The fetlock joint in horses is a complex articulation located between the cannon bone and the proximal phalanx, playing a pivotal role in equine locomotion. This joint is characterized by its hinge-like structure, allowing for flexion and extension movements essential for a horse's gait. The fetlock joint is supported by a network of ligaments, tendons, and synovial fluid that contribute to its stability and function. Common conditions affecting the fetlock joint include inflammation, osteoarthritis, and injuries to the supporting soft tissues. This section provides access to peer-reviewed studies and scholarly articles that explore the anatomy, biomechanics, and pathologies associated with the fetlock joint in horses.
Yovich JV, McIlwraith CW.Arthroscopic surgery for osteochondral fractures of the proximal phalanx was performed on 74 fetlock joints of 63 horses for a total of 87 fractures during a 2-year period. The medial dorsal proximal aspect of the proximal phalanx of the forelimbs was most commonly involved (59 fractures), followed by the lateral aspect (26 fractures), and 2 fractures occurred in the fetlock joint of the right hindlimb. At surgery, 82 fragments were removed and 5 fragments that had healed or were embedded in the joint capsule were not removed. Of the fragments removed, 15 were fixed firmly to the proximal phal...
Yovich JV, McIlwraith CW, Stashak TS.Osteochondritis dissecans of the sagittal ridge of the third metacarpal and metatarsal bones was diagnosed in 8 horses during an 18-month period. Seven of the horses were less than or equal to 2 1/2 years old. Synovial distention of the affected fetlock joints and a pain response to fetlock flexion were typical findings. Lameness predominated in 1 limb at a trot, although fetlock flexion frequently elicited lameness in other affected limbs. Radiography revealed bony lesions (flattening, erosion, or fragmentation) of the sagittal ridge in at least 2 fetlock joints in all horses. The onset of si...
Barclay WP, Foerner JJ, Phillips TN.Axial sesamoid injuries were found in 4 of 18 horses with lateral condylar fractures of the metacarpus or metatarsus. The injuries appeared as axial sesamoid fractures or progressive demineralization of the axial border of one of the sesamoids. None of the horses with axial sesamoid injuries returned to performance soundness. Axial sesamoid injury appeared to be an indication of severe fetlock trauma due to condylar fracture. Such injuries appeared to indicate a poor prognosis for return to performance soundness.
Gerring EL, Webbon PM.Restriction of free movement of the flexor tendons through the fetlock canal results in lameness. The commonest cause was chronic synovitis of the digital sheath. The condition is characterised by an unremitting lameness, synovial distension and a notch on the caudal aspect of the limb. The condition can be relieved by section of the annular ligament of the fetlock. In a series of 24 cases 16 horses returned to work with no recurrence of lameness, three cases were lost to follow up and five animals remained lame; three of these had intercurrent disease.
Fretz PB, McIlwraith CW.Five young horses with fetlock varus deformities of 8 degrees or greater were treated by means of wedge osteotomy of the distal end of the 3rd metacarpal or metatarsal bone. Three patients were admitted to the Western College of Veterinary Medicine and 2 to Colorado State University. Their selection as surgical patients was based on the following criteria: (1) an angular limb deformity of 8 degrees or greater, (2) patient older than 120 days, (3) no evidence of lameness, and (4) no evidence of degenerative joint disease. The surgery was successful in all cases.
Sønnichsen HV, Kristoffersen J, Falk-Rønne J.Joint mice in the horse is a wellknown condition, but during the last years diagnosed with increasing frequency. Ethiology and prognosis thus become of major interest. 53 cases of mice in the fetlock are examined and divided in 3 groups on the basis of localization and appearance. On one group characterised by a localization in the plantar aspect of the joint and clearly separated from the tuberosites of the first phalanx histological investigations were carried out resulting in the statement that the mice can be the result of osteochondrosis. Surgical intervention in cases with clinical sympt...
O'Brien TR, Hornof WJ, Meagher DM.Subchondral lesions were identified in the distal palmar region of the third metacarpus in 21 fetlock joints of 15 Thoroughbred horses. The lesions were more commonly identified on the lateromedial and flexed lateral projection, with the flexed lateral projection permitting optimal visualization of the lesion. Lesions appeared as poorly marginated, radiolucent defects and were located at the level of the base of the proximal sesamoid bones. The shape and distribution of the radiolucent defects were: crescent, 4; flattened, 4; shallow concavity, 5; deep concavity, 3; oval, 3; and circular, 2. S...
van Veenendaal JC, Moffatt RE.Eight cases of sessile, intra-articular soft tissue masses originating from the cranio-dorsal attachment of the capsule of the fetlock joint of horses are presented. In 4 of these cases an osteochondral fracture of the first phalanx was also present. Clinically the condition closely resembled villonodular synovitis; however the microscopic changes did not correspond to those reported. The clinical signs included lameness after exercise, joint effusion and pain on manipulation. The offending masses were surgically resected and their histology indicated a chronic proliferative synovitis. The res...
