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OBJECTIVE: To determine historical, physical, and microbiologic findings in horses with limb cellulitis and identify factors associated with short- and long-term outcome. DESIGN: Retrospective case series. ANIMALS: 44 horses with limb cellulitis. PROCEDURES: Information obtained from medical records included use, history, affected limb, diagnostic procedures, treatment, and short-term outcome. Long-term follow-up information was obtained by means of a telephone survey. RESULTS: Twenty-four horses had primary cellulitis, and 18 of the 24 (75%) had a hind limb affected. Results of microbiologic culture were positive for all 20 horses with primary cellulitis from which specimens were obtained, with coagulase-positive Staphylococcus spp recovered from 12 of the 20. Short-term survival rate was 67% (16/24) for horses with primary cellulitis; 7 of the 9 horses available for long-term follow-up were being used for their intended use, and 4 had had a recurrence. Results of microbiologic culture were positive for 13 of the 16 (81%) horses with secondary cellulitis from which specimens were obtained. Short-term survival rate for horses with secondary cellulitis was 90% (18/20). Eleven of the 17 horses available for long-term follow-up were being used for their intended use; 2 had had a recurrence. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that cellulitis can be a life-threatening condition in horses. Horses that were febrile at admission or that developed laminitis were significantly less likely to survive. The prognosis for return to function was guarded, and recurrence was a potential concern.  相似文献   
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OBJECTIVE: To assess the long-term clinical outcome of horses with distal tarsal osteoarthritis (OA) in which a 3-drill-tract technique was used to induce arthrodesis of the affected joints, identify any preoperative or operative factors associated with outcome, and describe any complications associated with the technique. DESIGN: Retrospective study. ANIMALS: 54 horses. PROCEDURE: Medical records were reviewed for information on signalment, use, history, physical and lameness examination findings, surgical technique, and postoperative care. Radiographs were examined, and severity of OA was graded. Follow-up information was obtained through telephone interviews with owners at least 13 months after the procedure. RESULTS: 32 (59%) horses had a successful outcome, 6 (11%) improved but were not sound after surgery, and 16 (30%) did not improve following surgery. Outcome was negatively associated with the previous use of intra-articular injections. Few postoperative complications were evident. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that distal tarsal OA in horses can be successfully treated by means of distal tarsal arthrodesis with a 3-drill-tract technique. Horses with advanced distal tarsal OA are likely to have poorer outcomes, and the procedure will likely be of minimal benefit in horses with concomitant causes of hind limb lameness prior to surgery and in horses with preexisting proximal intertarsal joint disease.  相似文献   
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OBJECTIVE: To evaluate the use of hydrothermal ablation of articular cartilage for arthrodesis in horses through investigation of the effects of joint lavage with physiologic saline (0.9% NaCI) solution (80 degrees C) for various treatment times on chondrocyte viability in the articular cartilage of the metacarpophalangeal and metatarsophalangeal joints of cadaveric horse limbs. Sample Population-7 pairs of metacarpophalangeal and 8 pairs of metatarsophalangeal joints from 8 Thoroughbreds. PROCEDURE: The horses were euthanatized for reasons unrelated to musculoskeletal disease. On a random basis, 1 joint of each pair underwent intra-articular lavage for 5, 10, or 15 minutes with heated saline solution (80 degrees C); the other joint underwent sham treatment of similar duration with saline solution at 22 degrees C (control). Cartilage samples from the distal articular surface of metacarpus III (or metatarsus III), the proximal surface of the proximal phalanx, and the lateral and medial proximal sesamoid bones were assessed for chondrocyte viability via confocal microscopy and viability staining following enzymatic digestion. RESULTS: Compared with the control joints, findings of both viability assays indicated that the percentage of sites containing viable chondrocytes in heat-treated joints was decreased.Treatment hazard ratios of 0.048 (confocal microscopy) and 0.2 (digestion assay) were estimated. Histologically, periarticular soft tissues had minimal detrimental effects after heat treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Ex vivo intra-articular lavage with saline solution at 80 degrees C resulted in the death of almost all articular chondrocytes in the joint. This technique may be a satisfactory method for extensive cartilage ablation when performing arthrodesis by minimally invasive techniques.  相似文献   
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Delivery of growth factors using gene therapy to enhance bone healing   总被引:7,自引:0,他引:7  
OBJECTIVE: To review the delivery of growth factors using gene therapy for enhancing long-bone fracture healing. STUDY DESIGN: Literature review. METHODS: MEDLINE and CAB Abstracts literature search (1980-2004). RESULTS: Non-union and infected non-union are relatively common complications of long-bone fractures in human and veterinary patients. Growth factors are cytokines that regulate many cell functions important in fracture healing. Exogenous growth factors can be delivered to the fracture site as recombinant proteins or using gene therapy. Recombinant human bone morphogenetic protein-2 and -7 (rhBMP-2 and -7), in particular, enhance fracture healing in numerous experimental and clinical studies. Some limitations with use of recombinant proteins may be overcome by use of gene therapy. Gene therapy involves delivery of the growth factor gene to cells at the fracture site using a viral or non-viral vector. The gene is then expressed (protein synthesis) by cells at the fracture site. Delivery of the BMP gene to the fracture site using gene therapy has been evaluated in laboratory animal models of non-union, with favorable results and without complications. CONCLUSION: Delivery of growth factors, particularly members of BMP family, to the fracture site using gene therapy may be a method to enhance fracture healing. Use of this technology may improve the prognosis for patients with long-bone fractures. CLINICAL RELEVANCE: Clinical application of gene therapy could improve the prognosis for human and veterinary patients with long-bone fractures, but has not been evaluated clinically.  相似文献   
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REASON FOR PERFORMING STUDY: The effectiveness and best method to perform a partial arytenoidectomy in racehorses is unclear. This study was performed to evaluate the success of and complications that can occur after a unilateral partial arytenoidectomy with primary mucosal closure in Thoroughbred racehorses. HYPOTHESIS: Partial arytenoidectomy is an effective surgical procedure to return Thoroughbred racehorses, afflicted by arytenoid chondropathy or a failed laryngoplasty, to preoperative levels of performance. METHODS: Seventy-six Thoroughbred racehorses admitted to the New Bolton Centre between 1992 and 2006 were assessed. Information was obtained from the medical records about the horse, laryngeal abnormalities, surgery and other findings during hospitalisation. Racing information was evaluated relative to those independent variables by an analysis of variance with a level of significance of P<0.05. RESULTS: Arytenoid chondropathy was the presenting complaint in 54 horses and failed laryngoplasty in 22 horses. Thirteen horses (17%) underwent a second surgery for laser excision of intralaryngeal granulation tissue at the arytenoidectomy site. Seventy-three horses were discharged from the hospital and racing outcome was evaluated. Sixty horses (82%) raced after surgery and 46 horses (63%) raced 5 or more times after surgery. The median time from surgery to the first start was 6 months. The average earnings/start was not significantly different before and after surgery. There was no association between earnings after surgery and age, gender, location of lesion, type of lesion, duration of tracheal intubation or undergoing a second surgery. CONCLUSIONS AND POTENTIAL RELEVANCE: A Thoroughbred racehorse is likely to race after a unilateral partial arytenoidectomy with primary mucosal closure and return to a preoperative level of performance.  相似文献   
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