A sustainable structure for jockey injury data management for the North American horse racing industry.

Jockey injuries in North American racing are not well understood. The types and severity of injuries as well as exposure need to be better characterized in order to reduce risk. We consider existing data sources and the opportunity to combine this data with a new data collection effort to better understand and potentially reduce risk to riders. Using a two-phase approach, data appears to be available which would allow useful information on jockey injuries that could inform efforts for risk reduction quickly and with modest resources. Initial successes can help to develop support for a more comprehensive data collection and risk reduction program.

Detection of articular pathology of the distal aspect of the third metacarpal bone in thoroughbred racehorses: comparison of radiography, computed tomography and magnetic resonance imaging.

OBJECTIVE: To compare digital radiography (DR), computed tomography (CT), and magnetic resonance imaging (MRI) for detection of pathology of the distal aspect of the third metacarpal bone (MC3) and to assess whether arthrography would improve detection of articular cartilage or subchondral bone cracking. STUDY DESIGN: Cross-sectional study. SAMPLE POPULATION: Limb specimens from 17 Thoroughbred horses after catastrophic injury and 4 age-matched control horses. METHODS: Standard DR, CT, and MRI images of the metacarpophalangeal joint were acquired before and after iohexol injection. Pathologic features detected with imaging and on visual inspection of cartilage and subchondral bone of the distal aspect of MC3 were graded. Imaging observations were compared with pathologic abnormalities. RESULTS: Inspection revealed obvious changes in the cartilage and subchondral bone surfaces in Thoroughbreds. Both CT and MRI were superior to DR for detection of subchondral bone pathology. Cracking of cartilage was not detected by any imaging modality. Signal changes associated with cartilage loss and development of repair tissue were evident on MRI in 9/19 cases. There was significant correlation (P < .05) between subchondral bone pathology detected on both CT and MRI, and cartilage pathology on gross examination. Contrast arthrography did not improve the detection of articular cartilage or subchondral plate cracking. CONCLUSION: Both CT and MRI are superior to DR for detection of subchondral bone pathology, but underestimate the extent of joint adaptation and pathologic damage. MRI was able to detect cartilage degeneration.

Evaluation of horseshoe characteristics and high-speed exercise history as possible risk factors for catastrophic musculoskeletal injury in thoroughbred racehorses.

OBJECTIVE: To evaluate horseshoe characteristics and high-speed exercise history as risk factors for catastrophic musculoskeletal injury in Thoroughbred racehorses. ANIMALS: 377 horses (37,529 race starts). PROCEDURES: Shoe characteristics included material, toe grab height, heel traction device, pads, and rim shoes. Racing variables were obtained from a computerized database. Forty-three horses that had a musculoskeletal injury and then failed to race or train for 6 months (cases) and 334 noninjured horses from the same race in which a horse was injured (controls) were compared regarding risk factors. RESULTS: Overall, 98% of race starts were associated with aluminum shoes, 85% with toe grabs, 32% with pads, and 12% with rims on forelimb horseshoes. Among 43 horses with musculoskeletal injury, sex (geldings), an extended interval since last race, and reduced exercise during the 30 or 60 days preceding injury were risk factors for catastrophic injury. Odds of injury in racehorses with toe grabs on front shoes were 1.5 times the odds of injury in horses without toe grabs, but this association was not significant (95% confidence interval, 0.5 to 4.1). CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that horses that return to racing after an extended period of reduced exercise are at high risk of catastrophic musculoskeletal injury. Results regarding the use of toe grabs as a possible risk factor for catastrophic injury were inconclusive because the probability of declaring (in error) that use of toe grabs was associated with an increased risk of musculoskeletal injury (eg, odds ratio > 1.0) was 38%.

Scanning electron microscopic examination of third metacarpal/third metatarsal bone failure surfaces in thoroughbred racehorses with condylar fracture.

