Treatment of horses with distal tarsal osteoarthritis

Most horses with distal tarsal osteoarthritis (OA) respond favorably to various forms of medical management, including intraarticular medication. One or both distal tarsal joints are commonly treated intraarticularly with corticosteroids with or without hyaluronan to return affected horses to performance. The tarsometatarsal (TMT) joint may be medicated alone with good clinical results in some horses with distal tarsal OA. However, because of the variability in communication and differences in severity of OA between the distal intertarsal and TMT joints, better clinical results, may be achieved by treating each joint individually. Horses with severe distal tarsal OA and those not responding to medical management may require surgical treatment to help achieve soundness. Surgical options include cunean tenectomy, intraarticular drilling, subchondral bone fenestration, laser-facilitated arthrodesis, joint stabilization, or a combination of these techniques. The success of these surgical techniques in returning horses to their previous level of performance is controversial. The particular surgical treatment that is recommended to horse owners often depends on the severity of the distal tarsal OA, how long the horse can be out of work, the veterinarian's clinical judgment and experience, availability of equipment, cost of treatment, and the expertise of the surgeon.