Wayne McIlwraith, BVSc, PhD, FRCVS, DSc, DrMedVet (hc), Dipl. ACVS, Barbara Cox Anthony Chair and Director of Orthopaedic Research at Colorado State University, spoke on current and new therapeutic options to manage musculoskeletal injuries and osteoarthritis at the AAEP Focus meeting in Ft. Collins, Colo., on July 29.

He reminded the veterinary audience that interleukin-1 (a deleterious cytokine) is at the head of the inflammatory cascade, leading to a breakdown in the cartilage matrix through signaling factors that alter regulation and effect of inflammatory biochemical mediators. The goals of therapeutic intervention focus on returning a joint to normal as quickly as possible, when possible, and to prevent the occurrence and severity of osteoarthritis in an injured joint.

McIlwraith discussed intervention that targets management of capsulitis (joint capsule inflammation) and synovitis (inflammation of the synovial membrane lining the joint), since these tend to occur in advance of degenerative joint disease. One strategy that merits more investigation is physiotherapy, such as swimming or underwater treadmill therapy. This might be cutting-edge therapy, but more research and data is necessary to determine the extent of its value. One point McIlwraith made of great interest is the recent finding that two-thirds of the force across the carpus (knee) at the trot comes from muscle forces, rather than ground reaction forces as previously believed.

McIlwraith mentioned that extracorporeal shock wave therapy (ESWT) significantly reduces lameness and synovial fluid parameters as compared to control horses (those not receiving treatment) in the study; these findings support a pain and inflammatory mechanism of action that elicits lameness