ADVANCES IN TREATMENT OF
OSTEOARTHRITIS
Michael Schramme
VetAgro Sup, Campus Vétérinaire de Lyon, Marcy L’Etoile, Rhône-Alpes, France
Treatment of joint diseases in the horse are determined by two axiomatic
concepts:
(1) Established osteoarthritis cannot be cured and
(2) In spite of the current classification of arthritis drugs in SMOADS (symptom
modifying osteoarthritis drugs) and DMOADS (disease modifying osteoarthritis
drugs), clinically demonstrable disease modification has yet to be achieved. In
other words, we aim to improve lameness while knowing we cannot cure its
cause.
Modified Classification of Traumatic Joint Diseases in Horses
In order to make the appropriate selection of drug best suited for the treatment
of joint pain in individual patients, it is helpful to know which type or stage of
disease the clinician is faced with. It is therefore important to know the
different types of joint disease and to be able to be able to make the clinical
and imaging distinction between them based on an accurate diagnosis. In
broad terms, we recognize joint pain due to soft tissue inflammation (synovitis
and capsulitis), traumatic joint sprains with damage to articular structures like
cartilage, bone, menisci or ligaments, primary subchondral bone injuries as
recognized in the condyles of the third metacarpal bone and radial facet of the
third carpal bone and osteoarthritis.
• Synovitis and capsulitis: post-traumatic joint conditions with
inflammation of the synovial membrane and / or the fibrous joint
capsule, but without articular cartilage damage or disruption of
supporting structures.
• Traumatic joint sprains: in addition to synovitis/capsulitis, joint trauma
may also result in direct damage to the articular cartilage and
supporting joint structures (ligaments, menisci) and/or intra-articular
fractures
1. Mild to moderate sprain: stretching or partial tearing of
collateral ligament
2. Severe sprain: complete loss of continuity and function
of the ligament with separation of the ends. Separation
may occur within the substance of the ligament or at
one of its attachments.
3. Subluxation and luxation: joint inflammation with (partial)
disruption of collateral ligament and loss of articular
congruity
4. Intra-articular fractures: chip fractures, slab fractures,
comminuted fractures, all progress to degenerative
osteoarthritis if left untreated
15-‐18
February
2016
East
London
Convention
Centre,
East
London,
South
Africa
152