Brommer H, Brama P A J, Barneveld A, van Weeren P R
Department of Equine Sciences, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 12, 3584 CM, Utrecht, The Netherlands.
Equine Vet J. 2004 Sep;36(6):506-10. doi: 10.2746/0425164044877369.
The equine metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints, although having virtually the same geometrical appearance, differ in the prevalence of joint pathologies, such as osteochondral fragmentation, and in biomechanical behaviour. The recently developed cartilage degeneration index (CDI) technique offers a possibility to assess quantitatively differences in cartilage degeneration between these joints and to compare these with known differences in biomechanics and clinical observations.
To compare the topographical distribution of articular cartilage degeneration across the proximal articular surface of the proximal phalanx (P1) in the equine fore- and hindlimb.
In 24 distal hindlimbs from 24 horses, articular cartilage degeneration of the proximal articular surface of P1 was quantified using the CDI. Overall CDI value (CDI(P1)) and CDI values of 6 areas of interest were determined: the medial dorsal surface (mds), lateral dorsal surface (lds), medial central fovea (mcf), lateral central fovea (lcf), medial plantar surface (mps) and lateral plantar surface (lps). The joints were divided into 4 equally sized groups of increasing CDI(P1) values. From an existing CDI database of MCP joints, 24 joints were selected with matching CDI(P1) values to the MTP joints and CDI values for the same areas of interest were determined.
In both the MCP and MTP joints, highest CDI values were determined at the dorsal articular surfaces. Values were not significantly different between fore- and hindlimbs. In contrast to the MCP joint, CDI values at the plantar joint margin were significantly higher compared to CDI values in the central sites in the MTP joint. CDI values for the plantar surfaces of P1 were significantly higher than those for the palmar surfaces in the forelimb in joints with advanced stages of OA; and values for the central regions of P1 were significantly lower in the hindlimb compared with the forelimb in joints with severe OA.
In both fore- and hindlimbs, initial cartilage degeneration started at the dorsal articular margin of P1. There was a major difference in the spread of cartilage degeneration; in the forelimb both the central and palmar parts are about equally involved, whereas in the hindlimb the plantar parts were significantly more and the central parts significantly less involved. These differences can be linked to differences in biomechanical loading reported elsewhere.
This study supports the hypothesis that differences in biokinematics between fore- and hindlimbs are associated with differences in the development of cartilage degeneration and other joint pathologies such as osteochondral fragmentation in the MCP and MTP joints. This information is indispensable for a better understanding of the dynamic nature and progression of these joint disorders and may be of help when monitoring the effects of therapeutic interventions and preventative measures.
马的掌指关节(MCP)和跖趾关节(MTP)虽然在几何外观上几乎相同,但在关节病变(如骨软骨碎裂)的发生率和生物力学行为方面存在差异。最近开发的软骨退变指数(CDI)技术为定量评估这些关节之间软骨退变的差异以及将这些差异与已知的生物力学和临床观察差异进行比较提供了可能。
比较马前肢和后肢近端指骨(P1)近端关节面关节软骨退变的地形分布。
在24匹马的24个后肢远端,使用CDI对P1近端关节面的关节软骨退变进行量化。确定总体CDI值(CDI(P1))和6个感兴趣区域的CDI值:内侧背侧表面(mds)、外侧背侧表面(lds)、内侧中央凹(mcf)、外侧中央凹(lcf)、内侧足底表面(mps)和外侧足底表面(lps)。将关节分为4个大小相等、CDI(P1)值递增的组。从现有的MCP关节CDI数据库中,选择24个与MTP关节CDI(P1)值匹配的关节,并确定相同感兴趣区域的CDI值。
在MCP和MTP关节中,背侧关节面的CDI值最高。前肢和后肢的值无显著差异。与MCP关节不同 , MTP关节足底关节边缘的CDI值显著高于中央部位的CDI值。在OA晚期的关节中,P1足底表面的CDI值显著高于前肢掌侧表面的CDI值;在严重OA的关节中,后肢P1中央区域的值显著低于前肢。
在前肢和后肢中,软骨退变均始于P1的背侧关节边缘。软骨退变的扩散存在主要差异;在前肢中,中央和掌侧部分受累程度大致相同,而后肢中足底部分受累明显更多,中央部分受累明显更少。这些差异可能与其他地方报道的生物力学负荷差异有关。
本研究支持以下假设,即前肢和后肢生物运动学的差异与软骨退变和其他关节病变(如MCP和MTP关节的骨软骨碎裂)发展的差异有关。这些信息对于更好地理解这些关节疾病的动态性质和进展是必不可少的,并且在监测治疗干预和预防措施的效果时可能会有所帮助。