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Summary
Reasons for performing study: Hyaluronan (HA) has been used
to treat joint disease via intra-articular, i.v. and oral
administration. The efficacy of intra-articular and i.v. use
has been evaluated but the oral route has yet to be examined.
Objectives: To determine the effect of oral hyaluronan gel
on joint effusion following arthroscopic surgery for
osteochondritis dissecans (OCD) of the tarsocrural joint of
yearling Thoroughbreds.
Methods: Forty-eight yearlings diagnosed with unilateral or
bilateral osteochondritis dessicans (OCD) of the tarsus were
arbitrarily chosen prior to arthroscopic surgery. The
yearlings were included only if they had mild or no synovial
effusion pre-surgery. Twenty-four of the yearlings (27 joints)
were treated with 100 mg of HA orally for 30 days post
operatively and 24 (30 joints) with a placebo orally for
30 days. At 30 days post operation, a blinded examiner
scored the effusion of the dorsomedial tarsocrural joint
individually using a scale of 0 to 5 (0 = no effusion, 1 = barely
palpable effusion, 2 = palpable effusion [without plantar
effusion], 3 = golf ball sized effusion with plantar effusion,
4 = tennis ball sized effusion with plantar effusion,
5 = > tennis ball sized effusion with plantar effusion). Half
grades were allowed and OCD lesion sizes and locations
were compared.
Results: A total of 57 joints were examined, of which 33 had
OCD of the distal intermediate ridge of the tibia, 19 OCD of
the distal lateral trochlear ridge of the talus and 5 OCD of
the medial malleolus. The mean 30 day effusion score of the
HA treated group (27 joints) was 0.67 while the mean of the
30 day placebo group (30 joints) was 2.05 (P≤0.0001).
Similar results were noted when comparing treated vs.
placebo for each lesion location as well as for lesion sizes.
Conclusions and potential relevance: Oral preparations of
hyaluronan are being used to treat joint disease in horse.
Anecdotal reports supporting the efficacy of these
preparations already exist. This study provides objective
evidence that oral HA reduces joint effusion post operatively
following the arthroscopic removal of an OCD lesion in the
tarsocrural joint.
Oral hyaluronan gel reduces post operative tarsocrural
effusion in the yearling Thoroughbred
B. J. BERGIN*, S. W. PIERCE, L. R. BRAMLAGE and A.
STROMBERG†
Rood and Riddle Equine Hospital, PO Box 12070, Lexington,
Kentucky, 40580-2070, USA. †Department of Statistics, University
of Kentucky,
Lexington, Kentucky 40506-0027, USA.
Keywords: horse; thoroughbred; joint effusion; oral hyaluronan;
osteochondritis dissecans; hyaluronan; arthroscopic; tarsocrural
Reasons for performing study: Hyaluronan (HA) has been used
to treat joint disease via intra-articular, i.v. and oral
administration. The efficacy of intra-articular and i.v. use
has been evaluated but the oral route has yet to be examined.
Objectives: To determine the effect of oral hyaluronan gel
on joint effusion following arthroscopic surgery for
osteochondritis dissecans (OCD) of the tarsocrural joint of
yearling Thoroughbreds.
Methods: Forty-eight yearlings diagnosed with unilateral or
bilateral osteochondritis dessicans (OCD) of the tarsus were
arbitrarily chosen prior to arthroscopic surgery. The
yearlings were included only if they had mild or no synovial
effusion pre-surgery. Twenty-four of the yearlings (27 joints)
were treated with 100 mg of HA orally for 30 days post
operatively and 24 (30 joints) with a placebo orally for
30 days. At 30 days post operation, a blinded examiner
scored the effusion of the dorsomedial tarsocrural joint
individually using a scale of 0 to 5 (0 = no effusion, 1 = barely
palpable effusion, 2 = palpable effusion [without plantar
effusion], 3 = golf ball sized effusion with plantar effusion,
4 = tennis ball sized effusion with plantar effusion,
5 = > tennis ball sized effusion with plantar effusion). Half
grades were allowed and OCD lesion sizes and locations
were compared.
Results: A total of 57 joints were examined, of which 33 had
OCD of the distal intermediate ridge of the tibia, 19 OCD of
the distal lateral trochlear ridge of the talus and 5 OCD of
the medial malleolus. The mean 30 day effusion score of the
HA treated group (27 joints) was 0.67 while the mean of the
30 day placebo group (30 joints) was 2.05 (P≤0.0001).
Similar results were noted when comparing treated vs.
placebo for each lesion location as well as for lesion sizes.
Conclusions and potential relevance: Oral preparations of
hyaluronan are being used to treat joint disease in horse.
Anecdotal reports supporting the efficacy of these
preparations already exist. This study provides objective
evidence that oral HA reduces joint effusion post operatively
following the arthroscopic removal of an OCD lesion in the
tarsocrural joint.
Oral hyaluronan gel reduces post operative tarsocrural
effusion in the yearling Thoroughbred
B. J. BERGIN*, S. W. PIERCE, L. R. BRAMLAGE and A.
STROMBERG†
Rood and Riddle Equine Hospital, PO Box 12070, Lexington,
Kentucky, 40580-2070, USA. †Department of Statistics, University
of Kentucky,
Lexington, Kentucky 40506-0027, USA.
Keywords: horse; thoroughbred; joint effusion; oral hyaluronan;
osteochondritis dissecans; hyaluronan; arthroscopic; tarsocrural
EQUINE VETERINARY JOURNAL
Equine vet. J. (2006) 38 (4) 375-378
Oral hyaluronan gel reduces post operative tarsocrural
effusion in the yearling Thoroughbred
B. J. BERGIN*, S. W. PIERCE, L. R. BRAMLAGE and A. STROMBERG†
Rood and Riddle Equine Hospital, PO Box 12070, Lexington, Kentucky, 40580-2070, USA. †Department of Statistics, University of Kentucky,
Lexington, Kentucky 40506-0027, USA.
Keywords: horse; thoroughbred; joint effusion; oral hyaluronan; osteochondritis dissecans; hyaluronan; arthroscopic; tarsocrural
Equine vet. J. (2006) 38 (4) 375-378
Oral hyaluronan gel reduces post operative tarsocrural
effusion in the yearling Thoroughbred
B. J. BERGIN*, S. W. PIERCE, L. R. BRAMLAGE and A. STROMBERG†
Rood and Riddle Equine Hospital, PO Box 12070, Lexington, Kentucky, 40580-2070, USA. †Department of Statistics, University of Kentucky,
Lexington, Kentucky 40506-0027, USA.
Keywords: horse; thoroughbred; joint effusion; oral hyaluronan; osteochondritis dissecans; hyaluronan; arthroscopic; tarsocrural