OBJECTIVE: To examine the fracture failure surfaces from Thoroughbred horses that had sustained a catastrophic condylar fracture. SAMPLE POPULATION: Bone specimens from the failure surface were obtained from 12 Thoroughbred racehorses with catastrophic injury and 2 non-racing horses with accidental long bone fracture. METHODS: Bone specimens from the failure surface of each fracture were incubated with gold microspheres to label microcracks before examination at x50 to x60,000 using scanning electron microscopy. Microcracking at the failure surface was assessed using a visual analog scale. RESULTS: Branching arrays or clusters of microcracks were seen over a range of magnifications in adapted subchondral bone in the distal end of the MC3/MT3 bone from racing Thoroughbreds with a catastrophic displaced condylar fracture. In the palmar/plantar region, microcracking was associated with the formation of an array of macroscopic cracks in the condylar groove. A different pattern of microcracking was seen in specimens of bone from distal metaphyseal and diaphyseal MC3/MT3 failure surfaces from Thoroughbred racehorses with catastrophic fracture and non-racing horses with an accidental diaphyseal long bone fracture. Few microcracks were seen and typically did not form branching arrays. CONCLUSION: These data suggest that propagation of condylar fracture in Thoroughbred racehorses is initiated by the formation of nanoscale microcracks in adapted subchondral bone that form during exercise-induced bone adaptation. CLINICAL RELEVANCE: Accumulation and coalescence of branching microcracks into arrays or clusters appears to eventually lead to the development of macroscopic subchondral cracks in the condylar groove and initiation of a condylar fracture.

Effect of focused and radial extracorporeal shock wave therapy on equine bone microdamage.

OBJECTIVES: To determine whether bone microcracks are altered after application of focused and radial extracorporeal shock wave therapy (ESWT) to the equine distal limb. STUDY DESIGN: An ex vivo experimental model. SAMPLE POPULATION: A contralateral limb specimen was obtained from 11 Thoroughbred racehorses with a unilateral catastrophic injury. Distal limb specimens were also obtained from 5 non-racing horses. METHODS: Three separate skin-covered bone segments were obtained from the mid-diaphysis of the metacarpus (MC3) or metatarsus (MT3). Focused (9,000 shockwaves, 0.15 mJ/mm2, 4 Hz) and radial (9,000 shockwaves, 0.175 mJ/mm2, 4 Hz) ESWT treatments were randomized to the proximal and distal segments and the middle segment was used as a treatment control for pre-existing microcracks. After treatment, bone specimens were bulk-stained with basic fuchsin and microcracks were quantified in transverse calcified bone sections. RESULTS: ESWT had small but significant effects on microcracks. Microcrack density (Cr.Dn) and microcrack surface density (Cr.S.Dn) were increased after focused ESWT, whereas Cr.Le was increased after radial ESWT. In racing Thoroughbreds, Cr.Le increased with increased number of races undertaken. Cr.Dn and Cr.S.Dn were not significantly influenced by the number of races undertaken. CONCLUSION: ESWT has small but significant effects on bone microcracking ex vivo. CLINICAL RELEVANCE: These preliminary data suggest that ESWT has the potential to increase bone microcracking in equine distal limb bone in vivo. Such effects may be more pronounced in Thoroughbreds that are actively being raced, because in vivo microcracking increases with increased number of races undertaken.

Macroscopic changes in the distal ends of the third metacarpal and metatarsal bones of Thoroughbred racehorses with condylar fractures.

OBJECTIVE: To determine changes in the distal ends of the third metacarpal and metatarsal bones (MCIII and MTIII) of Thoroughbred racehorses that had sustained a catastrophic condylar fracture during high-speed exercise. SAMPLE POPULATION: Fractured and contralateral MCIIIs and MTIIIs from 11 Thoroughbred racehorses that sustained a displaced condylar fracture during racing, both MCIIIs from 5 Thoroughbred racehorses euthanatized because of a catastrophic injury other than a condylar fracture, and both MCIIIs from 5 horses of other breeds that had not been professionally trained or raced. PROCEDURE: Macroscopic observations were made of the distal ends of the bones before and after digestion of the articular cartilage with NaOH. RESULTS: In all 11 racehorses with a displaced condylar fracture, the fracture was associated with a branching array of cracks in the condylar groove. In this region, fracture margins were smooth, and there was loss of subchondral bone. Comminution of the dorsal cortex was also seen. Parasagittal linear wear lines in the articular cartilage, erosions in the articular cartilage of the condyles, loss of the underlying subchondral bone, and cracking of condylar grooves were all more severe in the Thoroughbred racehorses than in the horses that had not been professionally trained or raced. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that condylar fractures in horses are pathologic fatigue or stress fractures that arise from a preexisting, branching array of cracks in the condylar groove of the distal end of MCIII or MTIII.