Joint Health in Horses: Understanding Arthrodesis

The surgical fusion of a joint, called arthrodesis, may be a viable alternative to more traditional medical approaches when managing horses with moderate to severe osteoarthritis (OA), according to new research. Before arthrodesis, one or more forms of traditional therapy is usually attempted, including:

• Nonsteroidal anti-inflammatory drugs, such as phenylbutazone (bute), administered orally, intravenously, or topically;
• Intra-articular corticosteroids, hyaluronic acid, and polysulfated glycosaminoglycans;
• Administration of oral joint health products containing glucosamine, chondroitin sulfate, hyaluronic acid, avocado-soybean unsaponifiables, and more;
• Interleukin receptor antagonist protein (IRAP I and IRAP II); and
• Extracorporeal shockwave therapy, among others.

“Of all joint and musculoskeletal diseases, OA remains one of the most common, and painful, conditions affecting horses and requiring long-term care,” noted Catherine Whitehouse, M.S., a nutrition advisor for Kentucky Equine Research. “Further, oral joint supplements continue to remain a popular option in the management of horses with OA.”

“Products such as EO-3, which contains marine-derived omega-3 fatty acids with natural anti-inflammatory properties; Synovate HA featuring hyaluronic acid to help lubricate horse’s joints; and KER-Flex with glucosamine and chondroitin sulfate may help horses with OA,” she added.  Australian horse owners should look for Glucos-A-Flex.

When these methods fail to improve a horse’s mobility and comfort, alternative approaches, including arthrodesis, may fit the bill. Arthrodesis is a surgical procedure in which the cartilage is removed and the junction between adjacent long bones is converted from a mobile joint to a stable bony bridge. The procedure reportedly improves the comfort of horses with moderate to severe OA. In these cases, however, it is important to appreciate such horses may have an improved quality of life but will only be pasture sound or appropriate for minimal work or breeding purposes only.

Based on a review of medical records from 17 horses with OA of the ankle (fetlock) joints treated with arthrodesis, surgery resulted in a comfortable outcome, associated with few postoperative complications, and had satisfactory long-term outcomes (based on follow-up data obtained 6-161 months postsurgically).

The veterinary researchers thus concluded that arthrodesis for horses with OA of the fetlock “should be considered in horses with moderate or severe OA. These horses have an excellent long-term prognosis for pasture and breeding soundness.”

*Chapman, H.S., D.W. Richardson, and K.F. Ortved. Arthrodesis of the metacarpophalangeal and metatarsophalangeal joints to treat osteoarthritis in 17 horses. Veterinary Surgery. In press.