Invited review: Prevalence, risk factors, treatment, and barriers to best practice adoption for lameness and injuries in dairy cattle-A narrative review.

Lameness and leg injuries are both painful and prevalent across the dairy industry, and are a major welfare concern. There has been a considerable amount of research focused on investigating the risk factors associated with lameness and injuries and how they might be prevented and treated. The objectives of this narrative review were to summarize herd-level prevalence estimates, risk factors, strategies for prevention, control, and treatment of these conditions, and the barriers to best practice adoption for lameness and injuries on dairy farms. There is a relatively high within-herd prevalence of lameness on dairy farms globally, with a recent systematic review estimating the mean prevalence at 22.8%. Similarly, there is a relatively high prevalence of hock injuries, with within-herd estimates ranging from 12% to 81% of cows affected. Knee and neck injuries have been reported to be less common, with 6% to 43% and 1% to 33%, respectively. Numerous risk factors have been associated with the incidence of lameness, notably housing (e.g., access to pasture, bedding depth, bedding type, flooring type, stall design), management (e.g., stall cleanliness, frequency of trimming, holding times, stocking density), and cow-level (e.g., body condition, parity, injured hocks) factors. Risk factors associated with hock injuries can be similarly classified into housing (e.g., bedding type and depth, outdoor access, parlor type, stall design), management (e.g., bedding depth, cleanliness), and cow (e.g., parity, days in milk, lameness) factors. Key preventative approaches for lameness include routine preventative and corrective hoof trimming, improving hoof cushioning and traction through access to pasture or adding rubber flooring, deep-bedded stalls, sand bedding, ensuring appropriate stocking densities, reduced holding times, and the frequent use of routine footbaths. Very little research has been conducted on hock, knee, and neck injury prevention and recovery. Numerous researchers have concluded that both extrinsic (e.g., time, money, space) and intrinsic (e.g., farmer attitude, perception, priorities, and mindset) barriers exist to addressing lameness and injuries on dairy farms. There are many diverse stakeholders in lameness and injury management including the farmer, farm staff, veterinarian, hoof trimmer, nutritionist, and other advisors. Addressing dairy cattle lameness and injuries must, therefore, consider the people involved, as it is these people who are influencing and implementing on-farm decisions related to lameness prevention, treatment, and control.