Abstract:
Tarsocrural osteochondrosis (OCD) is a developmental orthopedic disease commonly affecting young Standardbreds, with different fragment localization and size. Clinically, it is characterized by variable synovial effusion in the absence of lameness, whose determinants are ill-defined. We hypothesized that localization and physical characteristics of the osteochondral fragments like dimensions, multifragmentation, and instability influence joint effusion and correlate with synovial markers of cartilage degradation and inflammation. Clinical data, synovial fluid and intact osteochondral fragments were collected from 79 Standardbred horses, aged between 12 and 18 months, operated for tarsocrural OCD. The severity of tarsocrural joint effusion was assessed semi-quantitatively. The osteochondral fragment site was defined radiographically at the distal intermediate ridge of the tibia (DIRT), medial malleolus (MM) of the tibia, and/or lateral trochlear ridge (LTR) of the talus. Size, stability, and arthroscopic appearance (unique or multi-fragmented aspect) of the fragments were determined intra-operatively. Synovial concentrations of C-terminal cross-linked telopeptides of type II collagen (CTX-II), leukotriene B4 (LTB4), and prostaglandin E2 (PGE2) were quantified. Tarsocrural synovial effusion was significantly affected by localization and stability of the fragments, with MM-located and unstable fragments being associated with highest joint effusion. Concentrations of CTX-II, LTB4, and PGE2 positively correlated with the severity of synovial effusion. This study underlines characteristics of the osteochondral fragments determining higher synovial effusion in OCD-affected tarsocrural joints and suggests both inflammation and extra-cellular matrix degradation are active processes in OCD pathology.
摘要:
颅骨骨软骨病(OCD)是一种发育性骨科疾病,通常会影响年轻的标准犬,具有不同的片段定位和大小。临床上,它的特点是在没有跛行的情况下可变的滑膜积液,其决定因素定义不明确。我们假设骨软骨碎片的定位和物理特征,多重碎片,和不稳定性影响关节积液,并与软骨降解和炎症的滑膜标志物相关。临床数据,滑液和完整的骨软骨碎片是从79匹标准马收集的,年龄在12至18个月之间,手术治疗强迫症。半定量评估了滑膜关节积液的严重程度。骨软骨碎片部位在胫骨远端中脊(DIRT)的影像学上确定,胫骨内踝(MM),和/或距骨的外侧滑车脊(LTR)。尺寸,稳定性,术中确定碎片的关节镜外观(独特或多片段方面)。Ⅱ型胶原(CTX-Ⅱ)C端交联端肽的滑膜浓度,白三烯B4(LTB4),和前列腺素E2(PGE2)进行定量。碎片的定位和稳定性显著影响了颅骨滑膜积液,MM定位和不稳定的碎片与最高的关节积液有关。CTX-II的浓度,LTB4和PGE2与滑膜积液的严重程度呈正相关。这项研究强调了骨软骨碎片的特征,这些骨软骨碎片决定了受OCD影响的tarsocural关节中更高的滑膜积液,并表明炎症和细胞外基质降解都是OCD病理学中的活跃过程。