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Chronic Hock Pain: Laser Arthrodesis (Surgical Fusion) May Be The Answer

Many performance horses, like their human athlete counterparts, experience deterioration and arthritis of the joints as years of training take their toll. Luckily for the horses, advancements in medicine and technology have led to a surgical solution that is available at Mid-Rivers Equine. Laser Arthrodesis,a form of ‘surgical fusion’, is a viable option used to treat osteoarthritis of the lower hock joints in equines.

The hock is a common source of lameness for many horses. The hock is made up of four distinct joints and the two lower joints (distal joints) are most often the source of lameness’s. The lower joints do not contribute much motion to the hock and often the arthritis that develops is conformational if not genetic in nature. The arthritic changes we see on x-rays indicate deterioration of cartilage. The cartilage in joints covers and protects the bone and there is a vast plexus of nerves in the sub-chondral (cartilage) bone. Once erosions develops in joints, the nerves become exposed and pain ensues. Over time the joints become so arthritic that the bones will actually fuse together and when this happens, the source of pain resolves.

The problem is this process can take years to complete. The good news is that once these joints have completely fused these horses are usually sound. In addition, the complete fusing of the bones generally results in little if any change in the horse’s speed or range of motion. Laser Arthrodesis (surgical fusion) is used to promote a quicker fusing of the bones. During this fusing period, the goal is focused on managing the pain so that the horse athlete can still compete at top levels. In most cases, the pain caused by joint deterioration and bone fusing can be managed though hock injections. This is the process of injecting steroids and hyaluronic acid into the hock joints. The steroids settle the inflammation and the HA lubricates the joint. Once the hock pain is no longer manageable through injections, surgical fusion may be the next step.

During the procedure, the horse is put under general anesthesia. A fiber optic laser is then inserted into the lower hock joints. The laser is used to evaporate the synovial (joint) fluids. The heat generated by the laser also destroys any remaining cartilage promoting fusion of the bones.

World champion trainer Brenda Wasser has had Mid-Rivers Equine Centre perform laser arthrodesis on three of her client’s horses. “(It) seems to have worked where other things have not,” Wasser said. “We have been really happy with the results.”

An additional benefit of fusion is that it can be a permanent fix for chronic hock pain in the lower joints. When considering the ongoing cost of pain management with fusion surgery, Wasser noted, “The beauty of it is that it is relatively inexpensive.”

Recovery time for surgical fusion patients is relatively quick. A horse generally spends 2-3 days in the hospital. When released, the patient will go home on antibiotics and anti-inflammatory drugs such as Bute and they will have bandages that will be changed every other day. A horse begins recovery by being hand-walked 15 minutes per day and is generally back to full work within 8 to 12 weeks.

Mid-Rivers Equine Centre has been performing laser arthrodesis surgeries since 1993. If you would like to have your horse’s hocks evaluated for this surgery please contact the hospital and request an appointment with Dr. Ellis or Dr. Baxter.

March 21, 2012

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