Relationship between serum biomarkers of cartilage and bone metabolism and joint injury in young Thoroughbred racehorses in training.

OBJECTIVE: To compare serum concentrations of biomarkers of cartilage and bone metabolism between racehorses with a carpal or metacarpophalangeal or metatarsophalangeal (ie, fetlock) joint injury and matched uninjured control horses, determine changes in biomarker concentrations following joint injury, and establish the biomarkers' diagnostic test performance. ANIMALS: 50 Thoroughbred racehorses with a carpal or fetlock joint injury and 50 matched uninjured horses (control horses). PROCEDURES: Serum concentrations of 2 cartilage synthesis biomarkers (carboxy-terminal propeptide of type II collagen [CPII] and chondroitin sulfate epitope 846 [CS846]), 2 cartilage degradation biomarkers (neoepitope generated by collagenase cleavage of type II collagen [C2C] and cross-linked carboxy-terminal telopeptide fragments of type II collagen [CTX-II]), and serum activity of a bone formation marker (bone-specific alkaline phosphatase [BAP]) were measured around the time of injury diagnosis and monthly thereafter for as long as possible. RESULTS: Injured horses as a group and horses specifically with fetlock joint injuries had significantly lower serum CPII concentrations and significantly higher serum BAP activities than matched control horses. Concentrations of CTX-II were decreased between 2 and 4 months following joint injury. Measurement of CPII concentration at baseline could distinguish between injured horses and control horses with a sensitivity of 82% and specificity of 50%. CONCLUSIONS AND CLINICAL RELEVANCE: Although significant differences in specific biomarker concentrations between horses with carpal and fetlock joint injuries and matched control horses were identified, there was no convincing evidence of the suitability of these biomarkers as diagnostic or prognostic tools in a clinical setting.

Exercise affects joint injury risk in young Thoroughbreds in training.

The aim of this study was to identify exercise-related risk factors for carpal and metacarpo- and metatarso-phalangeal (MCP/MTP) joint injury occurrence in young Thoroughbreds in flat race training. In a 2-year prospective cohort study, daily exercise and joint injury data were collected from horses in 13 training yards in England. Four injury categories were defined: (1) localised to a carpal or MCP/MTP joint based on clinical examination and/or use of diagnostic analgesia with no diagnostic imaging performed; (2) localised to a carpal or MCP/MTP joint with no abnormalities detected on diagnostic images; (3) abnormality of subchondral bone and/or articular margin(s) identified using diagnostic imaging; (4) fracture or fragmentation identified by diagnostic imaging. Multivariable Cox regression analysis was conducted to determine risk factors for injury occurrence, by type (carpal or MCP/MTP) and category. Exercise distances at canter and high speed in different time periods were modelled as continuous time-varying variables. A total of 647 horses spent 7785months at risk of joint injury and 184 injuries were recorded. Increasing daily canter distance reduced the risk of Category 1 and Category 3 injuries whereas greater 30-day canter distances increased Category 4 injury risk. More weekly high-speed exercise increased Category 1 injury risk. MCP/MTP injury risk reduced with increasing daily canter distance but increased with accumulation of canter or high-speed exercise since entering training, whereas accumulation of canter exercise was marginally associated with reduced carpal injury risk. Risk of all injury types varied significantly between trainers. The results of this study suggest that regular canter exercise is generally beneficial for joint health, while accumulation of high-speed exercise detrimentally affects MCP/MTP joints.