Intra-Synovial Injections

by Shanna Nelson DVM

“Joint injections,” also known as intra-synovial or intra-articular therapy, are common procedures used to manage mild to moderate lameness and performance issues in horses. Used judiciously, they can help keep the athlete performing at a high level.

Repetitive motions and athletic activity predispose the joints to inflammation. This creates pain and adaptive changes in gait and performance. Over time, the inflammation can also degrade the cartilage, reduce the lubricating effects of the synovial fluid, and deform the joint (as new bone is laid down to stabilize the inflamed structure). Range of motion is limited, and end-stage arthritis can eventually result (persistent lameness, effective joint fusion, etc.). Our goal with joint injections is usually to reduce inflammation and increase joint lubrication in order to maintain the essential function of the joint and restore comfort. In rare instances, we will instead inject an irritating substance into the joint to speed up the fusion process, by which we can eliminate the source of pain (by removing bone-on-bone action in an end-stage, low-motion joint, such as the lower hock).

Common compounds used in joint injections include a steroid for anti-inflammatory effects (frequently triamcinolone), hyaluronic acid for lubrication (similar composition to synovial fluid), or regenerative therapies (IRAP or, more recently, Pro-Stride–a new product that we are excited to offer). When used appropriately, these can be effective for maintaining a horse’s level of performance. It is not recommended to use joint injections in a “prophylactic” or “rescue” manner, however, as you risk damaging the joint and reducing the horse’s useful longevity.

Many horse owners have heard horror stories about joint infections subsequent to injection. This is a risk every time the joint is penetrated by a needle, because the synovial fluid is an excellent medium for bacterial growth. At Fox Creek Veterinary Hospital, we take great pains to make the procedure as sterile and safe as possible, and you can rest assured that we have your horse’s best interest at heart.

Please do not hesitate to give us a call at 636-458-6569 if you have any questions about the joint injection process or any recommendations thereof.