The metatarsophalangeal joint in horses, commonly referred to as the fetlock joint, is a complex anatomical structure located between the cannon bone and the long pastern bone in the hind limb. It plays a significant role in the locomotion and weight-bearing functions of the horse. This joint is composed of bones, ligaments, tendons, and synovial fluid, which together facilitate movement and provide stability. The health and functionality of the metatarsophalangeal joint are critical for equine performance and are often the focus of veterinary assessments due to their susceptibility to injuries and degenerative conditions. This page compiles peer-reviewed research studies and scholarly articles that explore the anatomy, biomechanics, pathology, and treatment options related to the metatarsophalangeal joint in horses.
van der Harst MR, Rijkenhuizen AB.The prognosis of ruptured collateral ligaments of the metacarpophalangeal or metatarsophalangeal joint in horses is usually considered to be poor, especially for future athletic performance. The main problem is the development, due to joint instability, of osteoarthritis, which may result in persistent lameness. In this paper a surgical technique is described in which joint stabilisation is realised by using a polypropylene mesh as a substitute for the ruptured ligaments, with the subsequent application of a cast for 7 weeks. The technique was successfully performed in 2 horses with ruptured l...
Southwood LL, Trotter GW, McIlwraith CW.To determine the outcome of horses after arthroscopic removal of abaxial fracture fragments of the proximal sesamoid bone and association of fracture grade with outcome. Methods: Retrospective study. Methods: 47 horses. Methods: Information obtained from dorsopalmar and dorsoplantar radiographic views of metacarpophalangeal and metatarsophalangeal joints was used to classify fractures as grade 1 ( 25 mm long) and type 1 (abaxial) and type 2 (apical-abaxial). Outcome was determined by whether the horse returned to its intended use, raced in the same class or higher (racehorses), or performed sa...
Ross MW.To correlate scintigraphic and clinical findings of the metatarsophalangeal joint (MTPJ) in Standardbreds, radiographic findings in horses with confirmed MTPJ lameness, and determine if stress reaction and more advanced bone remodelling occurred in the MTPJ, medical records of 114 Standardbreds admitted between September 1993 and April 1995 in which bone scintigraphy included standing lateral and plantar views of the metatarsophalangeal joint (MTPJ) were reviewed. Images obtained using a large field of view gamma camera were evaluated visually for location, definition and intensity of increase...
Roneus B, Andersson AM, Ekman S.Chronic synovitis may cause recurring lameness in competing race horses. Forty-five standardbred horses with recurring lameness secondary to chronic synovitis were studied. Arthroscopic synovectomy was performed in 32 metacarpo-/metatarsophalangeal joints and in 28 intercarpal joints of horses that had previously been treated unsuccessfully with commonly used intraarticular medication The outcome of the synovectomy was evaluated by comparing racing performance before and after surgery. The synovial membrane was microscopically characterized as chronic synovitis of varying severity. Racing perf...
Izumisawa Y, Yamaguchi M, Bertone AL, Tangkawattana P, Masty J, Yamashita K, Kotani T.The structural arrangement and cellular distribution of endothelial and lining cells of the synovial villi were studied in the equine palmar/plantar recess of the metacarpo- and metatarsophalangeal joints by light microscopy and electron microscopy. The extent and distribution of blood vessels varied with villous shape and length. The majority of vessels formed concentric circles in cross and longitudinal sections and probably are arranged in a convoluted, spiral or helical pattern. The villi do not contain smooth muscle cells or typical capillaries as observed in other organs. Under the elect...
Grøndahl AM, Jansen JH, Teige J.Fifty-six tarsocrural joints and 94 metatarsophalangeal joints were examined, at necropsy, from horses aged < or = 2 years. Osteochondral fragments at the cranial aspect of the intermediate ridge of the distal part of the tibia were seen in six horses, and at the proximoplantar aspect of the proximal phalanx in seven horses. Defects in the proximoplantar aspect of the proximal phalanx without osteochondral fragments were seen in a further two horses. Inflammatory and degenerative changes were not observed in any of the joints examined. From the incidence and natural course of these fragment...
