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Joint disease in horses includes synovitis (inflammation of the fluid-producing membrane), capsulitis (inflammation of the fibrous joint capsule), articular cartilage and bone fragmentation, ligamentous tearing, and eventually arthritis. In most cases, the disease process primarily involves soft tissue overuse and injury and cannot be diagnostically confirmed except for arthroscopy.
 
Intra articular treatment in joint disease is indicated to immediately decrease soft tissue swelling and inflammation as well as to postpone the onset of permanent osteoarthritic changes. The goal of any intra articular (medications put directly into the joint) therapy is to stop problems before they occur rather than wait for abnormal radiographs and then start aggressive therapy.
 
Inflammatory and degradative enzymes that destroy normal joint environments can be altered by use of hyaluronic acid (HA) and corticosteroids injected into the joint. The combination of the two has been scientifically proven to have a more thorough and lasting effect than HA alone or corticosteroids alone. Previous generalizations and perpetuation of myths about damage to joint environments caused by corticosteroids are primarily unfounded. Typically, when there is mild soreness (joint capsulitis or synovitis) in a joint, and joint therapy is instituted 2 to 3 times per year, the environment inside the joint becomes more hospitable to cartilage, not destructive.

It has been proven that corticosteroids and HA together allows the natural synovial lining of a joint to make a more viscous and lubricating environment.
 
Intra articular Hyaluronic Acid (HA)
 
Probably the most commonly used Intra articular treatment e.g. HY-50, Hyonate. These products are labelled for intra articular use insuring purity and consistency with each individual manufacturer. HA is normally synthesized by the synovial membrane. HA is responsible for the boundary lubrication of articular cartilage. Experimental evidence combined with anecdotal reports from equine practitioners that do sports medicine specialties, report that using the highest molecular weight (thickness) of HA provides the most benefit.

For more information please click on the link below.

www.animalhealth.bayerhealthcare.com

 Intra articular Corticosteroids
 
Joints that are inflamed must be treated with anti-inflammatory medication, as well as HA in some instances, to allow them to secrete normal joint fluid. Intra articular corticosteroids allow the joint to start producing lubricating HA as inflamed joint tissues WILL NOT make thick, lubricating HA. At the Chiltern Equine Clinic the total body dose of Corticosteroids is never exceeded in order to minimise the risk of  inducing laminitis.