Topic:Arthrodesis
Arthrodesis in horses refers to the surgical fusion of a joint to alleviate pain or restore function in cases where other treatments are ineffective. This procedure is typically employed for conditions such as severe arthritis, joint instability, or fractures that do not heal properly. Arthrodesis aims to eliminate movement in the affected joint, thereby reducing pain and improving the horse's ability to bear weight. The process involves removing the cartilage from the joint surfaces and stabilizing the joint with implants or other fixation methods to encourage bone growth and fusion. This page compiles peer-reviewed research studies and scholarly articles that explore the techniques, outcomes, and implications of arthrodesis in equine orthopedic surgery.
The influence of a tension band fixation as an adjunct for arthrodesis of the metacarpophalangeal joint in the horse. To determine the influence of a stainless-steel cable (SSC) tension band fixation as an adjunct to a locking compression plate (LCP) for arthrodesis of the equine metacarpophalangeal (MCP) joint. Methods: Experimental. An ex vivo biomechanical paired equine cadaver limb study. Methods: Five MCP joint pairs were collected from adult Thoroughbred horses, euthanized for reasons unrelated to orthopedic disease. Methods: Each pair of MCP joints were randomly implanted with either a dorsally placed 5.5 mm LCP and a palmarly placed 2.0 mm SSC or a dorsally placed 5.5 mm LCP alone. Each construc...
A novel surgical technique for treatment of cervical vertebral stenotic myelopathy (wobbler syndrome) in a filly. Cervical vertebral stenotic myelopathy (CVSM), also known as equine wobbler syndrome or cervical ataxia, is a devastating neurological syndrome resulting from compression of the spinal cord at the cervical region. This report describes a novel surgical technique for treatment of 16-month-old Arabian filly with CVSM. The filly showed grade 4 ataxia, hypermetria, weakness of the hind limbs, stumbling during walking, and abnormal gait. Case history, clinical signs and myelography revealed spinal cord compression between the C3 and C4 and C4-C5. The filly underwent a novel surgical interference fo...
Minimally Invasive Arthrodesis of the Equine Proximal Interphalangeal Joint: A Biomechanical Comparison of Three 5.5-mm Cortical Screws Inserted in Lag Fashion and Two 7.0-mm Headless Cannulated Dual-Pitch Compression Screws. The aim of this study was to compare the biomechanical properties of two minimally invasive arthrodesis techniques of the equine proximal interphalangeal (PIP) joint (three transarticular 5.5-mm cortical screws [AO-3TLS] vs. two transarticular 7.0-mm headless cannulated multi-use compression screws [MUC-2TS]) in dynamic non-destructive testing and compression testing to failure. Methods: The experimental study included six pairs of cadaveric adult equine forelimbs; one limb from each horse was randomly assigned to one of the treatments, and the contralateral limb was submitted to the rem...
Proximal Interphalangeal Arthrodesis in Horses: A Meta-Analysis of Retrospective Studies. The aim of this study was to determine the clinical outcomes reported in retrospective studies of proximal interphalangeal arthrodesis (PIA) in horses through a meta-analysis of retrospective studies. CAB Abstracts, PubMed, ScienceDirect, Web of Science, and Scopus were searched. The primary outcomes included survival and surgical site infection (SSI) rates, return to activities, and time of hospital stay and casting. Subgroups were formed for fractures and other conditions. Meta-analyses were performed with fixed and random effects models to estimate proportions, mean values, and effect size ...
Use of Locking Compression Plate and Locking Compression T-Plate for Surgical Arthrodesis of the Carpometacarpal and Distal Tarsal Joints in 13 Horses. The aim of this study was to describe the use of the locking compression plate (LCP) and locking compression T-plate (LCTP) in cases of carpometacarpal and distal tarsal arthrodesis for the treatment of osteoarthritis and small carpal or tarsal bone fractures, and to document clinical outcomes. Methods: Case records of horses treated with carpometacarpal or distal tarsal arthrodesis via internal fixation using an LCP or LCTP between 2013 and 2021 were reviewed. All cases were evaluated retrospectively. Follow-up information was gained via phone conversation with owners and referring vete...
Ex-vivo articular cartilage removal from equine proximal interphalangeal joints using cannulated drill bits. This report evaluates the use of 4.5- and 5.5-mm cannulated drill bits for articular cartilage removal from the proximal interphalangeal joints of equine cadaver limbs. Limbs from 8 equine cadavers, all with normal proximal interphalangeal joints. Proximal interphalangeal joints of 32 limbs from 8 equine cadavers were drilled using either 4.5- or 5.5-mm cannulated drill bits. Pastern joints were then disarticulated, and intra-articular drilling was evaluated by visual inspection. Post-drilling evaluation revealed complete intra-articular drilling occurred in all 32 joints. Canulated 4.5- and 5...
