Mineral density and bone elasticity determination after extracorporeal shock waves application in third metacarpus of athlete equines

The porpoise of this study was to evaluate the effects of extracorporeal shock waves in third metacarpus bone from healthy horses by determination of bone elasticity. It were used 20 Thoroughbred horses, male and female, with two years old, on top of training and selected as the state healthy. At the beginning of the experiment (D0), all animals were submitted for evaluation of bone elasticity held in the third metacarpus bone. The animals were divided into two groups (Control Group - CG and Experimental Group - EG). The application of extracorporeal shock wave therapy (ESWT) was performed on the right forelimb of the animals in the experimental group in the same place evaluated for bone elasticity and was used apparatus for extracorporeal therapy of waves with 0.15 mJ/mm² energy flux density and 2000 pulses with E6R20 probe, with focus feature of the shock wave of 20 mm. The ESWT were repeated every 21 days, a total of three sessions (D0, D21 and D42). The analysis of bone elasticity determination was realized at D21, D42 and D72. The average of speed ultrasound differed between groups at D21, D42 and D72, and the animals from EG had lower bone mineral density after applications of ESWT. There was also difference in the analysis of bone mass (Z-Score) between the groups at D21 and D42, which animals from EG showed a significant decrease in bone mass. The risk of fracture was higher in animals from experimental group at D21. It was concluded that ESWT is able to promote change in bone mineral density.Objetivou-se neste estudo avaliar os efeitos da aplicação de ondas de choque extracorpóreas (ESWT) no terceiro metacarpiano de equinos hígidos através da determinação da elasticidade óssea. Foram utilizados 20 equinos Puro Sangue Inglês, machos e fêmeas, com dois anos de idade, em início de treinamento e selecionados quanto ao estado de higidez. No início do experimento (D0), todos os animais foram submetidos à avaliação da elasticidade óssea do terceiro metacarpiano. Os animais foram divididos em dois grupos (Grupo Controle - GC e Grupo Experimental - GE). A aplicação das ESWT foi realizada no membro torácico direito dos animais do GE, na região coincidente à da avaliação da elasticidade óssea. Foi utilizado aparelho para terapia de ondas extracorpóreas com densidade de fluxo de energia de 0,15mJ/mm² e 2000 pulsos com probe E6R20, com característica do foco da onda de choque de 20 mm. A ESWT foi repetida a cada 21 dias totalizando três sessões (D0, D21 e D42). A análise da determinação da elasticidade óssea foi realizada no D0, D21, D42 e D72. A média da velocidade ultrassonográfica diferiu entre os grupos no D21, D42 e D72, sendo que os animais do GE apresentaram menor densidade mineral óssea após as aplicações das ESWT. Houve igualmente, diferença na massa óssea entre os grupos no D21 e D42, parâmetro onde os animais do GE apresentaram diminuição significativa da massa óssea. O risco de fratura apresentou-se maior nos animais do GE no D21. Concluiu-se que, a ESWT é capaz de promover alteração da densidade mineral óssea

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

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.O objetivo desse estudo foi avaliar as anormalidades articulares observadas em equinos submetidos à artroscopia terapêutica, utilizando protocolos baseados em pontuações e correlacionando os resultados do tratamento cirúrgico com a satisfação do proprietário. Neste estudo prospectivo, foram avaliadas 126 articulações de cavalos atletas, encaminhados para artroscopia. As articulações foram pontuadas de acordo com os achados da anamnese e exame físico, exame radiográfico, exame ultrassonográfico e avaliação artroscópica. A claudicação, resposta positiva ao teste de flexão e diminuição do ângulo máximo de flexão articular foram detectados em mais de 50% das articulações. Aumento de volume dos tecidos moles, esclerose subcondral, osteólise subcondral e fragmentos osteocondrais únicos foram os achados radiográficos mais comuns. O exame ultrassonográfico revelou, com frequência, as alterações no volume e na aparência do líquido sinovial, além de irregularidades osteocondrais. O aumento da vascularização das vilosidades sinoviais, fibrilação condral, fissuras condrais e erosões superficiais da cartilagem foram os achados artroscópicos mais significativos. As abordagens diagnósticas que demonstraram maior sensibilidade e melhor correlação entre o resultado do tratamento e satisfação do proprietário foram história médica, exame ultrassonográfico e artroscópico. O protocolo de avaliação utilizado, baseado em um sistema de pontuação das anormalidades articulares observadas em cada exame, permitiu uma avaliação objetiva, ressaltando os achados mais frequentes e estabelecendo um escore de gravidade da lesão para cada articulação

