A longitudinal study of fractures in 1488 Thoroughbred racehorses receiving intrasynovial medication: 2006–2011
Summary Background There is a need for investigation of associations between intrasynovial medication and fracture risk in racehorses. Objectives To document the proportion and type of fracture occurring following intrasynovial medication. Study design Retrospective longitudinal study. Methods Revie...
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| Veröffentlicht in: | Equine veterinary journal 2018-11, Vol.50 (6), p.774-780 |
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| creator | Smith, L. C. R. Wylie, C. E. Palmer, L. Ramzan, P. H. L. |
| description | Summary
Background
There is a need for investigation of associations between intrasynovial medication and fracture risk in racehorses.
Objectives
To document the proportion and type of fracture occurring following intrasynovial medication.
Study design
Retrospective longitudinal study.
Methods
Review of clinical records from all Thoroughbred flat racehorses receiving intrasynovial medication under the care of a first‐opinion veterinary practice between 2006 and 2011. Fractures pre‐ and post‐medication were categorised by location, type, and severity; analysis of fractures sustained within 56‐days of medication was undertaken. Survival analyses using Cox proportional hazards models were conducted for associations between medication used (corticosteroid vs. non‐corticosteroid), age at first medication, sex and total number of medications and fracture.
Results
A total of 1488 horses received intrasynovial medication during the period of study; 8692 synovial spaces were medicated in 3925 sessions. There were 96 fractures that occurred within 56‐days of medication, of which 44 were classified as ‘serious’ (44/1488; 3.0% total population, 95% CI 2.1, 3.8%) and 11 (11/1488, 0.7%, 95% CI 0.3, 1.2%) were euthanased due to severity of injury. Fifty‐four of 96 cases (56.4%, 95% CI 46.3, 66.2%) returned to racing. Targeted imaging of the subsequent injury site was undertaken prior to injury in only 7 (7/96, 7.3%) horses that injured post‐medication. Horses that had received ≥3 previous intrasynovial medication sessions had an increased hazard of sustaining a fracture within 56 days (HR 2.31, 95% CI 1.51, 3.54, P |
| doi_str_mv | 10.1111/evj.12833 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_2018667810</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2018667810</sourcerecordid><originalsourceid>FETCH-LOGICAL-c3533-7cfafd1c6bdbe6bc70792fd9175f240d256c2961a3f4e351a7f70fcea81fcd783</originalsourceid><addsrcrecordid>eNp1kc1O4zAURq0RaCgwC14AWWIDi1BfO7FTdhXib4TEBmYbOY5dXKUx2ElRd7zDvCFPwmVaZoGEN77WPTqyvo-QA2CngGdsl_NT4KUQP8iIs5xnQjC5RUY4FhnIPN8huynNGROC5_wn2eGTQhWg1Ig8T2kbupnvh8Z3uqUJhxUNjrqoTT9Em6jvKORlSe8fQwzD7LGOtqG4tfhOuI_WWL_03QzJPuq06sLSo2phG29070N3Rjlj8u31L2cA-2Tb6TbZX5t7jzxcXtyfX2e3d1c359PbzIhCiEwZp10DRtZNbWVtFFMT7poJqMLxnDW8kIZPJGjhcisK0Mop5ozVJTjTqFLskeO19ymG58Gmvlr4ZGzb6s6GIVX4l1JKVQJD9OgLOg9DxDiQAhCS5arkSJ2sKRNDStG66in6hY6rClj10UOFPVT_ekD2cGMcaszhP_kZPALjNfDiW7v63lRd_Pm9Vr4D6bCSRA</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2113604782</pqid></control><display><type>article</type><title>A longitudinal study of fractures in 1488 Thoroughbred racehorses receiving intrasynovial medication: 2006–2011</title><source>MEDLINE</source><source>Wiley Online Library All Journals</source><creator>Smith, L. C. R. ; Wylie, C. E. ; Palmer, L. ; Ramzan, P. H. L.</creator><creatorcontrib>Smith, L. C. R. ; Wylie, C. E. ; Palmer, L. ; Ramzan, P. H. L.</creatorcontrib><description>Summary
Background
There is a need for investigation of associations between intrasynovial medication and fracture risk in racehorses.
Objectives
To document the proportion and type of fracture occurring following intrasynovial medication.
Study design
Retrospective longitudinal study.
Methods
Review of clinical records from all Thoroughbred flat racehorses receiving intrasynovial medication under the care of a first‐opinion veterinary practice between 2006 and 2011. Fractures pre‐ and post‐medication were categorised by location, type, and severity; analysis of fractures sustained within 56‐days of medication was undertaken. Survival analyses using Cox proportional hazards models were conducted for associations between medication used (corticosteroid vs. non‐corticosteroid), age at first medication, sex and total number of medications and fracture.
