Effect of arthroscopic lavage and repeated intra‐articular administrations of antibiotic in adult horses and foals with septic arthritis

Cousty, M.; Stack, John D.; Tricaud, C.; David, Florent

doi:10.1111/vsu.12696

Cited by 24 publications

(30 citation statements)

References 29 publications

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“…The rate of survival of horses with SI in this study was 90.1%. This is comparable with recent reports of survival rates for horses with SI of 84–90.3% (6, 17, 18, 23), including a study from a similar geographical location (south-eastern Australia) where 84% of horses survived (6). Initial reports had lower rates of survival (65%) (36) and a poor prognosis for affected horses was described (37).…”

Section: Discussionsupporting

confidence: 90%

“…All horses with SI presented to the Charles Sturt University equine hospital over a 9 year period (April 1st 2008 and May 1st 2017) were included in the study. Confirmed or suspected SI were defined as direct contamination through a breach of a joint or a tendon sheath, and/or a total nucleated cell count (TNCC) ≥30 x 10 9 cells/L, total protein concentration ≥30 g/L and differential cell count of >80% neutrophils in a synovial fluid sample and/or a positive microbiological culture from synovial fluid (6, 7, 17, 23, 29). Microbiological culture was done by inoculating the recommended amount of synovial fluid into the BACTEC Peds Plus™/F culture bottle and this was this was immediately placed into the BACTEC 9050 automated blood culture system.…”

Section: Methodsmentioning

confidence: 99%

“…Synovial infections can be associated with high rates of morbidity and mortality. Reported rates of survival in horses with SI range from 42 to 98% (1, 4, 6–9, 17–25), while rates of return to function also vary widely (26–90%) (1, 4, 7–9, 20, 22, 23). Consequently, factors associated with outcome for horses with SI have been investigated, including etiology, time between synovial fluid contamination and treatment, microbiological culture results, location and number of synovial cavities affected, age, breed, treatment regimens, involvement of surrounding structures, and length of hospital stay (4, 6–9, 18, 20–23, 25–28).…”

Section: Introductionmentioning

confidence: 99%

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Factors Associated With Survival and Return to Function Following Synovial Infections in Horses

et al. 2019

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Synovial infections (SI) are common in horses of all ages and can be associated with high rates of morbidity and mortality. Identifying factors influencing survival and return to function may be useful for management of affected individuals and determination of prognosis. The objectives of this study were to identify factors associated with survival and return to function of horses and foals with SI presented to an equine hospital. This study is a retrospective case series. Data were collected from medical records of all horses with SI that were presented to a single equine hospital between April 1st, 2008 and May 1st, 2017. Long–term follow up was obtained by a semi-structured telephone questionnaire of clinical outcomes and analysis of online race records. Univariate models were created using generalized linear and linear mixed models to assess factors associated with outcomes. Multivariable models were created using generalized linear and linear mixed models to determine factors significantly associated with outcomes. Of 186 horses presented with SI, 161/186 (86.6%) were treated and 145/161 (90.1%) survived to discharge. The majority of joints were treated with synovial lavage (93.8%). One hundred and twenty horses were included in the return to function analysis and 79 (65%) returned to function. Increasing number of days of treatment with systemic antimicrobials was associated with increased likelihood of survival for each horse (OR 1.15, 95% CI 1.04−1.27, P = 0.025) and when considering each individual synovial structure (OR 1.11, 95% CI 1.04−1.17, P = 0.004). Horses treated with doxycycline were less likely to return to function (OR 0.39, 95% CI 0.19−0.8, P = 0.031). The overall rate of survival of horses treated with SI is good. The likelihood of return to function is lower than for survival. The findings of this study, combined with relevant antimicrobial stewardship practices, can be used as a part of evidence-based decision-making when veterinarians are treating horses with SI.

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Section: Discussionsupporting

confidence: 90%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Factors Associated With Survival and Return to Function Following Synovial Infections in Horses

et al. 2019

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“…Arthroscopic lavage has been used to treat OA and is commonly used to diagnose and treat intra-articular fracture, cartilage damage or idiopathic synovitis. [3][4][5][6] There are few non-terminal equine experimental joint injury models that can be used to evaluate changes in synovial uid composition and response to therapeutics. Intra-articular lavage and interleukin 1 beta (IL-1β)-induced synovitis are two transient experimental models used to mimic clinical synovitis and study early joint disease in a controlled manner without the requirement for euthanasia.…”

Section: Introductionmentioning

confidence: 99%

Investigation of Synovial Fluid Lubricants and Inflammatory Cytokines in the Horse: a Comparison of Recombinant Equine Interleukin 1β-induced Synovitis and Joint Lavage Models