Gray BW, Engel HN, Rumph PF, LaFaver J, Brown BG, McKibbin JS.To determine the sensory nerve supply of the metacarpophalangeal joint, lameness was induced in eight horses by injecting the joint with a glycerin suspension of glass micropheres. When the medial and lateral palmar nerves were anesthetized in 4 horses, there was noticeable improvement in the gait, but each horse remained lame. When the medial and lateral palmar metacarpal nerves were also anesthetized, 3 of the 4 horses became sound. To confirm the results of local anesthesia, neurectomies were performed on a second group of four horses. The lameness was alleviated only upon resection of both...
Meek DG, Dickinson EO.An illustrated approach to the medial aspect of the equine fetlock joint is described, whereby the collateral ligaments are transected. This approach is suggested as a possible technique for metatarsal or metacarpal bone fracture repair by retrograde pinning, arthrodesis of the fetlock joint and other joint and sesamoid bone surgery. The histological evidence of satisfactory healing is presented and the advantages and disadvantages are discussed.
Asheim A, Lindblad G.Forty-five race-horses with arthritis of non-in-fectious type in 54 joints were treated with sodium hyaluronate intra-articularly. All joints had previously been treated without lasting success by conventional methods, such as firing, blistering or intraarticular injection of cortisone. In most cases only 1 injection of 2 ml (20 mg) sodium hyaluronate was needed. To avoid subjective evaluation, the effects of the treatment were based on the joint’s capacity of withstanding extreme stress, which means that the horse should be able to train and race again. The treatment was concentrated on the...
Sack WO.The nerve distribution to the digit of the horse was studied with the compound microscope in serial transverse sections of fetal limbs and plotted on life-size outlines of the horse's foot. It was learned that there is much variation in the topography of the branches of the principal nerves. There is no mirror-image nerve distribution on the 2 sides of the foot. The dorsal branch of the ulnar nerve does not extend below the fetlock. The communication between the palmar metacarpal nerves and branches of the dorsal branch of the digital nerves is only a crossing of nerves without exchange of fib...
Milne FJ.FOR MANY YEARS, concern has been expressed at the wastage of young Thoroughbreds at the racetrack. This concern even manifested itself in the publication of a book (1) which referred to the prevailing practice of prematurely start-ing the racing career of the Thoroughbred long before it had attained sufficient maturity to engage in stiff, damaging competition. This is not a fault of the Thoroughbred industry alone, because in certain parts of the U.S.A., Quarter Horses less than two years of age are already racing. We could swing to the opposite extreme, of course, to the pleasure horse world ...
In horses, osteoarthritis (OA) mostly affects metacarpophalangeal and metatarsophalangeal (fetlock) joints. The current modalities used for diagnosis of equine limb disorders lack ability to detect early OA. Here, we propose a new alternative approach to assess experimental cartilage damage in fetlock joint using Acoustic Emissions (AE). Objective: To evaluate the potential of AE technique in diagnosing OA and see how AE signals changes with increasing severity of OA. Methods: An in vitro experimental study. Methods: A total of 16 distal limbs (8 forelimbs and 8 hindlimbs) from six Finn horses...
Stolk PW, Firth EC.Eight metatarsophalangeal (fetlock) joints were studied in anaesthetized young ponies. Pressure measurements were made in the joint and at various sites in the marrow cavity of the third metatarsal bone with simultaneous measurement of systemic arterial and venous blood pressures. Fetlock joint flexion was always associated with a statistically significant initial decrease in intra-articular pressure (p < 0.05) followed by a marked increase in pressure (p < 0.05). Subsequent extension was accompanied by a similar pressure pattern, although there appeared to be a hysteretic relationship. ...
Brommer H, van Weeren PR, Brama PA, Barneveld A.The equine fetlock joint has the largest number of traumatic and degenerative lesions of all joints of the appendicular skeleton. Objective: To gain insight into the distribution of cartilage degeneration across the articular surface in relation to age in order better to understand the dynamic nature and progression of osteoarthritis (OA). Objective: That there would be a specific age-related distribution pattern of cartilage degeneration in the equine metacarpophalangeal joint. Methods: The proximal articular cartilage surfaces of the first phalanges (P1) of 73 slaughter horses (age range 0.4...
