The Effect of Capacitive-Resistive Electrical Therapy on Neck Pain and Dysfunction in Horses.

Neck pain and stiffness are increasingly recognized in horses and often treated using multimodal pharmaceutical and rehabilitation approaches. In humans, deep tissue heating is reported to reduce neck pain and increase flexibility. The objective of this project was to determine the effects of capacitive-resistive electrical therapy on neck pain and stiffness in horses. A blinded, randomized, controlled clinical trial with 10 horses assigned to active and 10 horses assigned to sham treatment groups. Neck pain, stiffness, and muscle hypertonicity were assessed by manual palpation. Forelimb postural stability was evaluated using a portable media device with built-in inertial sensing components. All outcome parameters were recorded once weekly for four weeks. Using manufacturer recommendations, the treatment group received active capacitive-resistive electrical therapy to the lower cervical region (C4-C7), twice weekly for a total of six treatments, while the control group received a sham (inactive) treatment. Data was analyzed using a mixed model that was fit separately for each response variable. There were no significant differences noted over time or between groups for any outcome parameter evaluated. While neck pain and stiffness decreased by week three in both groups, the improvement was not significant. Limitations include the lack of a definitive pathoanatomic diagnosis of cervical pathology and in vivo temperature measurements. Capacitive-resistive electrical therapy was ineffective in reducing neck pain and dysfunction using the recommended treatment protocols. No short-term adverse effects were noted. Specific clinical applications and effective treatment parameters need further evaluation.

Microfracture Augmentation With Trypsin Pretreatment and Growth Factor-Functionalized Self-assembling Peptide Hydrogel Scaffold in an Equine Model.

BACKGROUND: Microfracture augmentation can be a cost-effective single-step alternative to current cartilage repair techniques. Trypsin pretreatment combined with a growth factor-functionalized self-assembling KLD hydrogel ("functionalized hydrogel") has been shown to improve overall cartilage repair and integration to surrounding tissue in small animal models of osteochondral defects. HYPOTHESIS: Microfracture combined with trypsin treatment and a functionalized hydrogel will improve reparative tissue quality and integration as compared with microfracture alone in an equine model. STUDY DESIGN: Controlled laboratory study. METHODS: Bilateral cartilage defects (15-mm diameter) were created on the medial trochlear ridge of the femoropatellar joints in 8 adult horses (16 defects total). One defect was randomly selected to receive the treatment, and the contralateral defect served as the control (microfracture only). Treatment consisted of 2-minute trypsin pretreatment of the surrounding cartilage, subchondral bone microfracture, and functionalized hydrogel premixed with growth factors (platelet-derived growth factor and heparin-binding insulin-like growth factor 1). After surgery, all horses were subjected to standardized controlled exercise on a high-speed treadmill. Clinical evaluation was conducted monthly, and radiographic examinations were performed at 2, 16, 24, 32, 40, and 52 weeks after defect creation. After 12 months, all animals were euthanized. Magnetic resonance imaging, arthroscopy, gross pathologic evaluation of the joint, histology, immunohistochemistry, and biomechanical analyses were performed. Generalized linear mixed models (with horse as random effect) were utilized to assess outcome parameters. When P values were <.05, pairwise comparisons were made using least squares means. RESULTS: Improved functional outcome parameters were observed for the treatment group, even though mildly increased joint effusion and subchondral bone sclerosis were noted on imaging. Microscopically, treatment resulted in improvement of several histologic parameters and overall quality of repaired tissue. Proteoglycan content based on safranin O-fast green staining was also significantly higher in the treated defects. CONCLUSION: Trypsin treatment combined with functionalized hydrogel resulted in improved microfracture augmentation. CLINICAL RELEVANCE: Therapeutic strategies for microfracture augmentation, such as those presented in this study, can be cost-effective ways to improve cartilage healing outcomes, especially in more active patients.

Current joint therapy usage in equine practice: Changes in the last 10 years.

BACKGROUND: Osteoarthritis is a common clinical condition in the performance horse. In the last 10 years, there has been substantial growth in understanding of the disease and in the development of novel therapies. OBJECTIVES: To document changes in clinical use of joint therapies over the past 10 years. We also aimed to understand how newly developed therapies have been added to routine clinical practice. STUDY DESIGN: Survey of veterinary professionals. METHODS: We administered an electronic survey to members of the American Association of the Equine Practitioners. Questions from a similar survey in 2009 were repeated and new questions were added. The responses were tabulated, analysed and compared to those of the previous survey. RESULTS: A total of 407 completed surveys were returned. There were no significant differences between the current and previous surveys with respect to demographic parameters. Triamcinolone acetonide (TA) remained the most common corticosteroid used to treat high-motion joints. Methylprednisolone acetate (MPA) remained the most common corticosteroid to treat low-motion joints. The use of MPA for high-motion joints was significantly more common in 2009 than in 2019 (odds ratio [OR]: 2.38, 95% confidence interval [CI]: 1.66-3.42, P = .001). Biological therapies became more popular, and the likelihood of respondents reporting having used autologous conditioned serum was substantially higher in 2019 than in 2009 (OR: 4.24, 95% CI: 3.16-5.68, P < .001). Concomitant use of antibiotics with intra-articular medications became more common as well. MAIN LIMITATIONS: This is a report of survey data and not directly measured treatments. CONCLUSIONS: There is a decrease in the use of MPA to treat high-motion joints. The use of biological therapies in joints has become more prevalent. There are clear differences in the use of joint therapies over time. While some differences agree with the scientific evidence, others are not fully concordant or are in direct conflict with the scientific literature.