Stolk PW, de Waal Malefijt MC, Buma P, Barneveld A.In this paper the successful replacement of an equine metatarsophalangeal joint by a human total condylar knee prosthesis is reported. In the period of observation following implantation of the endoprosthesis the experimental animal showed almost no lameness when exercised at walk, bearing weight on the operated limb. Flexion and extension of the joint were markedly reduced. The clinical and histological observations clearly support further investigation into the equine metatarsophalangeal joint replacement by an endoprosthesis.
Grøndahl AM, Engeland A.The tarsocrural, metacarpophalangeal, and metatarsophalangeal joints of 753 Standardbred yearlings were radiographed. On the basis of radiographic findings, the horses were allotted into 4 groups. Group-1 horses had osteochondrosis in the tarsocrural joints. Group-2 horses had palmar/plantar bony fragments in the metacarpo- and metatarsophalangeal joints. Group-3 horses had radiographic changes in the metacarpo- and metatarsophalangeal joint region, such as bony fragments located at the dorsoproximal end of the proximal phalanx, osteochondrosis of the sagittal ridge of the third metacarpus/met...
Grøndahl AM, Gaustad G, Engeland A.Radiographic examination of the metacarpo- and metatarsophalangeal joints was performed on 753 Standardbred trotters (6-21 months of age): 21 showed obvious changes in 26 proximal sesamoid bones on lateromedial projection. The radiographic changes were divided into 6 different types: (1) irregular abaxial margin (8 horses); (2) enlargement of the sesamoid bone (6 horses); (3) 'fracture' or separate centre of ossification of the apex (4 horses); (4) vertical, non-articular fracture of the plantar part of the sesamoid bone (1 horse); (5) a small bony fragment located in a defect in the apical pa...
Firth EC, Whittem T, Nouws JF.Six adult ponies were injected in the same intramuscular site with kanamycin sulphate (10 mg/kg). Two hours later, arthrocenteses of the right metacarpophalangeal, radio-carpal, intercarpal, tibio-tarsal and metatarsophalangeal joints were performed within 3 minutes. Arthrocenteses of the same joints on the left side were conducted 5 hours later. When expressed as a percentage of plasma drug concentration, differences in synovial fluid drug concentration between the joints sampled at 2 and 5 hours after injection were not detected.
Kobluk CN, Schnurr D, Horney FD, Sumner-Smith G, Willoughby RA, Dekleer V, Hearn TC.High-speed cinematography with computer aided analysis was used to study equine hindlimb kinematics. Eight horses were filmed at the trot or the pace. Filming was done from the side (lateral) and the back (caudal). Parameters measured from the lateral filming included the heights of the tuber coxae and tailhead, protraction and retraction of the hoof and angular changes of the tarsus and stifle. Abduction and adduction of the limb and tarsal height changes were measured from the caudal filming. The maximum and minimum values plus the standard deviations and coefficients of variations are prese...
Sandgren B.Radiographic examination of the tarsocrural, metacarpo- or metatarsophalangeal joints was made in 139 Standardbred horses. Most were under three years old with no history of orthopaedic problems. In the tarsocrural joint, osteochondrosis was observed in 25 (18.1 percent) of the horses (n = 138) and 14 (56 percent) of these were affected bilaterally. In the metatarsophalangeal joint, the most frequent radiographic abnormality was single or multiple bony fragments or defects at the plantar proximal end of the proximal phalanx, which was noticed in 40 (28.8 percent) of the horses (n = 139). The l...
Barclay WP, Foerner JJ, Phillips TN.Osteochondral fragmentation of the plantar aspect of the proximal phalanx was diagnosed as a cause of hind limb lameness in 19 horses. The lameness was evident at the upper levels of the horses' performance capabilities, and was isolated to the metatarsophalangeal joints by use of intra-articular or regional anesthesia. Fragments were surgically removed from 10 horses that later returned to full use. Seven horses were treated intra-articularly with polysulfated glycosaminoglycans or corticosteroids; only one horse was able to return to full use. One horse was retired from work at the time of d...
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...
