When hock injections no longer manage the pain of osteoarthritis in the hock, laser arthrodesis may be an option. The goal of the surgery is to accelerate the speed at which the lower hock joints are fusing naturally, untimely preventing pain.
The Physiology
The hock consists of four distinct joints, and the two lower joints (distal joints) are most often the source of painful osteoarthritis. As arthritis progresses, the protective cartilage in the joint deteriorates, and bones grind against each other, resulting in pain, inflammation, and lameness.
 
Bone continually sheds and regrows tissue; this is called remodeling. Arthritis causes the bone to “remodel” in an irregular pattern. Over time, the unorganized bone regrowth will fuse the joint, rendering it immobile. The lower hock joints do not contribute much motion to the hock, and we notice little change to a horse’s speed or range of movement after fusing.
 
The pain resolves when hock fusion is complete by effectively locking the joint in place.
 
Laser Arthrodesis Surgery
During surgery, the horse goes under general anesthesia. A doctor inserts and fires a fiber optic laser into the lower hock joint evaporating the synovial (joint) fluids. The heat generated by the laser also destroys any remaining cartilage, which kick-starts a rapid fusion of the bones.
 
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 and require a bandage change every other day. Post-op therapy includes hand-walked 15 minutes per day to start, with a gradual transition, under doctor guidance, to complete work within 8 to 12 weeks.
 
Take Away Message
The surgical fusing of the hocks can be a viable long-term solution to hock pain when other pain management methods fail or provide little relief.
 
Video: Dr. Lanham performing Laser Arthrodesis surgery.#fusinghocks #laserarthrodesis #equinevets