Evaluation of an intra-articular carboxymethylcellulose crosslinked hydrogel in horses with osteoarthritis.
Authors: Rinnovati R, Spadari A, Malpighi A, Meistro F, Ralletti M V, Marcucci E, Tarasconi M A, Chiatto R Lo, Tommasa S Della
Journal: Journal of equine veterinary science
Summary
# Evaluating Carboxymethylcellulose Hydrogel for Equine Osteoarthritis Researchers from Italy compared intra-articular injection of a carboxymethylcellulose (CMC) hydrogel against a combination of triamcinolone acetonide and hyaluronic acid in 30 sport horses with metacarpophalangeal joint osteoarthritis, hypothesising that CMC would produce sustained lameness reduction compared to conventional treatment. The study employed a randomised controlled design with lameness assessed at baseline, 15, 30, and 90 days using standardised AAEP scoring, with success defined as ≥1 grade improvement without additional intervention. Whilst conventional treatment showed faster initial results (90% of control horses improved by day 15 versus only 20% of CMC-treated horses), the trajectory diverged markedly by 90 days: 75% of CMC-treated horses achieved success with a mean lameness score of 1.3, compared to just 7.1% in the control group (P = 0.001). The delayed onset but superior long-term outcome suggests CMC hydrogel may offer distinct advantages for horses requiring sustained joint support, though practitioners should counsel owners about the slower initial response and counsel cautiously given the small control group success rate. This finding warrants consideration in treatment planning, particularly for performance horses where durability of effect beyond the initial post-injection window could prove economically and welfare-significant.
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Practical Takeaways
- •CMC hydrogel may be a more durable option for OA management in sport horses, particularly for cases where sustained lameness reduction beyond 30 days is desired
- •The delayed onset (first improvement visible around 30 days) means owner expectations must be managed differently compared to corticosteroid/HA combinations that act faster
- •Consider CMC for horses where repeated injections may be problematic, as the 90-day superiority suggests longer therapeutic window than traditional treatments
Key Findings
- •CMC hydrogel achieved 75% success rate at 90 days vs 7.1% in corticosteroid/HA control group (P=0.001)
- •CMC showed delayed onset of action (20% improved at 15 days vs 90% controls) but superior long-term durability
- •Mean lameness score reduction was 1.3±0.6 in CMC group vs 0.2±0.4 in control group at 90 days
- •Both treatments achieved equivalent 75% success at 30 days, indicating sustained benefit beyond early response phase