Firth EC, Whittem T, Nouws JF.Six adult ponies were injected in the same intramuscular site with kanamycin sulphate (10 mg/kg). Two hours later, arthrocenteses of the right metacarpophalangeal, radio-carpal, intercarpal, tibio-tarsal and metatarsophalangeal joints were performed within 3 minutes. Arthrocenteses of the same joints on the left side were conducted 5 hours later. When expressed as a percentage of plasma drug concentration, differences in synovial fluid drug concentration between the joints sampled at 2 and 5 hours after injection were not detected.
Izumisawa Y, Yamaguchi M, Bertone AL, Tangkawattana P, Masty J, Yamashita K, Kotani T.The structural arrangement and cellular distribution of endothelial and lining cells of the synovial villi were studied in the equine palmar/plantar recess of the metacarpo- and metatarsophalangeal joints by light microscopy and electron microscopy. The extent and distribution of blood vessels varied with villous shape and length. The majority of vessels formed concentric circles in cross and longitudinal sections and probably are arranged in a convoluted, spiral or helical pattern. The villi do not contain smooth muscle cells or typical capillaries as observed in other organs. Under the elect...
Stolk PW, de Waal Malefijt MC, Buma P, Barneveld A.In this paper the successful replacement of an equine metatarsophalangeal joint by a human total condylar knee prosthesis is reported. In the period of observation following implantation of the endoprosthesis the experimental animal showed almost no lameness when exercised at walk, bearing weight on the operated limb. Flexion and extension of the joint were markedly reduced. The clinical and histological observations clearly support further investigation into the equine metatarsophalangeal joint replacement by an endoprosthesis.
van der Harst MR, Rijkenhuizen AB.The prognosis of ruptured collateral ligaments of the metacarpophalangeal or metatarsophalangeal joint in horses is usually considered to be poor, especially for future athletic performance. The main problem is the development, due to joint instability, of osteoarthritis, which may result in persistent lameness. In this paper a surgical technique is described in which joint stabilisation is realised by using a polypropylene mesh as a substitute for the ruptured ligaments, with the subsequent application of a cast for 7 weeks. The technique was successfully performed in 2 horses with ruptured l...
Roneus B, Andersson AM, Ekman S.Chronic synovitis may cause recurring lameness in competing race horses. Forty-five standardbred horses with recurring lameness secondary to chronic synovitis were studied. Arthroscopic synovectomy was performed in 32 metacarpo-/metatarsophalangeal joints and in 28 intercarpal joints of horses that had previously been treated unsuccessfully with commonly used intraarticular medication The outcome of the synovectomy was evaluated by comparing racing performance before and after surgery. The synovial membrane was microscopically characterized as chronic synovitis of varying severity. Racing perf...
Southwood LL, Trotter GW, McIlwraith CW.To determine the outcome of horses after arthroscopic removal of abaxial fracture fragments of the proximal sesamoid bone and association of fracture grade with outcome. Methods: Retrospective study. Methods: 47 horses. Methods: Information obtained from dorsopalmar and dorsoplantar radiographic views of metacarpophalangeal and metatarsophalangeal joints was used to classify fractures as grade 1 ( 25 mm long) and type 1 (abaxial) and type 2 (apical-abaxial). Outcome was determined by whether the horse returned to its intended use, raced in the same class or higher (racehorses), or performed sa...
Grøndahl AM, Jansen JH, Teige J.Fifty-six tarsocrural joints and 94 metatarsophalangeal joints were examined, at necropsy, from horses aged < or = 2 years. Osteochondral fragments at the cranial aspect of the intermediate ridge of the distal part of the tibia were seen in six horses, and at the proximoplantar aspect of the proximal phalanx in seven horses. Defects in the proximoplantar aspect of the proximal phalanx without osteochondral fragments were seen in a further two horses. Inflammatory and degenerative changes were not observed in any of the joints examined. From the incidence and natural course of these fragment...