Goodman NL, Baker BK.Lameness problems constitute a major part of racing Quarter Horse practice. This article considers the diagnosis, prognosis, and treatment of the frequently encountered lamenesses. The main conditions included are synovitis, intra-articular fractures, osteochondritis dissecans, and degenerative joint disease as they relate to the coffin, fetlock, carpal, and tarsal joints. Intra-articular injection techniques and medications are discussed because of the frequency of joint disease. Bucked shins and stress fractures are also reviewed.
Bailey CJ, Reid SW, Hodgson DR, Rose RJ.A prospective study of injuries and disease in a cohort of Australian thoroughbreds in training was conducted with the participation of 24 trainers. From the horses catalogued at a major yearling sale in 1995, 169 were enrolled in the study and followed through their two- and three-year-old racing seasons. The principal aim was to quantify the time lost in training as a result of the various categories of injuries and disease, recorded as either days of modified training, or weeks rested at pasture. Shin soreness was the most common condition in two-year-olds (affecting 42 per cent of the hors...
Colborne GR, Lanovaz JL, Sprigings EJ, Schamhardt HC, Clayton HM.A method is described for the estimation of joint moments of force and power in the equine forelimb using S-VHS video and force platform data. Video and force data were collected for 5 walking trials in a sound Dutch Warmblood horse. The sagittal plane positional and angular data were combined with the vertical and cranio-caudal ground reaction forces to calculate net joint moments of force in the sagittal plane across the carpal, fetlock and coffin joints during the stance phase of the forelimb. The mechanical power was calculated as the product of the netjoint moment and the joint's angular ...
Robert C, Valette JP, Denoix JM.There is limited published data on conformational changes in the forelimbs of growing foals. This study was designed to describe the changes in conformation of the carpus and distal forelimb from birth to weaning in foals of three different breeds. Evaluation of the conformation of the carpus, fetlock, pastern and foot was carried out in 134 Thoroughbreds, 162 French Trotters and 98 Selle Français (French Warmblood) within 1 month of age and then at approximately 2 month intervals until weaning at approximately 6 months of age. The prevalence of limb deviations decreased from birth to weaning...
Ciamillo SA, Wulster KB, Gassert TM, Richardson DW, Brown KA, Stefanovski D, Ortved KF.Catastrophic injuries of the fetlock joints occur in Thoroughbred racehorses and are preceded by stress-induced bone injury. Early detection of subchondral bone injury is essential to prevent irreversible damage or bone failure. Objective: To investigate the use of standing, robotic cone-beam computed tomography (CBCT) for assessing longitudinal changes in subchondral bone morphology and pathology of the fetlock joints associated with race training in young Thoroughbreds. Methods: Observational cohort study. Methods: Forty-one 2-year-old Thoroughbred racehorses were recruited prior to the star...
Faulkner JE, Joostens Z, Broeckx BJG, Hauspie S, Mariën T, Vanderperren K.Sagittal groove disease of the proximal phalanx in equine athletes is commonly considered a bone stress injury. Repetitive hyperextension of the fetlock under high load is thought to contribute to its development. Concurrent changes are often reported in the dorsal sagittal ridge of the third metacarpus/metatarsus (MC3/MT3). Objective: To describe the spectrum of associated osseous abnormalities that are present in the fetlock in a large group of horses diagnosed with sagittal groove disease on low-field magnetic resonance imaging (MRI). Methods: Retrospective, cross-sectional. Methods: MRI im...
Bierau J, Rott P, Röcken M, Staszyk C.This study aimed to delineate the detailed anatomy of the metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints in healthy horses using cone beam computed tomography (CBCT). The fetlock region of 15 cadaveric forelimbs and 14 cadaveric hindlimbs from nine adult horses without orthopaedic disease underwent CBCT scanning. Additionally, arthrography CBCT scans were conducted following intra-articular injection of a radiopaque contrast medium containing blue epoxy resin dye. Subsequently, limbs were frozen and sectioned to visualize anatomical structures in sectional planes corresponding ...
Okudaira M, Cresswell EN, Wollman CW, McDonough SP, Engiles JB, Reesink HL.To describe the development and maturation of equine proximal sesamoid bones (PSBs) in fetuses and young horses using radiography, microcomputed (micro)-CT, and histology. Methods: A descriptive study. Forelimb PSBs from 12 equids ranging in age from 105 days of gestation to 540 days postgestation were evaluated. Radiography was used for preliminary assessment of metacarpophalangeal joint and PSB mineralization, and micro-CT imaging was performed to assess mineralized PSBs. Tissue volume, bone volume fraction, height, width, depth, trabecular thickness, and anisotropy were quantified from midp...
