Intra-Articular Joint Injections

Joint therapy is an important part of maintaining your horse at its optimal performance level.  Most horses begin life with joints that function smoothly, properly, and without pain.  Gradually, with exercise and competition, certain joints may develop damage to the cartilage and underlying bone, a process called osteoarthritis.  Osteoarthritis is a gradual and irreversible process which has the potential to cause pain, affecting your horse's performance and often causing lameness.  Joint therapy is used to help slow down the process of osteoarthritis while at the same time relieving pain and extending the performance career of your horse.  This therapy can consist of both intra-articular (within the joint) and systemic (whole-body) treatments that serve to improve the health and longevity of the joints.  

The joints we most commonly inject are synovial joints.  These joints are made up of bones that are covered with articular cartilage, a smooth, low friction substance designed to make joint movement fluid and to cushion the impact on the underlying bone.  The joint is surrounded by a synovial membrane, or capsule, which produces and contains the joint fluid that is essential for lubrication and health of the cartilage within the joint. 

How can I tell if my horse needs joint injections?

The most obvious sign that you will notice is that your horse is "off" or lame during exercise.  Often, horses who are in need of joint injection therapy may not be obviously lame, but may exhibit signs such as poor performance, irritability, or reluctance to work.  Often, the horse will have a history of osteoarthritis which needs to be maintained with routine joint injections.  

Why are joint injections beneficial?

A good analogy for a joint injection is that of a car needing an oil change.  A healthy car engine requires clean, thick oil for proper function.  As the engine runs, the oil becomes thinner and should be changed in order to maintain proper function of the engine.  Similarly, a joint needs healthy joint fluid to maintain proper function.  Inflammation from osteoarthritis causes the fluid within the joint to become thinner, reducing its lubricating qualities.  Intra-articular injection of substances such as hyaluronic acid, low doses of steroids, and adequan can help to alleviate inflammation while improving the quality of the joint fluid and stimulating the synovial membrane within the joint to produce healthier fluid as well.  

What happens during the procedure?

The joint that we isolate as needing treatment will be surgically prepared, and a needle inserted into the joint.  Often synovial (joint) fluid will be visibly coming from the needle.  Normal, healthy joint fluid is clear, pale yellow to colorless, and very thick (normal joint fluid should form a string that reaches almost to the ground when dripping from the needle).  Unhealthy joint fluid is excessive in amount, and often is thin and discolored (may be darker yellow, orange, to blood-tinged) indicating the presence of inflammation in the joint.  A syringe usually containing hyaluronic acid, antibiotic, and a low dose of steroid is then administered to the joint.  

What can I expect to see following the procedure?

Usually, it takes approximately 7-10 days following the procedure to appreciate an improvement in your horse's performance.  Your horse should move more comfortably, with an appreciable resolution to the lameness that was present.