Vanderperren K, Martens AM, Declercq J, Duchateau L, Saunders JH.To compare clinical usefulness of ultrasonography versus radiography for detection of fragmentation of the dorsal aspect of the metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints in horses. Methods: Cross-sectional study. Methods: 36 horses with fragmentation of the MCP (n = 19) and MTP (29) joints. Methods: In all joints, radiography (4 standard projections) and ultrasonography were performed prior to arthroscopic examination and fragment removal. Number and location of fragments identified radiographically and ultrasonographically were compared with arthroscopic findings. Results...
Gonçalves LM, Pozzobon R, Dos Anjos BL, Pellegrini DCP, Azevedo MS, Dau SL, Oliveira GP, Klaus R.The term juvenile osteochondral condition (JOCC) has been used to identify developmental changes in the growth plates. The condition is characterized by a set of changes with similar pathogenesis that affect the immature skeleton and joints of growing foals. The aim of the current study is to investigate the prevalence and degree of severity of osteochondral changes in Brazilian warmblood (BW) foals in two farms in the south of Brazil. Radiological evaluation was applied to the metacarpophalangeal (MCP), carpal (C), metatarsophalangeal (MTP), tarsal (T), and femorotibiopatellar (FTP) joints of...
da Gracca Macoris D, Bertone A.The study of the influence of motion and initial intra-articular pressure (IAP) on intra-articular pressure profiles in equine cadaver metatarsophalangeal (MTP) joints was undertaken as a prelude to in vivo studies. Eleven equine cadaver MTP joints were submitted to 2 motion frequencies of 5 and 10 cycles/min of flexion and extension, simulating the condition of lower and higher (double) rates of passive motion. These frequencies were applied and pressure profiles generated with initial normal intra-articular pressure (-5 mmHg) and subsequently 30 mmHg intra-articular pressure obtained by inje...
Grøndahl AM, Gaustad G, Engeland A.Radiographic examination of the metacarpo- and metatarsophalangeal joints was performed on 753 Standardbred trotters (6-21 months of age): 21 showed obvious changes in 26 proximal sesamoid bones on lateromedial projection. The radiographic changes were divided into 6 different types: (1) irregular abaxial margin (8 horses); (2) enlargement of the sesamoid bone (6 horses); (3) 'fracture' or separate centre of ossification of the apex (4 horses); (4) vertical, non-articular fracture of the plantar part of the sesamoid bone (1 horse); (5) a small bony fragment located in a defect in the apical pa...
Pfau T, Clark KS, Bolt DM, Lai JS, Perrier M, Rhodes JB, Smith RK, Fiske-Jackson A.Limited evidence is available relating gait changes to diagnostic anaesthesia. We investigated associations between specific movement patterns and diagnostic anaesthesia of different anatomical structures in a retrospective analysis. Referral-level lameness cases were included with the following criteria: presence of diagnostic anaesthesia of a forelimb and/or hind limb; subjective efficacy classified as "negative", "partially positive", or "positive"; quantitative gait data available from inertial measurement units. Gait changes were calculated for three forelimb (palmar digital, abaxial sesa...
Drahonovska A, Bladon BM, O'Neill HD.To describe a technique and report outcomes for internal fixation of short frontal-plane fractures involving the dorsoproximal articular surface of the proximal phalanx (P1) in standing horses. Methods: Short case series. Methods: Six Thoroughbred racehorses with short, frontal plane fractures involving the dorsoproximal P1. Methods: All fractures were located in the hindlimb. Horses presented with moderate lameness and marked effusion of the affected metatarsophalangeal joint. Fractures had a medial bias extending from the central aspect of proximal P1 to involve the dorsomedial prominence. F...
Boado A, Pollard D, Dyson S.There are no studies that have investigated factors influencing the outcome of dressage horses with suspensory ligament (SL) branch injuries. The aim was to determine if age, breed, work level, injury severity, anatomical localisation of injury, number of injured branches, periligamentous fibrosis, persistence of power Doppler signal or coexistent osteoarthritis of a metacarpophalangeal (MCP) or metatarsophalangeal (MTP) joint influenced the prognosis of 70 dressage horses. Outcome was defined as good (return to pre-injury level of work or higher), poor (return to a lower level of work) or ret...