Hanousek K, Fiske-Jackson A, O'Leary L, Smith RKW.In vivo measurement of limb stiffness and conformation provides a non-invasive proxy assessment of superficial digital flexor tendon (SDFT) and suspensory ligament (SL) function. Here, we compared it in fore and hindlimbs and after injury. Objective: To compare the limb stiffness and conformation in forelimbs and hindlimbs, changes with age, and following injury to the SDFT and SL. Methods: Retrospective cohort study. Methods: Limb stiffness was calculated using floor scales and an electrogoniometer taped to the dorsal fetlock. The fetlock angle and weight were simultaneously recorded five tim...
Van Mol B, Oosterlinck M, Janssens S, Buys N, Pille F.Various environmental and genetic risk factors are linked to the pathogenesis of equine osteochondrosis and osteochondral fragments in the fetlock joint. Therefore, a scoping review was conducted to describe current evidence linking genetic factors and environmental factors of these osteochondral disorders. This article constitutes the first part of this scoping review and focuses on environmental factors, with the second part addressing genetic factors. To identify potentially relevant papers online bibliographical databases PubMed and Web of Science were utilised, supplemented with articles ...
Hoey S, Fogarty U, McAllister H, Puggioni A, Cloak B, Richard H, Skelly C, Laverty S.Articular cartilage can be directly imaged using ultrasonography. The fetlock is a common site of osteochondrosis, with the sagittal ridge of the third metacarpal bone most commonly affected. In osteochondrosis, cartilage thickening may be an initial finding. This postmortem study investigated the ability of ultrasonography to accurately measure the dorsodistal articular cartilage of the third metacarpal bone in young horses, compared to computed tomographic arthrography (CTA) and histological measurements. A total of 33 metacarpophalangeal joints from 18 horses between the ages of 12 days and...
Van Mol B, Janssens S, Oosterlinck M, Pille F, Buys N.Equine osteochondrosis and osteochondral fragments in the fetlock joint are linked to various environmental and genetic risk factors. To assess the scope of the literature linking these risk factors to the development of these osteochondral disorders, while identifying knowledge gaps and challenges to guide future research, a scoping review was performed. This article constitutes the second part of this scoping review and focuses on genetic factors, with the first part addressing environmental factors. To identify potentially relevant papers, online bibliographical databases PubMed and Web of ...
Van Cauter R, Caudron I, Lejeune JP, Rousset A, Serteyn D.Osteochondral fragments within equine joints are commonly encountered and may predispose to lameness and limitation to sport purposes. Factors leading to this condition include genetic, nutritional and environmental conditions. However, few studies have evaluated the impact of conformation traits and their correlation with osteochondrosis. This study, based on the radiographic screenings of young horses born in Wallonia (266 individuals, 532 forelimbs), evaluated the correlation between foot, fetlock conformations of the front limb, height at the withers and presence of osteochondral fragments...
Riley JW, Chance LM, Barshick MR, Johnson SE.Hyaluronic acid (HA), a glycosaminoglycan found in joint synovial fluid, is administered to horses as an anti-inflammatory with lubrication properties. This experiment examined the effects of HA administered before and shortly after an exercise test on metacarpophalangeal (MCP; fetlock) and tibiotarsal (hock) joint range of motion (ROM). Horses were injected intravenously (IV) with placebo (4Â mL, saline) or HA (4Â mL, 40Â mg) 24Â h before performing a standardized exercise test (SET) on a high-speed treadmill and again at 6-h post-SET. Passive fetlock flexion was measured at 4 and 24Â h post-...
Whitaker B, Barnhard JA, Webb KR, Levine D, Green MM, Vieira MR.This study assessed the safety and tolerability of concurrent intra-articular (IA) injection of 2.5% polyacrylamide hydrogel (2.5% iPAAG) and betamethasone sodium phosphate and betamethasone acetate esters (BME) in the metacarpophalangeal joints (MCPJs) of healthy horses. Methods: 10 healthy therapeutic riding horses were enrolled in this open-label safety study from August 1 to September 14, 2023. Inclusion criteria required normal physical examinations, insulin level, hematology, biochemistry, soundness at all gaits, and negative forelimb flexion tests. Screening occurred from days -14 to -0...
