Randlab TechTalk Newsletter Issue 2

RANDLAB
Veterinary Medicines
Tech
Issue 2
Talk
Welcome to Randlab’s TechTalk
In this issue, well known specialist equine surgeon, Dr Nicholas Kannegieter takes a fresh look at an old faithful as he gives an update on the use of hyaluronic acid (HA) for the treatment of joint disease.
For access to a comprehensive library of journal articles on joint disease and other topics, check out the Randlab library at www.randlab.com.au/library.html. Access to the library is free and there are hundreds of key scientific publications available for reading on selected topics.
Update on the use of Hyaluronic Acid in the management of joint disease in the horse.
Associate Professor
Nicholas Kannegieter BVSc, DVCS, PhD, FACVSc Kannegieter Equine Specialists
Hyaluronic acid, often in combination with corticosteroids, has long been the mainstay in the treatment of joint disease in the horse. Despite a growing number of alternative treatments being available for treating joint disease combination
of hyaluronic acid and corticosteroids
still remains the gold standard by which other treatments must be judged. There are many different exogenous HA‘s currently available and it is important
that the practitioner is aware that there is considerable difference between available HA’s which can impact on both their efficacy and safety.
Hyaluronic acid (HA) is the major component of synovial fluid and is essential in providing the viscoelastic and shock absorbing properties to joint fluid that help protect cartilage from damage. Damage to articular cartilage that occurs in association with joint disease invariably results in changes in HA composition and content which can cause further damage to the joint.
There is also the potential that exogenous HA will stimulate the production by synoviocytes of high molecular weight HA which not only prolongs the duration of action of any medication but also increases the efficacy.
There have been many studies in many species, including horses, evaluating the efficacy of HA in the management of joint disease (see reference list below). As is found with all products used to treat joint disease it is very difficult to create a standardised scientific protocol, either clinical or experimental, which allows accurate comparison and evaluation of these products.
Consequently, there are some apparently conflicting accounts regarding the efficacy of HA treatments in
the horse. By way of example, some recent studies have suggested that HA may be less effective than
had previously been documented in a large volume of scientific data over the past 40 years. It is likely that if these studies were repeated that different results would be obtained due to the usual variability encountered when using clinical material for such studies.
The viscoelastic properties of exogenous HA can provide good improvement in the viscoelastic and protective properties of joint fluid and joint function that can last for many months following treatment.
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