Watkins

Fasanello

Stefanovski

et al. 2021

Preprint

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Background Lameness is a debilitating condition in equine athletes that leads to more performance limitation and loss of use than any other medical condition. There are a limited number of non-terminal experimental models that can be used to study early inflammatory and synovial fluid biophysical changes that occur in the equine joint. Here, we compare the well-established carpal IL-1β-induced synovitis model to a tarsal intra-articular lavage model, focusing on serial changes in synovial fluid inflammatory cytokines/chemokines and the synovial fluid lubricating molecules lubricin/proteoglycan 4 and hyaluronic acid. The objectives of this study were to evaluate clinical signs; synovial membrane and synovial fluid inflammation; and synovial fluid lubricants and biophysical properties in response to carpal IL-1β synovitis and tarsal intra-articular lavage. Results Hyaluronic acid (HA) concentrations, especially high molecular weight HA, and synovial fluid viscosity decreased after both synovitis and lavage interventions. Synovial fluid lubricin concentrations increased 17-20-fold for both synovitis and lavage models, with similar changes in both affected and contralateral joints, suggesting that repeated arthrocentesis alone resulted in elevated synovial fluid lubricin concentrations. Synovitis resulted in a more severe inflammatory response based on clinical signs (temperature, heart rate, respiratory rate, lameness and joint effusion) and clinicopathological and biochemical parameters (white blood cell count, total protein, prostaglandin E2, sulfated glycosaminoglycans, tumor necrosis factor-α and CC chemokine ligands − 2, -3, -5 and − 11) as compared to lavage. Conclusions Synovial fluid lubricin increased in response to IL-1β synovitis and joint lavage but also as a result of repeated arthrocentesis. Frequent repeated arthrocentesis is associated with inflammatory changes, including increased sulfated glycosaminoglycan concentrations and decreased hyaluronic acid concentrations. Synovitis results in more significant inflammatory changes than joint lavage. Our data suggests that synovial fluid lubricin, TNF-α, CCL2, CCL3, CCL5, CCL11 and sGAG may be useful biomarkers for synovitis and post-lavage joint inflammation. Caution should be exercised when performing repeated arthrocentesis clinically or in experimental studies due to the inflammatory response and loss of HA and synovial fluid viscosity.

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“…In adult horses, the most frequent causes of synovial sepsis are penetrating trauma and iatrogenic contamination by intrasynovial injection or surgical procedures [1,[3][4][5][6][7][8][9][10][11]. Haematogenous localisation of bacteria to multiple synovial structures is common and well documented in foals [5,12,13].…”

Section: Introductionmentioning

confidence: 99%

Synovial sepsis of unknown origin in the adult Thoroughbred racehorse

Byrne¹,

Lumsden²,

Lang³

et al. 2019

Equine Veterinary Journal

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Summary Background Synovial sepsis of unknown origin is a rare cause of lameness in the adult horse, and a haematogenous pathogenesis has been proposed in previous cases. Objectives To describe the features and outcome of synovial sepsis of unknown origin in adult Thoroughbred racehorses. Study design Retrospective case series. Methods Hospital records for admissions between 2005 and 2015 were reviewed to identify adult horses diagnosed with synovial sepsis of unknown origin. Presentation, clinicopathological, microbiological and diagnostic imaging findings were recorded. Treatment methods, surgical findings, complications and long‐term outcome were evaluated. Results Eleven cases were identified over the study period. Diagnosis was established from clinical examination and clinicopathologic findings, which were comparable to other aetiologies of synovial sepsis. Affected structures included synovial joints, tendon sheaths and bursae. Concurrent osteochondritis dissecans or articular cartilage lesions were evident during arthroscopic surgery in three cases. Significant intrasynovial haemorrhage was not identified. Microbial culture of synovial fluid or synovial biopsy was positive in 6/11 of cases, with all isolates being Gram‐positive cocci. Of the 6 positive microbial cultures, all isolates demonstrated in vitro sensitivity to a cephalosporin antimicrobial agent. A concurrent remote wound was present in a single case. No other potential origins of bacteraemia were identified. Treatment methods included endoscopic surgery, standing multineedle lavage, intravenous regional limb perfusion, intrasynovial medication and/or systemic antimicrobial administration. All horses survived to hospital discharge. For the 6/11 cases that raced following synovial sepsis, the median period for return to racing was 221 days. Main limitations A small study population, which was retrospectively reviewed. Conclusions Synovial sepsis of unknown origin is rare in the adult Thoroughbred racehorse and can affect a range of synovial structures. A concurrent potential source of bacteraemia is rarely identified. With appropriate management, the prognosis to return to racing is fair.

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Effect of arthroscopic lavage and repeated intra‐articular administrations of antibiotic in adult horses and foals with septic arthritis

Cited by 24 publications

References 29 publications

Factors Associated With Survival and Return to Function Following Synovial Infections in Horses

Factors Associated With Survival and Return to Function Following Synovial Infections in Horses

Investigation of Synovial Fluid Lubricants and Inflammatory Cytokines in the Horse: a Comparison of Recombinant Equine Interleukin 1β-induced Synovitis and Joint Lavage Models

Synovial sepsis of unknown origin in the adult Thoroughbred racehorse

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Effect of arthroscopic lavage and repeated intra‐articular administrations of antibiotic in adult horses and foals with septic arthritis

Cited by 24 publications

References 29 publications

Factors Associated With Survival and Return to Function Following Synovial Infections in Horses

Factors Associated With Survival and Return to Function Following Synovial Infections in Horses

Investigation of Synovial Fluid Lubricants and Inflammatory Cytokines in the Horse: a Comparison of Recombinant Equine Interleukin 1β-induced&nbsp;Synovitis and Joint Lavage Models

Synovial sepsis of unknown origin in the adult Thoroughbred racehorse

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Product

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Investigation of Synovial Fluid Lubricants and Inflammatory Cytokines in the Horse: a Comparison of Recombinant Equine Interleukin 1β-induced Synovitis and Joint Lavage Models