Nizolek D J, White K K
Cornell Vet. 1981 Oct;71(4):355-75.
Degenerative arthrosis is perhaps the most common debilitating disease of performance horses. Treatment should be based upon a knowledge of the anatomy and physiology of normal joints and upon an understanding of the processes of degeneration and repair. These topics are briefly reviewed. Although rest is probably, the most beneficial therapy, physical and pharmaceutical treatments are often employed in an effort to speed recovery. The effects and relative benefits of intrasynovial injections of corticosteroids, hyaluronica cid, and Arteparon are considered in detail. Although local corticosteroid therapy is inexpensive and is effective in reducing lameness caused by degenerative joint disease, it is rarely indicated. Septic arthritis and "steroid arthropathy" are two serious sequelae. Whereas the incidence of the former may be avoided through careful technique, the latter effect is inherent in the action of the drug. The accelerated rate of joint destruction observed in steroid arthropathy is due to suppression of chondrocyte metabolism and thus the processes of cartilage maintenance and repair. Hyaluronic acid is present in the synovial fluid and within the matrix of cartilage. The commercial preparation is no approved for use in the United States, but it is commonly obtained from other countries. Although hyaluronate apparently does not function in the lubrication of cartilage surfaces, it may improve lubrication of soft tissues thus decreasing resistance to joint movement and lessening pain. Reports substantiate the effectiveness of hyaluronic acid in treating early cases of degenerative arthrosis despite the fact that the drug does not significantly promote cartilage healing. Arteparon, a polysulfated glycosaminoglycan, has been used in Europe for two decades in the treatment of degeneration joint disease and is currently being tested in this country. The drug is deposited within diseased cartilage and improves the functional properties of the cartilage as well as stimulates cartilage metabolism.
退行性关节病可能是影响竞技用马的最常见的致残性疾病。治疗应基于对正常关节解剖学和生理学的了解，以及对退变和修复过程的认识。这些主题将作简要回顾。尽管休息可能是最有益的疗法，但为了加速恢复，常常采用物理和药物治疗。本文将详细探讨关节腔内注射皮质类固醇、透明质酸和阿替派隆的效果及相对益处。尽管局部皮质类固醇治疗价格低廉且能有效减轻由退行性关节病引起的跛行，但很少被采用。脓毒性关节炎和“类固醇性关节病”是两种严重的后遗症。前者的发生率可通过仔细操作来避免，而后者是药物作用所固有的。在类固醇性关节病中观察到的关节破坏加速是由于软骨细胞代谢受到抑制，进而影响软骨维持和修复过程。透明质酸存在于滑液和软骨基质中。这种商业制剂在美国未获批准使用，但通常可从其他国家获得。尽管透明质酸盐显然对软骨表面润滑不起作用，但它可能改善软组织的润滑，从而降低关节运动阻力并减轻疼痛。尽管该药物并不能显著促进软骨愈合，但有报告证实透明质酸在治疗早期退行性关节病病例中是有效的。阿替派隆是一种多硫酸化糖胺聚糖，在欧洲已用于治疗退行性关节病二十年，目前正在美国进行试验。该药物沉积在患病软骨内，可改善软骨的功能特性并刺激软骨代谢。