Células-tronco mesenquimais em gel de plasma rico em plaquetas associados com microfraturas no tratamento de lesões condrais articulares em equinos

Several methods of cell therapy, such as mesenchymal stem cells (MSC) associated with platelet rich plasma (PRP), have been commonly used in the treatment of chondral articular defects and osteoarthritis, with satisfactory outcomes. Nowadays, the literature already shows an amount of positive features inherent to the MSC and the PRP. The use of cell therapy in association with other kinds of treatment, such as microfractures, allowed the researchers come closer to the ideal results. Thus, this study aimed to compare the clinical response and joint inflammation, the morphology and the structure of repair tissue from chondral defects experimentally induced in horses which were treated with microfractures, MSC, PRP alone or in combination of treatments. For this purpose, a first arthroscopic surgery was performed in 12 horses, which was considered time zero of the experiment (T0). A chondral defect of 15 mm diameter was created on medial femoral trochlea of both hindlimbs. The 24 patellofemoral joints of these animals were divided into four groups. The chondral defect was treated according to the group: GA: received treatment only with microfractures. GB received treatment with microfractures associated with MSC in PRP-gel scaffold. CG received treatment only with MSC in PRP-gel, and the GD was the control group, without treatments. MSCs were obtained from adipose tissue and PRP gel was obtained through double centrifugation method, followed by adding lyophilized bovine thrombin to achieve the gel consistency. The joints were followed during five months (T150) by clinical and laboratory assessment. At T150 there was performed a new arthroscopy aiming the macroscopic evaluation and repair tissue samples collection for histopathological, immunohistochemistry and qPCR analysis. We observed that the use of CTM in PRP-gel in the treatment of experimental chondral defects can modify the IL-1 and PGE2 concentrations in the synovial fluid. There ...As diferentes formas de terapia celular, como as células-tronco mesenquimais (CTM) associadas ao plasma rico em plaquetas (PRP), têm sido amplamente utilizadas no tratamento de lesões condrais e da osteoartrite, apresentando resultados interessantes. Atualmente, a literatura já traz uma série de competências positivas inerentes às CTM e ao PRP. O emprego da terapia celular em associações com outros tipos de tratamento, como as microfraturas, possibilitou que os pesquisadores aproximassem-se de resultados muito próximos ao ideal. Sendo assim, este estudo teve como objetivo comparar a resposta clínica e a inflamação articular, a morfologia e a composição do tecido de reparação de lesões condrais experimentalmente induzidas em equinos, tratadas com microfraturas e CTM em gel de PRP de forma isolada ou com a associação desses tratamentos. Para isso, 12 equinos foram submetidos a uma primeira cirurgia artroscópica, considerada tempo zero do experimento (T0), onde foi induzida uma lesão condral de 15 mm de diâmetro na tróclea medial femoral de ambos os membros pélvicos. As 24 articulações femoropatelares desses animais foram divididas em quatro grupos. O defeito condral foi submetido ao tratamento conforme o grupo: GA: recebeu o tratamento apenas com microfraturas. GB recebeu o tratamento com microfraturas associadas ao implante de CTMs em arcabouço de PRP em gel. GC recebeu o tratamento apenas com o implante de CTM em gel de PRP, e o GD foi o grupo controle do experimento, sem a aplicação de tratamentos. As CTMs foram extraídas do tecido adiposo e o PRP em gel foi obtido por protocolo de dupla centrifugação seguido da adição de trombina liofilizada bovina para a formação do gel. As articulações foram acompanhadas até os cinco meses (T150) através de exames clínicos e laboratoriais. Em T150 foi realizada nova artroscopia para avaliação macroscópica e coleta de amostras do tecido de reparação para...Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Efeito do implante autólogo de plasma rico em plaquetas (PRP) e células tronco mesenquimais na reparação de lesões condrais articulares induzidas experimentalmente em equinos

