Distal Tarsal Joint Synovitis & Osteoarthritis EQS 200 The Hock A Review The most common site for rear limb stress injuries, performance-limiting problems, and pain Receives considerable concussive forces Consists of one large hinge joint and three narrow, horizontal, relatively
immobile joints Tibiotarsal joint Proximal intertarsal joint Distal intertarsal joint Tarsometatarsal joint Distal Tarsal Joint Synovitis & Osteoarthritis So what is it? An Osteoarthritis, or final phase of degenerative joint disease (DJD), in the lower three hock joints
A common cause of hock lameness or pain in all horses Also called Bone Spavin The term spavin refers to problems in the narrow lower joints in the hocks The Many Spavins The term Bone Spavin can be further broken down depending on clinical signs Blind/Occult Spavin
Inability to see or palpate the bony growth Jack Spavin A bony growth of variable size that pushes out against the overlying tendon Juvenile Spavin Seen in young horses Due to abnormal development of the
small cuboidal bones of the hock or incomplete ossification in premature or dysmature foals Causes This is a Wear and Tear Injury! 1. Cartilage Compression Excessive compression over time can cause the cartilage between the upper and lower surfaces of the lower tarsal bones to become
flattened and eroded Joint spaces become narrow, eventually filling with new bone 2. Uneven Loading Causes excessive compression on the cartilage and bone on one side and strain in the joint capsule and supporting ligaments on the other Repeated overloading of a joint surface can cause remodeling and new bone production in the form of bone spurs Bony changes such as narrowing of joint space and
bone spurs around the joint are indicators of a bone Contributing Factors Conformation Results in uneven loading of the hocks Cow hocks, in at the hocks, sickle hocked Poor trimming and shoeing Activity Sports that require a lot of hock flexion Excessive concussive forces acting on the hock Subtle, vague, intermittent
hindlimb lameness that may shift from one leg to another Often bilateral Tend to land toe first and have shorter arc of foot flight To reduce concussion and hock flexion Results in dragging of the toe Hindlimb flexion tests produce temporary worsening of lameness
Advanced cases have bony swelling on the hock, usually on the inside of the joint Clinical Signs Diagnostic Tools A combination of. Gait evaluation Flexion tests Radiographs Unless it is an early spavin or very mild
Will show new bone production (bone spurs) and narrowing of joint spaces Severity of bony changes does not always match the degree of pain and lameness Scinitigraphy Good for early or mild cases that show no radiographic evidence Joint Block Can be difficult due to the lower hock joints being narrow
Examples of Varying Degrees of Distal Osteoarthritis #1 Examples of Varying Degrees of Distal Osteoarthritis #2 Examples of Varying Degrees of Distal Osteoarthritis #3 Treatment No specific treatment due to
the changes being irreversible A combination of pain relieving and management changes NSAIDs Corticosteriods Short-term, anti-inflammatory relief HA and Adequan Good for mild cases Shoeing Quicken the breakover and restore hoof balance
Training Should be exercised daily, but reduction of exercise intensity will be necessary Surgery Natural bone fusion (ankylosis) of the lower two joints can help reduce or eliminate lameness but it can be slow and unpredictable The point of surgical intervention is to accelerate the bone fusion process Surgical Fusion = arthrodesis Hock Drilling Destruction of the joint cartilage with a drill bit
Filling holes with bone graft Chemical Injection of a caustic substance to destroy cartilage Laser Heat the cartilage so cells in the cartilage die, resulting in eventual fusion Video Surgical Fusion of Distal Hock Joints
Prognosis Dependent on: The joints involved Number of joints affected Severity of bony changes How quickly the horses condition is worsening What the horse is used for For horses performing high-level athletic function, prognosis is not good Medical and pain management are key for longevity of both the horses career and
overall well-bring! Please use the following password to access Quiz 9 Osteo2015
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