Ep.21 Osteoarthritis and drugs used to counteract the Tornado inflammation. Keeping the Water bed of cartilage plump

In this episode. Dr. Rice and Yardley Talk about equine joint Arthritis. 
1. Components of joint fluid
a. Synoviocytes produce hyaluronan and lubricin
i. Act to regulate the composition of synovial fluid
ii. Act as barrier lubricant for the surfaces in the joint
iii. Hyaluronan also a component of the articular cartilage
2. Articular cartilage composition – brief
a. Collagen – major component
b. Proteoglycans
i. Protein + glycosaminoglycans
ii. Glycosaminoglycans attract water and create pressure in the cartilage
3. Aim of therapies
a. Decrease pain
b. Prevent progression of disease
c. Do this by mimicking those components of joint fluid and cartilage
d. Help diminish inflammatory response in the joint
e. Claims
i. Prevention
ii. Retardation
iii. Reversal of OA
iv. Don’t always have the science to back it up
4. Common Products
a. Corticosteroids
i. Most potent anti-inflammatory
ii. Can be beneficial when used judiciously
1. At high concentrations and sustained usage à detrimental effects on joint
iii. Most common
1. TA – often more common in high motion joints
2. Methylprednisolone
3. Betamethasone
4. All can have beneficial and detrimental effects
b. Hyaluronic Acid
i. Glycosaminoglycan à component of synovial fluid and cartilage
ii. Can help to replenish what is lost during joint disease and OA
iii. Often used in conjunction with other IA products
1. Synergistic effects of corticosteroids + HA in people
iv. IV formula – Legend
1. Non-invasive
2. Able to treat more than one joint
3. Studies have shown it mainly acts as an anti-inflammatory
c. Adequan - Polysulfated glycosaminoglycans
i. IA formula
1. Often combined with antibiotics
2. Studies have shown that it can modify OA
a. Reduces bone remodeling
b. Decreases inflammatory cytokines
c. Increases synthesis of HA
d. Decrease lameness
ii. IM Formula
1. Easier to administer
2. Used more frequently due to previous issues with joint infections and IA Adequan
3. Less data than IA use
4. More as a preventative for OA