Lesões na cartilagem articular representam um desafio para a Medicina Veterinária devido ao limitado potencial intrínseco de reparação. As células tronco mesenquimais (CTM) e o plasma rico em plaquetas (PRP) vêm sendo utilizados na reparação condral pela capacidade de imunomodulação, quimiotaxia, por diminuir a degradação da cartilagem articular e exercer efeito anti-inflamatório. Esse trabalho estudou a eficácia das CTM e do PRP no tratamento de lesões condrais articulares, experimentalmente induzidas em equinos, apresentando os benefícios e os principais obstáculos encontrados na aplicação clínica e cirúrgica de equinos. Para isso, foi induzida uma lesão condral, na tróclea medial femoral dos dois membros pélvicos de oito animais. Após 30 dias da indução dessa lesão os animais, divididos em quatro grupos, receberam os tratamentos propostos: com CTM (Grupo 1); PRP (Grupo 2); CTM e PRP (Grupo 3) e um controle sem tratamento (Grupo 4). As avaliações dos parâmetros clínico-laboratoriais foram realizadas antes da indução da lesão (T-0), quinzenalmente até 120 dias e aos 150 dias (T-150). Avaliações macroscópicas, histopatológicas e histoquímicas foram realizadas em T-0 e T- 150. Pôde-se observar discreta melhora clínico-laboratorial dos grupos tratados quando comparados ao grupo controle. Os exames macroscópicos, histopatológicos e histoquímicos revelaram um melhor tecido de reparação nos grupos tratados, principalmente nos grupos 2 e 3. Sendo assim, o implante autólogo de CTM e do PRP apresentou efeitos benéficos no tratamento de lesões condrais, experimentalmente induzidas em equinosArticular cartilage defects represent a challenge for Veterinary Medicine due to the limited intrinsic potential of repair. Mesenchymal Stem Cells (MSC) and Platelet-Rich Plasma (PRP) have been used in cartilage repair to promote immunomodulation, chemotaxis, to decrease the degradation of articular cartilage and to take antiinflammatory effect. This work aims to study the use of intralesional MSC and the PRP in the treatment of articular cartilage defects induced experimentally in horses, noting the benefits and challenges encountered in implementing clinical-surgical in horses. For this purpose, both patellofemoral joints of eight animals were approached by arthroscopic surgery to perform a cartilage defect, on the medial femoral trochlea. After 30 days of induction the animals, who were divided into four groups, received treatment with: MSC (Group 1), PRP (Group 2), MSC and PRP (Group 3) and a control without treatment (Group 4). The clinical and laboratory assessments were performed every 15 days in 120 days, with last analysis in day 150. The macroscopic and morphologic analyses were performed at 0 and 150 day. There were clinical and laboratory improvement in the treated groups compared with control group. The macroscopic and morphological analysis showed a better tissue repair in the treated groups, mainly in groups 2 and 3. Thus, the implantation of autologous MSC and PRP showed beneficial effects in the treatment of chondral lesions, experimentally induced in horsesFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP

Determinação da densidade mineral e da elasticidade óssea após a aplicação de ondas de choque extracorpóreas no terceiro metacarpiano de equinos atletas

