracolumbar spine and an inability to perform at fast paces.     

Basic three-dimensional kinematics of the vertebral column of horses trotting on a treadmill

OBJECTIVE: To determine movements of the vertebral column of horses during normal locomotion. ANIMALS: 5 young Dutch Warmblood horses that did not have signs of back problems or lameness. PROCEDURE: Kinematics of 8 vertebrae (T6, T10, T13, T17, L1, L3, L5, and S3) and both tuber coxae were determined, using bone-fixated markers. Measurements were recorded when the horses were trotting on a treadmill at a constant speed of 4.0 m/s. RESULTS: Flexion-extension and axial rotation were characterized by a double sinusoidal pattern of motion during 1 stride cycle, whereas lateral bending was characterized by 1 peak and 1 trough. Ranges of motion for all vertebrae were: flexion-extension, 2.8 degrees to 4.9 degrees; lateral bending, 1.9 degrees to 3.6 degrees; axial rotation, 4.6 to 5.8 degrees, except for T10 and T13, where the amount of axial rotation decreased to 3.1 degrees and 3.3 degrees, respectively. CONCLUSION AND CLINICAL RELEVANCE: During locomotion, 3 types of rotations are evident in the thoracolumbar vertebrae. Regional differences are observed in the shape and timing of the rotations. These differences are related to actions of the limbs. The method described here for direct measurement of vertebral column motion provides insights into the complex movements of the thoracolumbar portion of the vertebral column in trotting horses. Information on normal kinematics is a prerequisite for a better understanding of abnormal function of the vertebral column in horses.     

The difference in kinematics of horses walking, trotting and cantering on a flat and banked 10 m circle

Reasons for performing study: Locomotion adaptation mechanisms have been observed in horses, but little information is available in relation to banked and nonbanked curve locomotion, which might be important to optimise training environments. Objectives: To determine if adaptation mechanisms in horses existed when moving on a banked compared to a flat curve and whether adaptation was similar in different gaits. Methods: Eight infrared cameras were positioned on the outside of a 10 m lungeing circle and calibrated. Retroreflective markers were used to define left and right metacarpus (McIII) and proximal phalanges (P1), metatarsus (MtIII), head and sacrum. Data were recorded at 308 Hz from 6 horses lunged at walk, trot and canter on a flat and 10° banked circle in a crossover design. Measurements extracted were speed, stride length, McIII inclination, MtIII inclination, relative body inclination and duty factor. Data were smoothed with a fourth order Butterworth filter with 30 Hz cut‐off. ANOVA was used to determine differences between conditions and limbs. Results: Adaptation mechanisms were influenced by gait. At canter inside forelimb duty factor was significantly longer (P<0.05) on a flat curve compared to a banked curve; at walk this was reversed. McIII inclination, MtIII inclination and relative body inclination were significantly greater (P<0.05) at trot and canter on a flat curve, so more inward tilt was found relative to the bearing surface. Conclusion: Adaptation to curved motion is gait specific. At faster gaits it appears that horses negotiate a banked curve with limb posture closer to body posture and probably with demands on the musculoskeletal system more similar to straight canter.     

Compensatory load redistribution of horses with induced weightbearing hindlimb lameness trotting on a treadmill

REASONS FOR PERFORMING STUDY: The compensatory mechanisms of horses with weightbearing hindlimb lameness are still not fully understood. HYPOTHESIS: That weightbearing, unilateral hindlimb lameness would not only alter stride characteristics to diminish structural stress in the affected limb but also induce compensatory load adjustments in the other supporting limbs. OBJECTIVE: To document the load and time shifting mechanisms of horses with unilateral weightbearing hindlimb lameness. METHODS: Reversible lameness was induced in 8 clinically sound horses by applying a solar pressure model. Three degrees of lameness (subtle, mild and moderate) were induced and compared with the nonlame (sound) control measurement. Vertical ground reaction forces were recorded for all 4 limbs simultaneously on an instrumented treadmill. RESULTS: Compared to the sound situation, moderate hindlimb hoof lameness induced a decrease in stride duration (-3.3%) and stride impulse (-3.1%). Diagonal impulse decreased selectively in the lame diagonal stance (-7.7%). Within the diagonal limb pair, vertical impulse was shifted to the forelimb during the lame diagonal stance (+6.5%) and to the hindlimb during the sound diagonal stance (+3.2%). Peak vertical force and vertical impulse decreased in the lame limb (-15%), but only vertical impulse increased in the contralateral hindlimb (+5.7%). Stance duration was prolonged in both hindlimbs (+2.5%). Suspension duration was reduced to a greater extent after push-off of the lame diagonal limb pair (-21%) than after the sound diagonal limb pair (-9.2%). CONCLUSIONS: Four compensatory mechanisms could be identified that served to reduce structural stress, i.e. peak vertical force on the affected limb: 1) reduction of the total vertical impulse per stride; 2) diagonal impulse decreased selectively in the lame diagonal; 3) impulse was shifted within the lame diagonal to the forelimb and in the sound diagonal to the hindlimb; and 4) the rate of loading and peak forces were reduced by prolonging the stance duration. POTENTIAL RELEVANCE: Load shifting mechanisms are not only effective in diminishing peak forces in the affected limb, but also suppress compensatory overload in other limbs. Selected force and time parameters allow the unequivocal identification of the lame limb. Future studies have to examine how far these compensatory mechanisms may be generalised for other defined orthopaedic problems in the hindlimb.     

