Retrospective study of the effect of intra‐articular treatment of osteoarthritis of the distal tarsal joints in 51 horses

Abstract

Osteoarthritis of the distal tarsal joints, affecting the centrodistal and tarsometatarsal joints, is a common cause of hindlimb lameness in horses. This paper describes the outcome of the intra-articular treatment of 51 horses with the condition with either methylprednisolone acetate (mpa) or triamcinolone acetonide (tr), either with or without hyaluronic acid (ha). The outcome was assessed in terms of the changes in the horses' grade of lameness. Follow-up information was obtained from the owners by means of a telephone questionnaire. Horses treated once with mpa or tr, either with or without ha, improved after a median of 56 days (P<0.0001), and there was no significant difference between mpa and tr. There was no significant further improvement in the horses treated twice. In the horses in which there was a diffuse increase in the uptake of a radiopharmaceutical by the distal tarsal joints, identified by scintigraphy, the lameness tended to improve (P=0.032), whereas in the horses in which the uptake was focal, it did not. At telephone follow-up 13 of 34 horses were reported to have had a positive outcome, but the outcome in the other 21 was reported to have been negative.

Is there a relationship between clinical presentation, diagnostic and radiographic findings and outcome in horses with osteoarthritis of the small tarsal joints?

“…Radiographic findings were predominantly 'mild' or 'moderate' and tended to be more marked in the CD joint, consistent with the findings of Labens et al (2007b). The mild to moderate level of overall radiographic change in clinically affected cases supports the previous assertion that radiography of the tarsus in isolation should not be used for definitive diagnosis of lameness due to OA-STJ.…”

The use of intra‐articular corticosteroids in the horse: What is known on a scientific basis?

“…A recent retrospective study of the effect of i.a. treatment of OA in the distal tarsal joints with MPA or TA (with or without HA) led to a positive outcome in only 38% of horses (Labens et al. 2007).…”

Osteochondral lesions in distal tarsal joints of Icelandic horses reveal strong associations between hyaline and calcified cartilage abnormalities

“…10a-b) that we detected in the distal tarsal joints of these young Icelandic horses agree with studies of distal tarsal OA in adult horses further supporting that the changes we have detected are related to the early stages of OA. Radiographic studies of adult horses consistently show that the frequency and severity of OA lesions is highest in centrodistal joints compared to tarsometatarsal joints Labens et al, 2007;Byam-Cook and Singer, 2009;Fairburn et al, 2010) and that the talocalcaneal-centroquartal joints have the lowest incidence of OA lesions Labens et al, 2007). Other studies also investigate the frequencies of marginal changes compared to other joint lesions in adult horses (Labens et al, 2007;Fairburn et al, 2010) and, in agreement with our results, these studies report the frequencies of marginal osteophytes in the centrodistal and tarsometatarsal joints to be high and similar, but that lesions of the joint space region are more numerous in the centrodistal joint compared to the tarsometatarsal joint.…”