CT arthrography (CTA) for evaluating cartilage defects would be beneficial in clinical practice. Since the contrast medium (CM) volume is often driven by operator experience, the aim was to evaluate the minimum volume of iodinated CM for CTA sufficient to identify iatrogenic cartilage defects in horse fetlock. The study was conducted on ex-vivo 32 distal limbs from adult horses collected at slaughter. Iatrogenic cartilage defects were arthroscopically made on fetlock, at 5 predetermined locations. Subsequently, CT scans were performed, according to the following protocol: precontrast scan, fol...
Beck C, Hitchens PL, Whitton RC.Post-mortem studies have shown that fractures involving the metacarpophalangeal/metatarsophalangeal or fetlock joint are associated with focal areas of microdamage. Identification of computed tomography (CT) features consistent with microdamage and their association with fracture may aid in identification of horses at risk of fracture. Objective: To identify CT features associated with fracture of the metacarpophalangeal/metatarsophalangeal joint. Methods: Retrospective cohort study. Methods: Post-mortem CT images of 367 limbs from 157 Thoroughbred racehorses were graded for CT features. Multi...
Nagy A, Dyson SJ.There is no description of comparative magnetic resonance imaging (MRI) and fan-beam computed tomography (CT) findings in the fetlock of lame sports horses. Objective: To document low-field MRI and fan-beam CT diagnoses in the lame and nonlame limbs of sports horses with fetlock region pain, and to evaluate whether combined imaging provides superior information to either technique alone. Methods: Retrospective descriptive study. Methods: Clinical records of sports horses with pain causing lameness localised to the metacarpo/metatarsophalangeal joint region that had undergone fan-beam CT and lo...
Luque RM, Henderson B, McCorkell TC, Alizadeh AH, Russell KA, Koch TG, Koenig J.Mesenchymal stromal cells (MSCs) are widely used to treat osteoarthritis (OA). Optimising dose, timing, and safety while comparing efficacy with standard therapies like hyaluronic acid (HA) is essential for their standardisation. Objective: To assess the safety and efficacy of equine umbilical cord-derived (eCB) MSCs in client-owned horses with fetlock or carpus OA. Methods: Prospective single-blinded randomised clinical study. Methods: Horses diagnosed with fetlock or carpus OA via intra-articular (IA) anaesthesia were randomly assigned to receive either 10 or 20 million eCB-MSCs in HA or 3â€...
Solum G, Acutt E, Johnson SA, Zhou T, Contino EK, Donnell JR, Donnell A, Frisbie DD.Pathological changes of the fetlock joint are well documented in Thoroughbreds, but little information is available describing the common radiographic findings in western performance horses with fetlock lameness. Objective: To describe radiographic findings in western performance horses with fetlock lameness. It was hypothesised that the degree of lameness would correlate with the severity of radiographic findings. Methods: Retrospective case series. Methods: Retrospective review (2012-2022) of horses with lameness isolated to the fetlock joint via intra-articular analgesia and corresponding r...
Foucaud M, Haegeman L, Kadic D, Vinardell T, Mariën T, Declercq J.To describe a direct arthroscopic approach of the distal pouch of the palmar/plantar recess of the fetlock to facilitate fragment removal, highlighting its advantages over previously described arthroscopic methods for the fetlock. Additionally, to evaluate and present a retrospective case series. Methods: Ex vivo and retrospective clinical study. Methods: A total of 25 fetlocks in 23 horses. Methods: A direct approach to the distal pouch of the palmar/plantar recess of the fetlock was developed on five cadaveric limbs. Arthroscopic anatomy and landmarks were examined. The approach was clinical...
Pál Z, Tuska P, Vásárhelyi G, Hangody L, Hurtig M, Kaposi AD, Bodó G.To evaluate the clinical application of equine mosaic arthroplasty for joint surface repair, including outcomes and complications. Methods: Retrospective clinical study. Methods: A total of 31 horses diagnosed with subchondral bone cysts (SBCs) in the femoral condyle (22/31), distal metacarpus (7/31), or metatarsus (2/31). Methods: Medical records of horses that underwent autologous or allogeneic osteochondral graft transplantation were reviewed. Follow-up lasted at least 12 months. Success was determined in terms of improvements in lameness and post-surgical athletic performance, classified...
Northwood A, Berner D.Radiographic protocols for the metacarpo-/tarsophalangeal joint during pre-purchase examinations (PPE) vary internationally, but their impact on pathology detection remains unclear. Optimising imaging protocols is essential to balance diagnostic accuracy with workflow efficiency and radiation exposure. Objective: To evaluate the effect of different radiographic view combinations on fetlock pathology detection and observer agreement in a PPE context; hypothesising that detection rates vary with view selection. Methods: Retrospective observational study. Methods: Two observers reviewed fetlock r...