Results
A total of 1488 horses received intrasynovial medication during the period of study; 8692 synovial spaces were medicated in 3925 sessions. There were 96 fractures that occurred within 56‐days of medication, of which 44 were classified as ‘serious’ (44/1488; 3.0% total population, 95% CI 2.1, 3.8%) and 11 (11/1488, 0.7%, 95% CI 0.3, 1.2%) were euthanased due to severity of injury. Fifty‐four of 96 cases (56.4%, 95% CI 46.3, 66.2%) returned to racing. Targeted imaging of the subsequent injury site was undertaken prior to injury in only 7 (7/96, 7.3%) horses that injured post‐medication. Horses that had received ≥3 previous intrasynovial medication sessions had an increased hazard of sustaining a fracture within 56 days (HR 2.31, 95% CI 1.51, 3.54, P<0.001) compared with those receiving ≤3 medication sessions, adjusted for each increasing year of age (HR 0.67, 95% CI 0.53, 0.86, P = 0.001).
Main limitations
Absence of an unexposed cohort of nonmedicated racehorses.
Conclusions
Serious musculoskeletal injury following intrasynovial medication occurred in 3% (44/1488) horses. Reduction in injury rates may be possible through greater use of premedication diagnostic imaging.</description><identifier>ISSN: 0425-1644</identifier><identifier>EISSN: 2042-3306</identifier><identifier>DOI: 10.1111/evj.12833</identifier><identifier>PMID: 29575177</identifier><language>eng</language><publisher>United States: Wiley Subscription Services, Inc</publisher><subject><![CDATA[Animals ; Anti-Inflammatory Agents - administration & dosage ; corticosteroids ; Dexamethasone - administration & dosage ; Female ; fracture ; Fractures ; Fractures, Bone - epidemiology ; Fractures, Bone - etiology ; Fractures, Bone - veterinary ; horse ; Horses ; Horses - classification ; Horses - injuries ; Hyaluronic Acid - administration & dosage ; Injections, Intra-Articular - veterinary ; Longitudinal Studies ; Male ; Methylprednisolone Acetate - administration & dosage ; racehorse ; Racehorses ; Retrospective Studies ; Risk Factors ; Running - injuries ; Statistical models ; Survival Analysis ; Synovial Membrane ; Thoroughbred ; Triamcinolone Acetonide - administration & dosage ; Viscosupplements - administration & dosage]]></subject><ispartof>Equine veterinary journal, 2018-11, Vol.50 (6), p.774-780</ispartof><rights>2018 EVJ Ltd</rights><rights>2018 EVJ Ltd.</rights><rights>Copyright © 2018 EVJ Ltd</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c3533-7cfafd1c6bdbe6bc70792fd9175f240d256c2961a3f4e351a7f70fcea81fcd783</citedby><cites>FETCH-LOGICAL-c3533-7cfafd1c6bdbe6bc70792fd9175f240d256c2961a3f4e351a7f70fcea81fcd783</cites><orcidid>0000-0001-5854-5650 ; 0000-0001-8076-4235 ; 0000-0002-5294-1123</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fevj.12833$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fevj.12833$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27923,27924,45573,45574</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/29575177$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Smith, L. C. R.</creatorcontrib><creatorcontrib>Wylie, C. E.</creatorcontrib><creatorcontrib>Palmer, L.</creatorcontrib><creatorcontrib>Ramzan, P. H. L.</creatorcontrib><title>A longitudinal study of fractures in 1488 Thoroughbred racehorses receiving intrasynovial medication: 2006–2011</title><title>Equine veterinary journal</title><addtitle>Equine Vet J</addtitle><description>Summary
Background
There is a need for investigation of associations between intrasynovial medication and fracture risk in racehorses.
Objectives
To document the proportion and type of fracture occurring following intrasynovial medication.
Study design
Retrospective longitudinal study.
Methods
Review of clinical records from all Thoroughbred flat racehorses receiving intrasynovial medication under the care of a first‐opinion veterinary practice between 2006 and 2011. Fractures pre‐ and post‐medication were categorised by location, type, and severity; analysis of fractures sustained within 56‐days of medication was undertaken. Survival analyses using Cox proportional hazards models were conducted for associations between medication used (corticosteroid vs. non‐corticosteroid), age at first medication, sex and total number of medications and fracture.
