Surgical Arthrodesis of the Hock for Arthirits

vallin

vallin

Well-Known Member
Joined
10 April 2009
Messages
5,016
Location
Cambridge
Visit site
I was just wondering if anyone had had a horse that had undergone Surgical Arthrodesis of the Hock for Arthirits and how the horse had responded.

Quick bit of background: 16.1, 11yo, selle francais mare. Horse has had bilateral neurectomy for damage to suspensories, followed by corticosteroid injections into both hocks (for arthritis in lower hock joints) and sacro iliac, as well as tildren injections into the hocks. Horse was oringinally 4/10 right hind limb lame, after neurectomy went down to 2/10 right hind limb lame, few month field rest, arthritis treatment then slowly brought back into work, got to the stage of introducing trot work but still not sound, as has now returned to ~4/10 lame.

New x-rays show there has been further degeneration due to arthritis and a possible fracture to the central tarsal joint (pending conformation from vets).

Infering from what the vet has said the only two options appera to be either long term bute (at 11 not really happy to go down this route if there's an alternative) or surgical intervention. So just wondering if anyone has any info on surgical intervention for this sort of thing...

TIA x
 
Is arthrodesis fusing of the joint? If this is right I wonder what the implication for gait and suppleness of movement are afterwards?

Have you considered a barefoot approach to her problems. If the joint is too badly damaged it may help her other problems anyway... just wondering here of other alternatives to surgery.
 
My horse had arthrodesis of the pastern and is now as good as new (he just lifts that hind leg a little higher in trot - hardly noticeable) If you want any info on this let me know.
 
amandap said:
Is arthrodesis fusing of the joint? If this is right I wonder what the implication for gait and suppleness of movement are afterwards?

Have you considered a barefoot approach to her problems. If the joint is too badly damaged it may help her other problems anyway... just wondering here of other alternatives to surgery.
Click to expand...

Yup arthrodesis is fusion. It's would be of the lower joints rather than the upper joint which is the one that does most of the movement, so hopefully it shouldn't make it too bad, presumably just a little 'stiff' behind...
She was barefoot for a while but it made things worse :(
 
Basically you've got the main hock joint, and then just beow it two other tarsal joints and it's these bones that fuse, at the dorsal intertarsal joint. These joints act more as shock absorbers that actually contributing particulally to movement (or at least that's my understanding!)

bone-spavin-diagram.jpg
 
Not sure if this link will work, but you can see the black patch inbetween the two lower bones, that's where the bone is being 'eating' and those are the two bones they would fuse (this is an old xray, it looks worse now :( )
47193_1304873836774_1678350003_608297_51565_n.jpg
 
Last edited:
Well he was diagnosed last January, I'd only had him about 4 months on a full loan basis. He went in to have surgery February & was away at NEH in Newmarket for a month as they have to keep a cast on for a month & they're not allowed home due to the risk of cast rubs & infection. I took a very quiet down in the dumps tb in & came out with a nutter! He felt loads better as soon as the op was done. Then the fun began...lol. He was on approx 3-4 months complete box rest which I had to sedate him through when the others were being turned out & hide him away in a closed barn so he couldn't see the others going out. Then as well as box rest he had to be walked in hand for about 6 weeks. (But I was also putting in a small paddock the size of his stable with bucket loads of haylage to stop him trying to run round..it was the only way I could stop him kicking the wall & doing damage to himself in the stable..the vet doesn't know..lol) The thing is while the bone is fusing they have a thin alluminium plate & pins keeping the joint together so it's vital to keep them quiet until it's strong enough!
I'm sure if you have a horse that doesn't mind box rest or being in on his own it wouldn't be much of a problem. He also had deep nasty cast rubs so had to keep them clean. The surgeon originally told me that I wouldn't be able to ride him for 9 months to a year but he was back starting to be ridden by June/July time as he healed so quickly & the bone fused much more quicker than expected. He's been back in full work since October & is allowed to do anything a normal horse can do.. I don't tend to jump him because I wrap him up in cotton wool but the vet says there's no reason why he can't do whatever I want him to. The pastern is now quite thick where the bone has fused & does look different to his normal leg but he is sound & just lifts that hind leg a little higher than the other in a trot. The success rate is a lot higher for hind legs than front legs. He is now a very full of himself animal who is full of life & very happy. The rehab was REALLY hard work & I'm glad I did it but I'm not sure I would ever go through it all again..it was just soo stressful.
 
*few* thanks for all the info, that's really interesting. I was wondering how long the box rest was for this sort of thing, was he box rested to minimise infection or movement or both (not sure how she'll cope with it, then again she managed the four weeks after the suspensory op a lot better than I thought, apart from dropping A LOT of weight)? also if you don't mind answering (if you do no worries) how much did it cost? (I know it's a different op, but just for a ball park figure)

Thanks
 
At first he was mainly box rested as he literally had a joint that was being held together by the plate & screws until the pastern fused, he had a massive bandage supporting his weight on the joint & about a four inch cut where they had done the surgery healing.. (I wasn't secretly putting him in the paddock until he had done the 3 month box rest & joint had srated fusing - would have been far too risky, it was only when I spoke to my vet & he thought he was strong enough to go in a small paddock but the Newmarket surgeon said no..that's when I took the risk as he was just getting dangerous in the stable.) He also dropped a lot of weight..he's a good doer but I was giving him 20lb hay nets & haylage throughout the day & sometimes he'd eat it all but other times he'd leave it & stress..he looked terrible! The complete bill was in the region of £7,500...that goodness for the insurance!!
 
Forgot to add that the pastern is also a joint with not a lot of movement which is why the fusion doesn't make a lot of difference to his paces..
 
Hi, my horse Gus had surgical arthrodesis of the right hind tarsometatarsal joint 2 days ago. The following morning he was in very little pain and munching his breakfast. I have him home from the vet. hospital this eve and he seems happy. I'm dreading the box rest. The discharge instructions I got were as follows :
-Total box rest for 3 weeks
-After this time walking in hand for 5 mins per days for 1 week, then 10 mins per day for a week and then 15 mins per day for a week.

I have to take him back to the hospital then for re-evaluation! I can't really tell you much more except that the surgety was carried out by a german specialist called Fide Von Saldern who is very highly rated worldwide in this type of surgery. The cost was €1200 but we are in Ireland so I dont know what you could expect to pay.

If you would like more info as time goes on I would be happy to keep you updated...I'm hopeful at this point as the success rate is really good. I had tried the exercise/rest/bute/corticosteroid injections but nothing really worked...fingers (and toes) crossed.

Best of luck
Aoife
 
Thanks for the infomation, have had more vet work ups and they no longer think its the best option for the moment, but might have to come back to it later, so any infomation is always welcome!
 
I've also tried the steroid, tildren route which hasn't worked and was offered surgery or some sort of alcohol treatment but I can't remember what it's called.

Basically the alcohol is injected into the joint which helps it to fuse a bit like surgery but no need for the box rest. Just two weeks in a small paddock then she should go virtually sound whilst the joint is fusing as the nerve endings are killed off.

Like with any treatment there are risks but I'm sure your vet could answer any questions.

I'm just waiting for the spring as I can't do small paddock rest until the ground drys up.
 
You must log in or register to reply here.
Top