Tnibar Aziz, Schougaard Hans, Camitz Linus, Rasmussen Jonas, Koene Marc, Jahn Werner, Markussen Bo
Department of Large Animal Sciences, Faculty of Health and Medical Sciences, University of Copenhagen, Hoejbakkegaard alle 5, DK-2630, Taastrup, Denmark.
Noerlund Hestehospital, Roedebækvej 2, DK-8653, Them, Denmark.
Acta Vet Scand. 2015 Apr 15;57(1):20. doi: 10.1186/s13028-015-0110-6.
Polyacrylamide hydrogel (PAAG) was evaluated recently to treat osteoarthritis (OA) in horses with highly encouraging results; however no long term field-study was done to explore its clinical efficacy and lasting effect. The objective of this study was to evaluate the efficacy of PAAG in improving clinical signs of OA in horses. We hypothesized that lameness grade would significantly improve and the effect would last at least 2 years in osteoarthritic joints treated with PAAG. Forty three horses older than 2 years with OA in only one joint based on clinical evaluation, intra-articular anaesthesia and imaging (radiography) were included in this study. Horses were injected with 2 ml of PAAG into the affected joint and were followed up at 1, 3, 6, 12 and 24 months. Efficacy of PAAG was evaluated by blinded clinical assessment of lameness. Adverse reactions to joint injection were assessed. Data relating to case details, type of activity, joint and limb involved, lameness duration, lameness grading, previous joint treatment, joint effusion grading, radiographic grading, and owner assessment were recorded. Factors associated with the outcome measure "lameness grading" were analyzed using generalized linear mixed model for logistic regression.
At 1, 3, 6, 12 and 24 months follow-up, 59%, 69%, 79%, 81/% and 82.5% of horses were non-lame respectively. Reduction of joint effusion was observed over time. No side effect was observed in the treated joints. There was a significant decrease in lameness grade from baseline to 1, 3, 6, 12 and 24 months (P < 0.0001) and a significant positive association with joint effusion (P < 0.0001). Estimates for odds ratio (OR) showed that the effect of treatment increased over time (OR for lower lameness from month 1 to month 24 relative to baseline increased from 20 to 58).
PAAG significantly alleviated lameness and joint effusion in osteoarthritic joints. PAAG is a safe and lasting (at least 24 months) OA treatment in horses. PAAG is a promising new treatment for OA in horses.
最近对聚丙烯酰胺水凝胶（PAAG）治疗马骨关节炎（OA）进行了评估，结果令人鼓舞；然而，尚未进行长期的实地研究来探索其临床疗效和持久效果。本研究的目的是评估PAAG改善马OA临床症状的疗效。我们假设，在接受PAAG治疗的骨关节炎关节中，跛行等级将显著改善，且效果至少持续2年。本研究纳入了43匹2岁以上、仅一个关节患有OA的马，这些马基于临床评估、关节内麻醉和影像学检查（X线摄影）确诊。将2毫升PAAG注入患关节，在1、3、6、12和24个月进行随访。通过对跛行进行盲法临床评估来评价PAAG的疗效。评估关节注射的不良反应。记录与病例细节、活动类型、受累关节和肢体、跛行持续时间、跛行分级、既往关节治疗、关节积液分级、影像学分级和主人评估相关的数据。使用广义线性混合模型进行逻辑回归分析与结果指标“跛行分级”相关的因素。
在1、3、6、12和24个月的随访中，分别有59%、69%、79%、81%和82.5%的马无跛行。随着时间的推移，观察到关节积液减少。在治疗的关节中未观察到副作用。从基线到1、3、6、12和24个月，跛行等级显著降低（P < 0.0001），且与关节积液呈显著正相关（P < 0.0001）。优势比（OR）估计显示，治疗效果随时间增加（相对于基线，从第1个月到第24个月跛行程度降低的OR从20增加到58）。
PAAG显著减轻了骨关节炎关节的跛行和关节积液。PAAG是一种安全且持久（至少24个月）的马OA治疗方法。PAAG是一种有前景的马OA新治疗方法。
