Scapulohumeral osteochondrosis

F. Jenner; M. W. Ross; B. B. Martin; D. W. Richardson

doi:10.3415/VCOT-07-07-0072

Veterinary and Comparative Orthopaedics and Traumatology, Table of Contents

Vet Comp Orthop Traumatol 2008; 21(05): 406-412
DOI: 10.3415/VCOT-07-07-0072

Original Research

Schattauer GmbH

Scapulohumeral osteochondrosis

A retrospective study of 32 horses

Authors

F. Jenner

¹Department of Surgery, University College Dublin, School of Veterinary Medicine, Belfield, Dublin, Republic of Ireland
M. W. Ross

²Department of Clinical Studies New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Pennsylvania, USA
B. B. Martin

²Department of Clinical Studies New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Pennsylvania, USA
D. W. Richardson

²Department of Clinical Studies New Bolton Center, School of Veterinary Medicine, University of Pennsylvania, Pennsylvania, USA

Abstract

Summary

Objectives: To review the outcome of equine shoulder osteochondrosis (OC) with surgical or conservative treatment. Methods: Retrospective study of 32 horses, less than two years of age, with scapulohumeral joint (SHJ) OC. The lesion severity was graded based on measurements taken from lateromedial radiographs. Follo–up information was obtained from racing records or telephone conversations with owners. Successful outcome was defined as the ability of the horse to perform its intended use. Results: Sixteen of 32 horses were affected bilaterally (48 joints). Eleven of 16 horses with bilateral OC underwent arthroscopic surgery; five had bilateral arthroscopy, six had unilateral arthroscopy of the most severely affected joint. Eight of 16 horses with unilateral OC underwent arthroscopy. The overall outcome was ′poor′. Only 15.4% (4/26) of potential race horses started a race, whereas 67% (4/6) non-racehorses were ′sound′ for the intended use. Statistical analysis evaluating the effect of breed on outcome showed a statistically significant difference. There were no significant interactions between outcome and gender, affected limb, unilateral versus bilateral involvement, treatment or severity of the radiographic lesion. However, radiographic lesion severity on the humerus and glenoid showed significant positive correlation. Clinical significance: The overall poor prognosis for shoulder OC in young horses appears to be, in part, dependent on breed and intended use. There was not any difference in outcome between surgically and conservatively treated horses.

