New Hope For Joint Issues?

Hello Sumarians!

Splints fail more often than we'd like to admit. In fact, one study puts soft tissue complication rates at 63%. That number deserves a second look.

This week, three papers worth your time: new data comparing thermoplastic and premade splints applied by novice bandagers, emerging evidence that hydrogel therapies may be doing real anti-inflammatory work in equine joints (not just mechanical scaffolding), and a study showing whole-slide imaging meaningfully improves how vet students learn to submit diagnostic samples.

Different topics. One question underneath all of them: are we practicing the way the evidence actually says to?

Read on.

Thermoplastic Splinting In Dogs

External coaptation, including splints and casts, is a commonly used technique in veterinary medicine for stabilizing musculoskeletal injuries such as fractures. When applied correctly, splints can serve as either temporary or definitive stabilization. However, improper use is associated with a high risk of complications, including swelling, dermatitis, pressure sores, ischemic injury, joint stiffness, and delayed or failed fracture healing. Reported complication rates are substantial, with one retrospective study noting soft tissue injury in 63% of cases and another identifying complications in 40% of treated patients. These adverse outcomes are often linked to poor splint placement, inappropriate case selection, and inadequate post-placement management. 

An ideal splinting material should be easy to apply and remove, conform well to the patient, provide adequate rigidity, and be cost-effective. No single material fulfills all these criteria. Common options include premade splints, fiberglass casting tape, and thermoplastic materials. Premade splints are convenient and quick to use but may not fit individual patients well, increasing the risk of inadequate immobilization or soft tissue injury. Fiberglass casting tape is widely used in specialty settings but has limitations such as a limited working time, inability to be remolded, and expiration constraints. 

Thermoplastic splints offer several advantages, particularly for less experienced practitioners. They can be reheated and reshaped, allowing customization to the patient’s limb and reducing waste. Newer systems with precut sizes and simplified heating methods have improved their practicality in general practice. Although it was hypothesized that premade splints would be faster to apply and thermoplastics would provide a better fit, findings showed minimal differences in application time and overall performance.  

Ultimately, both splint types demonstrated similar clinical acceptability, and user preference was divided. The study highlights that for practitioners who infrequently place splints, both materials are viable options, but emphasizes the importance of training and technique, as improper application remains a major contributor to complications. 

Rothering, A. A., Aertsens, A., & Gordon-Evans, W. J. (2026). Comparable application metrics but poor clinical acceptability of thermoplastic and premade splints applied by novice bandagers in a canine hock cadaver model. Journal of the American Veterinary Medical Association https://doi.org/10.2460/javma.25.10.0664 

Bottom line — Techniques are the most important thing

Hydrogels Vs Steroids and Hyaluronic Acid

Osteoarthritis (OA) is a leading cause of lameness in horses, particularly in those subjected to high-intensity athletic activity. Although cartilage degeneration defines the disease, multiple joint tissues—especially the synovial membrane—play an important role in its development and progression. Current intra-articular (IA) treatments include corticosteroids, hyaluronic acid (HA), and newer hydrogel-based therapies. Corticosteroids are widely used due to their strong anti-inflammatory effects but are associated with potential adverse effects such as cartilage damage and metabolic disturbances, and their benefits are often short-lived. HA has also been commonly used for its lubricating and anti-inflammatory properties, though clinical outcomes have been inconsistent. 

Hydrogel therapeutics, including 2.5% injectable polyacrylamide hydrogel (iPAAG) and collagen-elastin hydrogel microparticles (CEHM), represent a newer class of IA treatments. These materials form three-dimensional polymer networks that can support joint mechanics, act as scaffolds, and potentially influence tissue remodeling. While traditionally thought to function primarily through mechanical effects, emerging evidence suggests they may also exert biological activity. 

This study investigated the tissue-level effects of hydrogels compared to corticosteroids and HA using a cytokine-stimulated explant model of early OA and synovitis. Proinflammatory stimulation increased nitric oxide (NO) production in cartilage and prostaglandin E2 (PGE2) in synovial tissue, both key mediators of inflammation and cartilage degradation. All treatments—including hydrogels, corticosteroids, and HA—reduced NO production in cartilage. Corticosteroids and CEHM significantly reduced PGE2 production, while hydrogels and corticosteroids also decreased certain inflammatory chemokines such as CCL2 and CCL3. These findings suggest that hydrogels may have anti-inflammatory and biologically active effects beyond mechanical support. 

Importantly, no treatment significantly altered glycosaminoglycan release, a marker of cartilage matrix degradation, likely due to variability in the model. Overall, the study provides evidence that hydrogel therapies may influence joint biology through modulation of inflammatory mediators, supporting their potential as alternatives or adjuncts to traditional OA treatments. Further research is needed to better understand their long-term mechanisms and clinical applications. 

Secor, E., Thomas, M., Chu, E., Hazzard, S., Raimondi, S., & Reesink, H. (2026). Intra-articular hydrogel therapeutics exhibit anti-inflammatory effects on cytokine-stimulated equine cartilage and synovial membrane explants. American Journal of Veterinary Research https://doi.org/10.2460/ajvr.25.12.0454 

Bottom line — Early results support this as a beneficial protocol

Whole Slide Imaging Technology

Whole-slide imaging (WSI) is a digital pathology technology that converts glass microscope slides into interactive, high-resolution images that can be viewed, navigated, and shared remotely. Historically, limitations in cost, speed, and technical complexity restricted its use to large diagnostic laboratories, while clinicians often relied on static images or physical slide submission. However, advances in accessibility now allow veterinary practices to use in-house scanners, enabling faster turnaround times and broader access to remote pathologists, including in rural settings.  

This study evaluated the use of WSI as a teaching tool for clinical veterinary students, with a focus on improving skills in cytology and hematology sample submission. Students participated in a structured activity in which they scanned slides, submitted cases digitally, and received feedback from remote pathologists. Pre- and post-activity surveys assessed changes in confidence, motivation, and understanding of both WSI and sample submission processes. 

Results demonstrated significant improvements across all measured domains. Students reported increased confidence in providing relevant clinical information, interpreting pathology reports, and understanding both the utility and limitations of WSI. They also felt better prepared to submit samples in general practice and showed greater motivation to communicate effectively with pathologists. Importantly, their ability to identify errors or deficiencies in submission forms improved, highlighting enhanced awareness of preanalytical factors that can affect diagnostic accuracy.  

Students viewed WSI favorably, citing its convenience, rapid turnaround, and educational value, particularly through annotated reports that reinforced learning. However, they also noted limitations, including technical challenges with slide scanning, concerns about image resolution for detecting small structures, and constraints on clinical history input. 

Overall, the study suggests that WSI is a valuable supplement to traditional veterinary education. While it cannot replace foundational skills such as sample collection and preparation, it enhances experiential learning and prepares students for evolving digital workflows. As digital pathology continues to expand, integrating WSI into training may improve both diagnostic communication and clinical competency in future practitioners. 

Garner, B. C., & Schlemmer, S. N. (2026). Whole-slide imaging enhances veterinary pathology education of cytology and hematology submission practices. American Journal of Veterinary Research https://doi.org/10.2460/ajvr.26.01.0026 

Bottom line — Potentially useful for training.

Just putting things in perspective …