Results
A total of 1488 horses received intrasynovial medication during the period of study; 8692 synovial spaces were medicated in 3925 sessions. There were 96 fractures that occurred within 56‐days of medication, of which 44 were classified as ‘serious’ (44/1488; 3.0% total population, 95% CI 2.1, 3.8%) and 11 (11/1488, 0.7%, 95% CI 0.3, 1.2%) were euthanased due to severity of injury. Fifty‐four of 96 cases (56.4%, 95% CI 46.3, 66.2%) returned to racing. Targeted imaging of the subsequent injury site was undertaken prior to injury in only 7 (7/96, 7.3%) horses that injured post‐medication. Horses that had received ≥3 previous intrasynovial medication sessions had an increased hazard of sustaining a fracture within 56 days (HR 2.31, 95% CI 1.51, 3.54, P<0.001) compared with those receiving ≤3 medication sessions, adjusted for each increasing year of age (HR 0.67, 95% CI 0.53, 0.86, P = 0.001).
Main limitations
Absence of an unexposed cohort of nonmedicated racehorses.
Conclusions
Serious musculoskeletal injury following intrasynovial medication occurred in 3% (44/1488) horses. Reduction in injury rates may be possible through greater use of premedication diagnostic imaging.</description><subject>Animals</subject><subject>Anti-Inflammatory Agents - administration & dosage</subject><subject>corticosteroids</subject><subject>Dexamethasone - administration & dosage</subject><subject>Female</subject><subject>fracture</subject><subject>Fractures</subject><subject>Fractures, Bone - epidemiology</subject><subject>Fractures, Bone - etiology</subject><subject>Fractures, Bone - veterinary</subject><subject>horse</subject><subject>Horses</subject><subject>Horses - classification</subject><subject>Horses - injuries</subject><subject>Hyaluronic Acid - administration & dosage</subject><subject>Injections, Intra-Articular - veterinary</subject><subject>Longitudinal Studies</subject><subject>Male</subject><subject>Methylprednisolone Acetate - administration & dosage</subject><subject>racehorse</subject><subject>Racehorses</subject><subject>Retrospective Studies</subject><subject>Risk Factors</subject><subject>Running - injuries</subject><subject>Statistical models</subject><subject>Survival Analysis</subject><subject>Synovial Membrane</subject><subject>Thoroughbred</subject><subject>Triamcinolone Acetonide - administration & dosage</subject><subject>Viscosupplements - administration & dosage</subject><issn>0425-1644</issn><issn>2042-3306</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2018</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kc1O4zAURq0RaCgwC14AWWIDi1BfO7FTdhXib4TEBmYbOY5dXKUx2ElRd7zDvCFPwmVaZoGEN77WPTqyvo-QA2CngGdsl_NT4KUQP8iIs5xnQjC5RUY4FhnIPN8huynNGROC5_wn2eGTQhWg1Ig8T2kbupnvh8Z3uqUJhxUNjrqoTT9Em6jvKORlSe8fQwzD7LGOtqG4tfhOuI_WWL_03QzJPuq06sLSo2phG29070N3Rjlj8u31L2cA-2Tb6TbZX5t7jzxcXtyfX2e3d1c359PbzIhCiEwZp10DRtZNbWVtFFMT7poJqMLxnDW8kIZPJGjhcisK0Mop5ozVJTjTqFLskeO19ymG58Gmvlr4ZGzb6s6GIVX4l1JKVQJD9OgLOg9DxDiQAhCS5arkSJ2sKRNDStG66in6hY6rClj10UOFPVT_ekD2cGMcaszhP_kZPALjNfDiW7v63lRd_Pm9Vr4D6bCSRA</recordid><startdate>201811</startdate><enddate>201811</enddate><creator>Smith, L. C. R.</creator><creator>Wylie, C. E.</creator><creator>Palmer, L.</creator><creator>Ramzan, P. H. L.</creator><general>Wiley Subscription Services, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>K9.</scope><scope>7X8</scope><orcidid>https://orcid.org/0000-0001-5854-5650</orcidid><orcidid>https://orcid.org/0000-0001-8076-4235</orcidid><orcidid>https://orcid.org/0000-0002-5294-1123</orcidid></search><sort><creationdate>201811</creationdate><title>A longitudinal study of fractures in 1488 Thoroughbred racehorses receiving intrasynovial medication: 2006–2011</title><author>Smith, L. C. R. ; Wylie, C. E. ; Palmer, L. ; Ramzan, P. H. L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c3533-7cfafd1c6bdbe6bc70792fd9175f240d256c2961a3f4e351a7f70fcea81fcd783</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2018</creationdate><topic>Animals</topic><topic>Anti-Inflammatory Agents - administration & dosage</topic><topic>corticosteroids</topic><topic>Dexamethasone - administration & dosage</topic><topic>Female</topic><topic>fracture</topic><topic>Fractures</topic><topic>Fractures, Bone - epidemiology</topic><topic>Fractures, Bone - etiology</topic><topic>Fractures, Bone - veterinary</topic><topic>horse</topic><topic>Horses</topic><topic>Horses - classification</topic><topic>Horses - injuries</topic><topic>Hyaluronic Acid - administration & dosage</topic><topic>Injections, Intra-Articular - veterinary</topic><topic>Longitudinal Studies</topic><topic>Male</topic><topic>Methylprednisolone Acetate - administration & dosage</topic><topic>racehorse</topic><topic>Racehorses</topic><topic>Retrospective Studies</topic><topic>Risk Factors</topic><topic>Running - injuries</topic><topic>Statistical models</topic><topic>Survival Analysis</topic><topic>Synovial Membrane</topic><topic>Thoroughbred</topic><topic>Triamcinolone Acetonide - administration & dosage</topic><topic>Viscosupplements - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Smith, L. C. R.