The porpoise of this study was to evaluate the effects of extracorporeal shock waves in third metacarpus bone from healthy horses by determination of bone elasticity. It were used 20 Thoroughbred horses, male and female, with two years old, on top of training and selected as the state healthy. At the beginning of the experiment (D0), all animals were submitted for evaluation of bone elasticity held in the third metacarpus bone. The animals were divided into two groups (Control Group - CG and Experimental Group - EG). The application of extracorporeal shock wave therapy (ESWT) was performed on the right forelimb of the animals in the experimental group in the same place evaluated for bone elasticity and was used apparatus for extracorporeal therapy of waves with 0.15 mJ/mm2 energy flux density and 2000 pulses with E6R20 probe, with focus feature of the shock wave of 20 mm. The ESWT were repeated every 21 days, a total of three sessions (D0, D21 and D42). The analysis of bone elasticity determination was realized at D21, D42 and D72. The average of speed ultrasound differed between groups at D21, D42 and D72, and the animals from EG had lower bone mineral density after applications of ESWT. There was also difference in the analysis of bone mass (Z-Score) between the groups at D21 and D42, which animals from EG showed a significant decrease in bone mass. The risk of fracture was higher in animals from experimental group at D21. It was concluded that ESWT is able to promote change in bone mineral density

Peritoneal reactivity evaluation in horses subjected to experimental small colon enterotomy and treated with subcutaneous heparin

Heparin is routinely administered in postoperative abdominal surgery aiming to prevent adhesions formation; however, there is no consensus indicating its effectiveness. This study evaluated the effect of heparin on peritoneal reactivity after abdominal surgery, through the association between peritoneal fluid features and ultrasonographic and laparoscopic examination. Ten adult horses were used: control group (CG) and treated group (TG). Both groups underwent laparotomy and small colon enterotomy. TG received subcutaneous heparin at 150 IU/kg every 12 hours for 5 days. The animals underwent ultrasonography and peritoneal fluid examination prior to enterotomy (M0) 12 hours (M1), 1 day (M2), 2 days (M3), 4 days (M4), 6 days (M5), 10 days (M6), and 14 days after enterotomy (M7) with laparoscopic examination being performed on the fifth postoperative day. Peritoneal inflammatory response was observed in both groups. The peritoneal fluid of TG animals showed higher echogenicity during heparin therapy. No inflammatory difference was observed between groups through peritoneal fluid features, except for the higher D-dimer concentration in CG. On laparoscopy, slightly diffuse peritoneal reactivity for both groups was observed, being higher for TG. Laparoscopy and ultrasonography association allowed detailed access to the abdominal cavity. Ultrasonography assessed the diffuse peritoneal inflammation, and laparoscopy allowed the detailed analysis of the segments. No gross beneficial reactions resulting from the use of heparin on peritoneal reactivity were observed; however, it was observed by D-dimer evaluation that the TG had less fibrin deposition, which is directly related to a lower rate of abdominal adhesions formation.Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq

Células mononucleares da medula óssea no tratamento da ruptura total dos tendões flexores e ligamento suspensor do boleto em equino

This paper describes the case of a horse treated in a Teaching Veterinary Hospital. The sutures of the flexor apparatus associated with cell therapy, the stem cell, provided a rapid response of repair compared to other cases treated in routine of the Hospital. The association of conventional treatments with the mononuclear fraction of bone marrow significantly contributed to the reduction of the hyperextension of the metatarsophalangeal joint. Ultrasound images showed rapid fill cell and decrease in inflammation

Estenose de piloro em eqüino adulto Pyloric stenosis in a mature horse

Neste trabalho, é descrito um caso de estenose hipertrófica de piloro diagnosticado por gastroscopia em um eqüino Quarto de Milha, de quatro anos de idade, que apresentava inapetência, emagrecimento progressivo, cólica, bruxismo e sialorréia. A gastroduodenite ulcerativa crônica e os espasmos prolongados foram as supostas causas da hipertrofia da musculatura circular do piloro, causando a estenose. O tratamento com substâncias antiulcerativas é paliativo e o acesso cirúrgico ao piloro no animal adulto é complexo, sendo o prognóstico duvidoso.<br>A case of hypertrophic pyloric stenosis diagnosed by gastroscopy was reported in a 4-years-old Quarter Horse gelding, with signs of inappetence, chronic weight loss, colic, bruxism and sialorrhea. Gastroduodenal ulceration and spasms were supposed as causes of pyloric muscular hypertrophy and stenosis. Antiulcerative medications are merely palliative and the complex surgical approach to the site of stenosis makes the prognostic to be doubtful