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BackgroundPolyacrylamide hydrogel (PAAG) was evaluated recently to treat osteoarthritis (OA) in horses with highly encouraging results; however no long term field-study was done to explore its clinical efficacy and lasting effect. The objective of this study was to evaluate the efficacy of PAAG in improving clinical signs of OA in horses. We hypothesized that lameness grade would significantly improve and the effect would last at least 2 years in osteoarthritic joints treated with PAAG. Forty three horses older than 2 years with OA in only one joint based on clinical evaluation, intra-articular anaesthesia and imaging (radiography) were included in this study. Horses were injected with 2 ml of PAAG into the affected joint and were followed up at 1, 3, 6, 12 and 24 months. Efficacy of PAAG was evaluated by blinded clinical assessment of lameness. Adverse reactions to joint injection were assessed. Data relating to case details, type of activity, joint and limb involved, lameness duration, lameness grading, previous joint treatment, joint effusion grading, radiographic grading, and owner assessment were recorded. Factors associated with the outcome measure “lameness grading” were analyzed using generalized linear mixed model for logistic regression.ResultsAt 1, 3, 6, 12 and 24 months follow-up, 59%, 69%, 79%, 81/% and 82.5% of horses were non-lame respectively. Reduction of joint effusion was observed over time. No side effect was observed in the treated joints. There was a significant decrease in lameness grade from baseline to 1, 3, 6, 12 and 24 months (P < 0.0001) and a significant positive association with joint effusion (P < 0.0001). Estimates for odds ratio (OR) showed that the effect of treatment increased over time (OR for lower lameness from month 1 to month 24 relative to baseline increased from 20 to 58).ConclusionsPAAG significantly alleviated lameness and joint effusion in osteoarthritic joints. PAAG is a safe and lasting (at least 24 months) OA treatment in horses. PAAG is a promising new treatment for OA in horses.

SUMMARY Synovial fluid and blood were collected from 18 clinically healthy brood mares in resting condition. The following parameters were analysed: total leucocytes, glucose, alkaline phosphatase (AP), lactate dehydrogenase (LDH), total protein, albumin, total globulin, albumin/globulin ratio and electrophoretic protein picture. The serum/synovia ratios were calculated for all parameters. It was considered to be of greater diagnostic value to compare these serum/synovia ratios rather than to look at the individual concentrations in synovia. The results obtained did not materially differ from those in the existing literature. In addition, this study confirmed that small protein molecules could more easily penetrate the synovial membrane than high‐molecular proteins. RÉSUMÉ Le liquide synovial et le sang de 18 poulinières cliniquement saines furent prélevés sur les animaux au repos. On analysa les paramètres suivants: leucocytes totaux, glucose, phosphatase alcaline, lactate déhydrogénase, protéines totales, albumine, globulines totales, rapport albumine/globuline, image électrophorétique des protéines. Les rapports sérum/liquide synovial furent évalués pour tous ces paramètres. Les résultats ne diffèrent point de ceux déjà publiés. Cette étude confirme que les protéines à petite molécule peuvent traverser plus facilement que celles à grosse molécule les membranes synoviales. La comparaison des rapports sérum/liquide synovial provenant de chevaux sains et de chevaux malades s'est révélée fructueuse. ZUSAMMENFASSUNG Synovialflüssigkeit und Blut wurden von 18 gesunden, ausgeruhten Zuchtstuten gewonnen. Die folgenden Parameter wurden analysiert: Gesamtleukozytenzahl, Glucose, alkalische Phosphatase (AP), Lactatdehydrogenase (LDH), Gesamteiweiss, Albumin, Gesamtglobulin, Albumin/Globulinverhältnis und das elektrophoretische Eiweissbild. Das Verhaltnis der Werte aus Serum und Synovia wurde für alle Parameter berechnet. Die Resultate weichen kaum ab von denjenigen in der Literatur. Die Untersuchungen bestätigten, dass kleine Eiweissmoleküle die Synovialmembran leichter penetrieren können als Proteine mit hohem Molekulargewicht. Es wird geschlossen, dass der Vergleich zwischen Serum/Synovia‐Verhältnissengesunder und denjenigen kranker Gelenke besonders wertvoll sei.

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