Compensatory load redistribution of horses with induced weight-bearing forelimb lameness trotting on a treadmill

The study was performed to obtain a detailed insight into the load and time shifting mechanisms of horses with unilateral weight-bearing forelimb lameness. Reversible lameness was induced in 11 clinically sound horses by applying a solar pressure model. Three degrees of lameness (subtle, mild and moderate) were induced and compared with sound control measurements. Vertical ground reaction force-time histories of all four limbs were recorded simultaneously on an instrumented treadmill. Four compensatory mechanisms could be identified that served to reduce structural stress, i.e. peak vertical force on the affected limb: (1) with increasing lameness, horses reduced the total vertical impulse per stride; (2) the diagonal impulse decreased selectively in the lame diagonal; (3) the impulse was shifted within the lame diagonal to the hindlimb and in the sound diagonal to the forelimb; (4) the rate of loading and the peak forces were reduced by prolonging the stance duration. Except in the diagonal hindlimb, where peak vertical forces increased slightly in the moderate lameness condition, no equivalent compensatory overload situation was observed in the other limbs. Specific force and time information of all four limbs allow the unequivocal identification of the affected limb.     

Computer-assisted kinematic evaluation of induced compensatory movements resembling lameness in horses trotting on a treadmill

OBJECTIVE: To characterize compensatory movements of the head and pelvis that resemble lameness in horses. ANIMALS: 17 adult horses. PROCEDURE: Kinematic evaluations were performed while horses trotted on a treadmill before and after shoe-induced lameness. Lameness was quantified and the affected limb determined by algorithms that measured asymmetry in vertical movement of the head and pelvis. Induced primary lameness and compensatory movements resembling lameness were assessed by the Friedman test. Association between induced lameness and compensatory movements was examined by regression analysis. RESULTS: Compensatory movements resembling lameness in the ipsilateral forelimb were seen with induced lameness of a hind limb. There was less downward and less upward head movement during and after the stance phase of the ipsilateral forelimb. Doubling the severity of lameness in the hind limb increased severity of the compensatory movements in the ipsilateral forelimb by 50%. Compensatory movements resembling lameness of the hind limb were seen after induced lameness in a forelimb. There was less upward movement of the pelvis after the stance phase of the contralateral hind limb and, to a lesser extent, less downward movement of the pelvis during the stance phase of the ipsilateral hind limb. Doubling the severity of lameness in the forelimb increased compensatory movements of the contralateral hind limb by 5%. CONCLUSIONS AND CLINICAL RELEVANCE: Induced lameness in a hind limb causes prominent compensatory movements resembling lameness in the ipsilateral forelimb. Induced lameness in a forelimb causes slight compensatory movements resembling lameness in the ipsilateral and contralateral hind limbs.     

Effect of three shoe types on the duration of breakover in sound trotting horses

In a controlled experimental study, eight sound horses were shod with a plain steel shoe on one forelimb (control limb) and with four different shoe types on the other forelimb (treated limb). The four shoe types used on the treated limb were a plain steel shoe, a rocker-toe shoe, a rolled-toe shoe, and a square-toe shoe. The selection of the treatment limb (left or right) was randomized between the horses and a replicated Latin square design was used to determine the order of application of the shoes to the treatment limb. High speed cinematography (200 frames/s) was used to film the horses trotting in hand on a concrete surface. Eight strides were analyzed for each shoeing treatment. The breakover times of both forelimbs were measured, and the breakover ratio was computed as the ratio between the breakover time of the treated limb to the breakover time of the control limb. The results of an analysis of variance, using a probability of 0.05 alpha, showed that the breakover ratio did not differ significantly between the four types of shoes (p=0.10). It is concluded that, in sound horses trotting at a slow speed on a hard surface, the application of a rocker-toe shoe, a rolled-toe shoe or a square- toe shoe did not shorten forelimb breakover duration significantly compared with a plain steel shoe.     

Effects of intra-articular administration of dimethylsulfoxide on chemically induced synovitis in immature horses

The effects of intra-articular administration of dimethylsulfoxide (DMSO) on chemically induced synovitis in the middle carpal joint of 6 weanling horses were evaluated. Following aseptic collection of synovial fluid, the middle carpal joint of each forelimb was injected with 50 mg of Na-monoiodoacetate to induce synovitis. Eight days after injection, synovial fluid was obtained and the right middle carpal joints were injected with 2 ml of 40% DMSO in lactated Ringer solution. The corresponding joints of the left limb (control) were injected with 2 ml of lactated Ringer solution. Sampling and treatments were repeated on post-injection days 11 and 14, for a total of 3 treatments. Horses were visually evaluated daily for lameness and joint effusion. Synovial fluid was evaluated for color and clarity, differential and total WBC count, total protein content, and hyaluronic acid concentration. The Kaegi gait analysis system provided an objective assessment of lameness prior to inducing synovitis, again on day 7, and on day 17. At necropsy (day 17), synovial fluid, synovial membrane, and articular cartilage specimens were collected. Joint effusion was evident 12 hours after injection of Na-monoiodoacetate in all joints. Mild lameness was evident at 24 hours; however, the lameness resolved by 72 hours. Objective assessment of lameness did not reveal significant differences between treatment or control limbs. Hyaluronic acid concentrations increased significantly (P = 0.023) above baseline values in most joints over the study period. Synovial fluid WBC counts increased significantly (P = 0.002) following Na-monoiodoacetate injection and remained significantly (P = 0.002) above baseline values throughout the study.(ABSTRACT TRUNCATED AT 250 WORDS)