Dr. Lisa Fortier, long-time equine surgeon and clinician-scientist at Cornell University and now Editor-in-Chief of JAVMA and AJVR, has devoted much of her career to understanding and treating OA. In conversation with us, she highlighted how the understanding of the disease has shifted over time, and what veterinarians can do to improve outcomes in practice today.

Osteoarthritis (OA) is not a single event or a simple, linear disease. It’s a gradual process that can begin in different tissues — the cartilage, the synovial membrane, or the subchondral bone — and progress in complex, interacting ways. Scientists still debate where it truly starts: Does inflammation in the joint capsule trigger cartilage degeneration? Does cartilage damage initiate inflammation and bone adaptation? Or should we view OA as a “joint-as-an-organ” process, involving all tissues from the start?

Osteoarthritis case: LF fetlock lameness.
A 10-year-old Arabian gelding presented with lameness following a trail ride. Imaging confirmed moderate osteoarthritis and a subchondral cystic lesion in the left front fetlock.
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To support your clinical decision-making, we sat down with leading equine orthopedic veterinarians at the Sports Medical Diagnostic Center in the Netherlands. In this series, they share how they manage OA across different joints—from early signs to long-term follow-up. The share their clinical reasoning, preferred treatment pathways, and practical rehab recommendations— grounded in extensive real-world experience.