</creatorcontrib><creatorcontrib>Wylie, C. E.</creatorcontrib><creatorcontrib>Palmer, L.</creatorcontrib><creatorcontrib>Ramzan, P. H. L.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><jtitle>Equine veterinary journal</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Smith, L. C. R.</au><au>Wylie, C. E.</au><au>Palmer, L.</au><au>Ramzan, P. H. L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A longitudinal study of fractures in 1488 Thoroughbred racehorses receiving intrasynovial medication: 2006–2011</atitle><jtitle>Equine veterinary journal</jtitle><addtitle>Equine Vet J</addtitle><date>2018-11</date><risdate>2018</risdate><volume>50</volume><issue>6</issue><spage>774</spage><epage>780</epage><pages>774-780</pages><issn>0425-1644</issn><eissn>2042-3306</eissn><abstract>Summary
Background
There is a need for investigation of associations between intrasynovial medication and fracture risk in racehorses.
Objectives
To document the proportion and type of fracture occurring following intrasynovial medication.
Study design
Retrospective longitudinal study.
Methods
Review of clinical records from all Thoroughbred flat racehorses receiving intrasynovial medication under the care of a first‐opinion veterinary practice between 2006 and 2011. Fractures pre‐ and post‐medication were categorised by location, type, and severity; analysis of fractures sustained within 56‐days of medication was undertaken. Survival analyses using Cox proportional hazards models were conducted for associations between medication used (corticosteroid vs. non‐corticosteroid), age at first medication, sex and total number of medications and fracture.
Results
A total of 1488 horses received intrasynovial medication during the period of study; 8692 synovial spaces were medicated in 3925 sessions. There were 96 fractures that occurred within 56‐days of medication, of which 44 were classified as ‘serious’ (44/1488; 3.0% total population, 95% CI 2.1, 3.8%) and 11 (11/1488, 0.7%, 95% CI 0.3, 1.2%) were euthanased due to severity of injury. Fifty‐four of 96 cases (56.4%, 95% CI 46.3, 66.2%) returned to racing. Targeted imaging of the subsequent injury site was undertaken prior to injury in only 7 (7/96, 7.3%) horses that injured post‐medication. Horses that had received ≥3 previous intrasynovial medication sessions had an increased hazard of sustaining a fracture within 56 days (HR 2.31, 95% CI 1.51, 3.54, P<0.001) compared with those receiving ≤3 medication sessions, adjusted for each increasing year of age (HR 0.67, 95% CI 0.53, 0.86, P = 0.001).
Main limitations
Absence of an unexposed cohort of nonmedicated racehorses.
Conclusions
Serious musculoskeletal injury following intrasynovial medication occurred in 3% (44/1488) horses. Reduction in injury rates may be possible through greater use of premedication diagnostic imaging.</abstract><cop>United States</cop><pub>Wiley Subscription Services, Inc</pub><pmid>29575177</pmid><doi>10.1111/evj.12833</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0001-5854-5650</orcidid><orcidid>https://orcid.org/0000-0001-8076-4235</orcidid><orcidid>https://orcid.org/0000-0002-5294-1123</orcidid></addata></record> |
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| ispartof | Equine veterinary journal, 2018-11, Vol.50 (6), p.774-780 |
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| source | MEDLINE; Wiley Online Library All Journals |
| subjects | Animals Anti-Inflammatory Agents - administration & dosage corticosteroids Dexamethasone - administration & dosage Female fracture Fractures Fractures, Bone - epidemiology Fractures, Bone - etiology Fractures, Bone - veterinary horse Horses Horses - classification Horses - injuries Hyaluronic Acid - administration & dosage Injections, Intra-Articular - veterinary Longitudinal Studies Male Methylprednisolone Acetate - administration & dosage racehorse Racehorses Retrospective Studies Risk Factors Running - injuries Statistical models Survival Analysis Synovial Membrane Thoroughbred Triamcinolone Acetonide - administration & dosage Viscosupplements - administration & dosage |
| title | A longitudinal study of fractures in 1488 Thoroughbred racehorses receiving intrasynovial medication: 2006–2011 |
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