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Osteoarthritis (OA) continues to be one of the most common causes of equine lameness. Although several therapeutic approaches have been shown to be beneficial in the treatment of OA, intra-articular medication remains one of the most effective treatment options. Since OA and its successful treatment is the subject of intensive ongoing research a vast quantity of scientific data regarding effectiveness, dosage and mechanism of action for joint medications is available.
Evidence-based medicine is the judicious use of the current best available scientific research in making decisions about the care of individual patients. The practice of evidence-based medicine means integrating one’s individual clinical expertise with the best available external clinical evidence from systematic research. Communicating evidence-based information about a clinical condition and the treatment options available helps the owner to make informed decisions about their animal.
Based on a systematic review of the current literature, relevant information about commonly used intra-articular joint medications as well as regenerative and innovative medications was summarised. Joint medication was shown to be a low-risk procedure when performed according to the standards of good veterinary practice.
Further the concentration of interleukin-1 repector antagonist (IL-1Ra) and IL-1β was determined in the synovial fluid (SF) and serum (SE) of horses with different grades of joint disease using equine specific ELISA systems. The concentration of IL-Ra in SF and IL-1β in SE appear to reflect the severity of intra-synovial inflammation. Modern equine specific ELISA tests have improved our capability to detect levels of biochemical parameters in SF and SE of horses with clinical joint disease. IL-1Ra in SF in combination with further biomarkers might be useful to assess the extent of intra-synovial inflammation. These results require a larger number of clinical cases to be utilized in order to confirm the benefit of using the equine specific ELISA. There remains a great deal of further experimentation to be undertaken to develop a testing system, which will reliably indicate the severity of joint disease in the horse.