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JOINT DISEASE

A large part of lameness diagnosis and treatment concerns joint disease. Svend believes that the key to successful management of joint disease, whether traumatic or degenerative, is early and aggressive interference.

If treatment is not instigated early and effectively, a traumatised joint unfortunately often remains inflamed and the inflammatory cascade soon spirals like a snowball down a mountain (many people would have heard me talk  about the “slippery slope” of joint degeneration) towards osteoarthritis where we still have no options of treatment and certainly have lost the horse from competitive sports.

Svend accordingly believes that this vicious cycle must be broken before being firmly established and that the joint can often help itself regenerate if treated aggressively early enough and managed correctly.

Various medications are available for joint treatment, varying from corticosteroids to hyaluronate, polysulphated glycosoaminoglycans and the more recently developed group of medications classified as regenerative medicine (IRAP and PRP, see separate headings).

Corticosteroids are frequently used in the treatment of joint disease, predominantly early cases of traumatic joint inflammation where the inflammatory cycle has to be broken fast and effectively. Used correctly and in combination with correct management, this group of products still provides the strongest anti-inflammatory effect in joint.

Svend has used Adequan (a poluysulphated glycoseaminoglycan) extensively for more than 25 years and has published and lectured extensively on its use in joint disease, predominantly the coffin joint and navicular bursa. This study was published in Equine Veterinary Journal in 2007 and was highlighted and discussed (Kester, News Hour) at the American Association of Equine Practitioners Congress in 2007 as a publication of distinction. Unfortunately, production difficulties has meant that this product has been unavailable in recent years.

Svend has equally strong views on rehabilitation of joints following either surgery or joint injections. He strongly believes that training of athletes should never be stopped but altered and targeted to the rehabilitation needs of the injured structure(s). Turn-out in paddocks does not figure in this regime, because it is non-controllable and non-quantifiable. Alternatively, controlled exercise (hand walking, horse walker, water treadmill etc.)  are used to “tease” the injured structure(s) back to work as soon as possible and under the same loading pattern as will be required when in full training.

 


'Blejan Ehyre’, National Hunt racehorse underwent carpal arthroscopy due to bone infection as a foal