Modified tenoscopic method for carpal flexor retinaculum release in a horse.

OBJECTIVE: To report the use of a proximolateral endoscopic portal with a distolateral instrument portal for carpal retinaculum release in a horse clinically affected with carpal canal syndrome. STUDY DESIGN: Clinical report. ANIMALS: A 4-year-old Thoroughbred female. METHODS: Carpal canal syndrome secondary to traumatic suppurative tenosynovitis was treated by accessory carpal bone debridement and carpal retinaculum release using a tenoscopic approach to the carpal flexor synovial sheath through a proximolateral endoscope portal and a distolateral instrument portal. RESULTS: Resolution of carpal sheath effusion and lameness occurred allowing racing 14 months later. Use of a distolateral instrument portal was not associated with complications or iatrogenic damage to neurovascular structures and reduced endoscope and instrument interference and offered easier access to the distal aspect of the carpal sheath. CONCLUSIONS: Carpal retinaculum release may be safely accomplished with a distolateral instrument portal when access to the distal aspect of the carpal sheath is needed. CLINICAL RELEVANCE: The distolateral instrument portal described may be a useful alternative to a proximolateral portal when distal carpal sheath instrument access is necessary or advantageous.

Effects of methylprednisolone acetate and glucosamine on proteoglycan production by equine chondrocytes in vitro.

OBJECTIVE: To evaluate the effects of methylprednisolone acetate (MPA) on proteoglycan production by equine chondrocytes and to investigate whether glucosamine hydrochloride modulates these effects at clinically relevant concentrations. SAMPLE POPULATION: Articular cartilage with normal gross appearance from metacarpophalangeal and metatarsophalangeal joints of 8 horses (1 to 10 years of age). PROCEDURES: In vitro chondrocyte pellets were pretreated with glucosamine (0, 1, 10, and 100 microg/mL) for 48 hours and exposed to MPA (0, 0.05, and 0.5 mg/mL) for 24 hours. Pellets and media were assayed for proteoglycan production (Alcian blue precipitation) and proteoglycan content (dimethylmethylene blue assay), and pellets were assayed for DNA content. RESULTS: Methylprednisolone decreased production of proteoglycan by equine chondrocytes at both concentrations studied. Glucosamine protected proteoglycan production at all 3 concentrations studied. CONCLUSIONS AND CLINICAL RELEVANCE: Methylprednisolone, under noninflammatory conditions present in this study, decreased production of proteoglycan by equine chondrocytes. Glucosamine had a protective effect against inhibition of proteoglycan production at all 3 concentrations studied. This suggested that glucosamine may be useful as an adjunct treatment when an intra-articular injection of a corticosteroid is indicated and that it may be efficacious at concentrations relevant to clinical use.

Effects of radial shock waves on membrane permeability and viability of chondrocytes and structure of articular cartilage in equine cartilage explants.

OBJECTIVE: To investigate in vitro effects of radial shock waves on membrane permeability, viability, and structure of chondrocytes and articular cartilage. SAMPLE POPULATION: Cartilage explants obtained from the third metacarpal and metatarsal bones of 6 horses. PROCEDURE: Equine cartilage was subjected to radial shock waves and then maintained as explants in culture for 48 hours. Treatment groups consisted of a negative control group; application of 500, 2,000, and 4,000 impulses by use of a convex handpiece (group A); and application of 500, 2,000, and 4,000 impulses by use of a concave handpiece (group B). Effects on explant structure were evaluated by use of environmental scanning electron microscopy (ESEM). Membrane permeability was determined by release of lactate dehydrogenase (LDH). Chondrocyte viability was assessed by use of vital cell staining. Comparisons of LDH activity and nonviable cell percentages were performed by ANOVA. RESULTS: Cell membrane permeability increased significantly after application of 2,000 and 4,000 impulses in groups A and B. A significant decrease in cell viability was observed for application of 4,000 impulses in explants of group A. There was no detectable damage to integrity of cartilage explants observed in any treatment group by use of ESEM. CONCLUSIONS AND CLINICAL RELEVANCE: Radial shock waves do not appear to structurally damage articular cartilage but do impact chondrocyte viability and membrane permeability. Caution should be exercised when extremely high periarticular pulse doses are used until additional studies can determine the long-term outcome of these effects and appropriate periarticular treatment regimens can be validated.