The correlation between score-based protocol for equine joint assessment and subsequent arthroscopic intervention outcomes

Abstract

This study aimed to grade joint abnormalities in horses submitted to therapeutic arthroscopy using score-based protocols for equine joint assessment, correlated with arthroscopic treatment outcomes and owner satisfaction. In this prospective study, we evaluated 126 joints of athletic horses referred for arthroscopy. The joints were scored according to findings of medical history and physical, radiographic, ultrasonographic and arthroscopic examination. Lameness, positive response to flexion test and decreased maximum joint flexion angle were detected in more than 50% of joints. Soft tissue swelling, sclerosis, subchondral bone osteolysis and single osteochondral fragments were the most common radiographic findings. Ultrasonographic examination revealed changes in synovial fluid volume and appearance, and subchondral bone irregularities. Increased vascularity of the synovial villi, chondral fibrillation, chondral fissures and superficial cartilage erosions were the most significant arthroscopic findings. The approaches that demonstrated greater sensitivity and correlation with treatment outcome and owner satisfaction were medical history, ultrasonographic and arthroscopic examination. The scoring protocol employed to grade joint abnormalities enabled the creation of a joint score system for the objective assessment, thus determining the most frequent findings and establishing an injury severity score for each joint.

Effects of oral treatment with chondroitin sulfate and glucosamine in an experimental model of metacarpophalangeal osteoarthritis in horses

“…Although these values were not statistically significant, in clinical practice, even minor angle variations of 2° to 3° degrees can demonstrate joint injury or flexion restriction. Therefore, this variation demonstrates a better condition of the joint in the GT [ 6 , 18 ]. GlcN and CS have been widely used for the treatment of rheumatoid arthritis in humans with favorable results [ 11 , 26 ].…”

“…The radiographic examination results can be explained by the lower sensitivity of this diagnostic modality, with significant changes only among the time-points of the study. Therefore, the analysis and scoring methodology used may not have been sensitive enough to detect minor differences between groups [ 6 ].…”

“…The Lameness Locator® (Equinosis, USA) motion sensor and software were used during these evaluations for greater examination accuracy and to confirm the degree of lameness, through the Q-score result. In addition, the joint angle was measured in degrees, according to the method by Silva et al [ 6 ], using a goniometer with the joint flexed to the physical limit or until observation of painful sensitivity.…”

“…This group of disorders resulting from osteoarthritis makes the treatment challenging, especially in athletes. Therefore, prevention and monitoring measures are essential to maintain joint integrity in these horses [ 3 – 6 ].…”

Effects of Joint Lavage with Dimethylsulfoxide on LPS-Induced Synovitis in Horses—Clinical and Laboratorial Aspects

“…All horses were evaluated for lameness, and the normality of the joints was determined by radiography and ultrasonography according to Silva et al [22]. For the radiographic evaluation, the lateromedial, dorsoplantar, dorsolateral-plantaromedial oblique, and dorsomedial-plantarolateral oblique views of both tarsi were performed (Poskom PXP 20HF X-Ray; Fujifilm, model CC).…”