Keywords

Osteochondrosis - shoulder - humerus - glenoid - racehorse

Full Text

References

References
1 Jeffcott LB. Osteochondrosis in the horsesearching for the key to pathogenesis. Equine Vet J 1991; 23: 331-338.
2 Jeffcott LB. Osteochondrosis: an international problem for the horse industry. J Equine Vet Sci 1996; 32-37.
3 Philipsson J, Andreasson E, Sandgren B. et al. Osteochondrosis in the tarsocrural joint and osteochondral fragments in the fetlock joints in Standardbred trotters. II. Heritability. Equine Vet J 1993; 16: 38-41.
4 Sandgren B, Dalin G, Carlsten J. Osteochondrosis in the tarsocrural joint and osteochondral fragments in the fetlock joints in Standardbred trotters. I. Epidemiology. Equine Vet J 1993; 16: 31-37.
5 Nyack B, Morgan JP, Pool R. et al. Osteochondrosis of the shoulderjoint of the horse. Cornell Vet 1981; 71: 149-163.
6 Bertone AL, McIlwraith CW, Powers BE. et al. Arthroscopic surgery for the treatment of osteochondrosis in the equine shoulderjoint. Vet Surg 1987; 16: 303-311.
7 Nixon AJ. Diagnostic and surgical arthroscopy of the equine shoulder joint. Vet Surg 1987; 16: 44-52.
8 Doyle PS, White NA. II. Diagnostic findings and prognosis following arthroscopic treatment of subtle osteochondral lesions in the shoulderjoint of horses: 15 cases (1996-1999). J Am Vet Med Assoc 2000; 217: 1878-1882.
9 McIlwraith CW. Inferences from referred clinical cases of osteochondrosis dissecans. Equine Vet J 1993; (Suppl. 01) 16: 27-30.
10 Auerbach B, Melzer C. Cross-linked hyaluronic acid in the treatment of osteoarthritis of the knee-results of a prospective randomized trial [in German]. Zentralbl Chir 2002; 127: 895-899.
11 Ausiello JC, Stafford RS. Trends in medication use for osteoarthritis treatment. J Rheumatol 2002; 29: 999-1005.
12 Barbucci R, Lamponi S, Borzacchiello A. et al. Hyaluronic acid hydrogel in the treatment of osteoarthritis. Biomaterials 2002; 23: 4503-4513.
13 Bijlsma JW. Glucosamine and chondroitin sulfate as a possible treatment for osteoarthritis. [In Dutch]. Ned Tijdschr Geneeskd 2002; 146: 1819-1823.
14 Blake G. Glucosamine for osteoarthritis. Adv Nurse Pract 2002; 10: 26-27.
15 Brief AA, Maurer SG, Di Cesare PE. Use of glucosamine and chondroitin sulfate in the management of osteoarthritis.(comment). J Am Acad Orthop Surg 2001; 9: 71-78.
16 Caron JP, Eberhart SW, Nachreiner R. Influence of polysulfated glycosaminoglycan on equine articular cartilage in explant culture. Am J Vet Res 1991; 52: 1622-1625.
17 Chen BH. Glucosamine: Apotential disease-modifying agent in osteoarthritis? (Miscellaneous). CMAJ 2001; 165: 79.
18 Fenton JI, Chlebek-Brown KA, Caron JP. et al. Effect of glucosamine on interleukin-1-conditioned articular cartilage. Equine Vet J 2002 (Suppl. 01) 34: 219-223.
19 Fenton JI, Chlebek-Brown KA, Peters TL. et al. Glucosamine HCl reduces equine articular cartilage degradation in explant culture. Osteoarthritis Cartilage 2000; 8: 258-265.
20 Frean SP, Cambridge H, Lees P. Effects of anti-arthritic drugs on proteoglycan synthesis by equine cartilage. J Vet Pharmacol Ther 2002; 25: 289-298.
21 Frean SP, Lees P. Effects of polysulfated glycosaminoglycan and hyaluronan on prostaglandin E2 production by cultured equine synoviocytes. Am J Vet Res 2000; 61: 499-505.
22 Ibrahim IM. Influence of polysulfated glycosaminoglycan on equine articular cartilage. Assiut Veterinary Medical Journal 1987; 19: 201-206.
23 Lippiello L, Han MS, Henderson T. Protective effect of the chondroprotective agent Cosequin(R) DS on bovine articular cartilage exposed in vitro to nonsteroidal antiinflammatory agents. Vet Ther 2002; 3: 128-135.
24 Lippiello L, Woodward J, Karpman R. et al. In vivo chondroprotection and metabolic synergy of glucosamine and chondroitin sulfate. Clin Orthop Relat Res 2000; 381: 229-240.
25 Orth MW, Peters TL, Hawkins JN. Inhibition of articular cartilage degradation by glucosamine-HCl and chondroitin sulphate. Equine Vet J 2002 (Suppl. 01) 34: 224-229.
26 White GW, Jones EW, Stites T. et al. The efficacy of systemically administered anti-arthritic drugs in an induced equine carpitis model. J Equine Vet Sci 1996; 139-145.
27 Laws EG, Richardson DW, Ross MW. et al. Racing performance of standardbreds after conservative and surgical treatment for tarsocrural osteochondrosis. Equine Vet J 1993; 25: 199-202.
28 Josten C, Muhr G, Lies A. Arthroscopic abrasion arthroplasty of the upper ankle joint. Long-term results in osteochondrosis dissecans. [in German]. Un Mdiirurg 1990; 93: 110-114.
29 Denoncourt PM, Patel D. Dimakopoulos P Arthroscopy update #1.. Treatment of osteochondrosis dissecans of the knee by arthroscopic curettage, follow-up study Orthopaedic Review 1986; 15: 652-657.
30 Glade M. Osteochondrosis in the ’90s. Equine Vet J 1993; 16: 348.
31 Wagner PC, Watrous BJ. Equine pediatric orthopaedics: clinical, radiographic, and therapeutic aspects; Part 1 - osteochondrosis. Equine Pract 1990; 12: 32-34.
32 Rose JA, Sande RD, Rose EM. Results of conservative management of osteochondrosis in the horse. Proc Am Ass Eq Pract 1986; 31: 617-626.
33 Bradley JP, Petrie RS. Osteochondritis dissecans of the humeral capitellum. Diagnosis and treatment. Clin Sports Med 2001; 20: 565-590.
34 Hefti F, Beguiristain J, Krauspe R. et al. Osteochondritis dissecans: a multicenter study of the European Pediatric Orthopedic Society. J Pediatr Orthop B 1999; 8: 231-45.
35 Dik KJ, Enzerink E, van Weeren PR. Radiographic development of osteochondral abnormalities, in the hock and stifle of Dutch Warmblood foals, from age 1to11 months. Equine Vet J 1999; (Suppl. 01) 31: 9-15.
36 Sandler EA, Bramlage LR. Correlation of lesion size with racing performance in Thoroughbreds after arthroscopic surgical treatment of subchondral cystic lesions of the medial femoral condyle: 150 cases (1989-2000).. Proc Am Ass Eq Pract. 2002 .
37 Nixon AJ, Fortier LA, Goodrich LR. et al. Arthroscopic reattachment of osteochondritis dissecans lesions using resorbable polydioxanone pins. Equine Vet J 2004; 36: 376-383.
38 Lebolt JR, Wall EJ. Retroarticular drilling and bone grafting of juvenile osteochondritis dissecans of the knee. Arthroscopy 2007; 23: 794 e1-4.
39 Iwasaki N, Kato H, Ishikawa J. et al. Autologous osteochondral mosaicplasty for capitellar osteo chondritis dissecans in teenaged patients. Am J Sports Med 2006; 34: 1233-1239.
40 Bodo G, Hangody L, Modis L. et al. Autologous osteochondral grafting (mosaic arthroplasty) for treatment of subchondral cystic lesions in the equine stifle and fetlockjoints. Vet Surg 2004; 33: 588-596.