Cost of Joint Injections in the UK for horses

Hock arthritis, or osteoarthritis (OA) of the tarsal joint, is a common degenerative condition affecting both canine and equine patients. As a load-bearing joint subjected to high mechanical stress, the hock is particularly prone to the wear-and-tear processes that underpin osteoarthritis. Early detection, targeted therapeutic interventions, and ongoing management are crucial for maintaining mobility and quality of life in affected animals. One widely used intervention is the administration of intra-articular joint injections. In this article, we explore the clinical rationale, mechanisms of action, advantages, limitations, and costs associated with this treatment option in the UK.

Prevalence of Hock Arthritis

In Canines

Osteoarthritis affects approximately 20% of dogs over one year of age, with prevalence increasing with age and body weight (Anderson et al., 2020). While the hip and stifle joints are commonly affected, the hock is also a frequent site, particularly in active or working breeds such as Labradors, German Shepherds, and agility dogs. Repetitive motion, previous injury, conformational abnormalities, or cruciate ligament disease may predispose the hock to arthritic changes.

In Equines

In horses, hock arthritis—specifically affecting the distal intertarsal and tarsometatarsal joints—is commonly referred to as “bone spavin.” It is especially prevalent in performance horses involved in disciplines that require collection, such as dressage, show jumping, and eventing. Studies estimate that up to 60% of lameness cases in sport horses are attributable to hock-related issues (McIlwraith et al., 2015).

Mechanism and Application of Joint Injections

What Are Joint Injections?

Joint injections involve delivering therapeutic agents directly into the synovial space of the affected joint. The most common substances used include:

• Corticosteroids (e.g. triamcinolone acetonide, methylprednisolone acetate)

• Hyaluronic Acid (HA)

• Polyacrylamide hydrogels

• Biologic agents such as Platelet-Rich Plasma (PRP) or Interleukin-1 Receptor Antagonist Protein (IRAP)

#How They Work

• Corticosteroids act as potent anti-inflammatory agents by suppressing the production of pro-inflammatory cytokines and enzymes that contribute to cartilage degradation. They also reduce synovial fluid viscosity and joint effusion.

• Hyaluronic Acid contributes to joint lubrication and viscoelasticity, providing a cushioning effect and stimulating endogenous HA production by synoviocytes.

• PRP and IRAP are regenerative options that modulate the inflammatory cascade and promote tissue repair through growth factors and cytokine inhibition (Murray et al., 2017).

The injection is typically guided via anatomical landmarks or, more precisely, via ultrasound guidance to ensure intra-articular placement, especially in smaller joints like the canine hock.

#Cost of Joint Injections in the UK for horses and canine

The cost of joint injections varies depending on the substance used, the number of joints treated, and whether imaging guidance is employed.

• Canine hock injection (per joint): £250–£450

• Equine hock injection (per joint pair): £300–£600

• Biologic therapies (e.g. PRP, IRAP): £600–£1,200

These prices typically include sedation, sterile preparation, drug administration, and post-procedure evaluation but may not include diagnostics such as imaging or follow-up treatments.

Pros and Cons of Joint Injections

#Pros

• Rapid Relief of Pain and Inflammation: Corticosteroid injections can provide pain relief within 24–72 hours (Budsberg et al., 2014).

• Minimally Invasive: Compared to surgical interventions, joint injections are less invasive and can often be performed under light sedation.

• Targeted Therapy: Direct delivery allows high local concentration of the drug with fewer systemic side effects.

• Supports Rehabilitation: Reducing pain and inflammation facilitates more effective physiotherapy and exercise-based rehabilitation.

#Cons

• Temporary Relief: Injections do not address the underlying disease process; they manage symptoms. Relief may last weeks to months, requiring repeat procedures.

• Risk of Joint Infection (Septic Arthritis): Although rare (<1% incidence with proper technique), it is a serious complication that requires immediate veterinary attention.

• Cartilage Damage with Repeated Use: Long-term or repeated corticosteroid use may accelerate cartilage degeneration if not carefully monitored (McIlwraith et al., 2015).

• Cost Accumulation: Ongoing injections can be costly over time, particularly when paired with adjunct therapies.

Clinical Considerations in Physiotherapy

For physiotherapists, knowing when joint injections are appropriate—and when they may mask signs of deeper biomechanical issues—is essential. Collaborating with the referring veterinary surgeon ensures integrated care. Once inflammation is controlled, a tailored rehabilitation programme focusing on **joint mobilisation, muscle strengthening, proprioceptive training, and weight management** is vital to prolong the therapeutic benefits.

Conclusion

Joint injections remain a valuable tool in the multidisciplinary management of hock arthritis. They provide significant, albeit temporary, relief of clinical signs, supporting mobility and quality of life. However, injections should be viewed as part of a broader, holistic approach involving physiotherapy, lifestyle modification, and ongoing monitoring. By integrating scientific insight with clinical expertise, we can offer the most effective and compassionate care for animals living with joint disease.

#References

• Anderson, K. L., O'Neill, D. G., Brodbelt, D. C., Church, D. B., Meeson, R. L., & Sargan, D. R. (2020). Prevalence, duration and risk factors for appendicular osteoarthritis in a UK dog population under primary veterinary care. Scientific Reports, 10(1), 1-12. [https://doi.org/10.1038/s41598-020-77795-2](https://doi.org/10.1038/s41598-020-77795-2)

• Budsberg, S. C., Torres, B. T., Kleine, S. A., Sandberg, G. S., & Bergh, M. S. (2014). Evaluation of the analgesic efficacy of intra-articular administration of triamcinolone acetonide in dogs with osteoarthritis. American Journal of Veterinary Research, 75(5), 448–453.

• McIlwraith, C. W., Frisbie, D. D., Kawcak, C. E., & Fuller, C. J. (2015). Joint disease in the horse (2nd ed.). Elsevier Health Sciences.

• Murray, R. C., Clegg, P. D., & Bolt, D. M. (2017). The effects of biologic therapies on inflammation in equine joints. Veterinary Journal, 225, 44–50.