Evaluation of factors associated with surgical site infection in equine proximal interphalangeal joint arthrodesis: 54 cases (2010-2019). The frequency of surgical site infection (SSI) following orthopaedic implant placement in horses has been reported but not compared with respect to specific antibiotic protocols administered. To determine factors associated with SSI in horses undergoing proximal interphalangeal joint (PIPJ) arthrodesis including perioperative antibiotic protocols. Records were evaluated (2010-2019), and horses undergoing PIPJ arthrodesis were identified. Patient signalment, supervising surgeon, reason for surgery, limb, implants placed, anaesthetic time, duration casting/coaptation postoperatively, antibiotic ...
Medial malleolus fragmentation following talocalcaneal arthrodesis by a dorsomedial approach in a horse. A 16-year-old, Quarter Horse mare was presented for a 3/5 right hind lameness associated with osteoarthritis of the talocalcaneal joint (TCLJ). Positron emission tomography (PET) and computed tomography (CT) demonstrated marked increased uptake of 18F-sodium fluoride and bone remodeling at the medial facet of the TCLJ, respectively. Under general anesthesia 2 cortical screws (4.5 and 5.5 mm) were placed in neutral fashion via an arthrotomy from dorsomedial to plantaromedial through the medial facet of the TCLJ followed by copious lavage of the tarsocrural joint. Eight weeks after surgery, obse...
Proximal interphalangeal locking compression plate for pastern arthrodesis in horses. Outcomes following proximal interphalangeal joint (PIPJ) arthrodesis by a variety of surgical methods are available. Reports detailing clinical outcomes following PIPJ arthrodesis utilising the proximal interphalangeal joint locking compression plate (PIP-LCP) and abaxial transarticular lag screws technique are limited. Objective: To report survival, radiographic and clinical outcomes following PIPJ arthrodesis with PIP-LCP and abaxial transarticular lag screw fixation. Methods: Retrospective case series. Methods: Medical records of all horses undergoing pastern arthrodesis from 2009 to 2018 w...
Modified Proximal Interphalangeal Joint Arthrodesis in a Yearling Filly with an Osseous Cyst-Like Lesion in the Proximal Phalanx. After the medial femoral condyle (MFC), the phalanges are the second most common site for osseous cyst-like lesions (OCLLs). Conservative treatment of phalangeal cysts on the convex surface of proximal phalanx presents a technical problem with access to the stoma of the cyst. Surgical therapy options usually aim to avoid cyst enlargement through drilling or screw placement or to encourage lesion filling with osteoconductive material. This paper describes a case of treatment of the OCLL in a yearling Czech warmblood filly with surgical arthrodesis, together with the packing of the OCLL with cal...
A retrospective multicenter study on the use of locking compression plates for scapulohumeral arthrodesis in small equids. To report on technical aspects and outcomes after scapulohumeral arthrodesis (SHA) with a locking compression plate (LCP) in small equids. Methods: Retrospective multicenter case series. Methods: Client-owned Shetland Ponies, Miniature Shetlands, and American Miniature Horses (n = 15). Methods: Inclusion criteria were completed SHA with an LCP to treat scapulohumeral osteoarthritis/subluxation and availability of postoperative radiographs. Contributing surgeons completed a questionnaire to collect data. All radiographs were reviewed for this study. Follow-up information was obtained via re-a...
Comparison of a 3-hole 4.5-mm Dynamic Compression Plate and a 7-hole 5.5-mm Y Locking Compression Plate for Arthrodesis of the Proximal Interphalangeal Joint in Horses-an Ex Vivo Biomechanical Study. The objective of this study was to compare the biomechanical properties in a single cycle axial loading test and the types of failures in two constructs (a 3-hole 4.5-mm dynamic compression plate (DCP) and 7-hole 5.5-mm Y locking compression plate (Y-LCP)) in equine proximal interphalangeal joint (PIJ) arthrodesis. One limb in each pair was randomly assigned to PIJ arthrodesis using a 3-hole 4.5-mm DCP combined with two transarticular 5.5-mm cortical screws, whereas the contralateral limb was submitted to PIJ arthrodesis using a 7-hole Y-shaped 5.0-mm LCP in conjunction with one transarticular...
Bilateral Total Knee Arthroplasty for Charcot Arthropathy After Cauda Equine Syndrome: A Case Report. Charcot arthropathy of the knee is a relatively rare and poorly understood condition. Diagnosis requires detailed history of the patient, radiological investigation and exclusion of other causes of arthropathy. Conservative treatment is sufficient only in early stages. In late stages, either arthrodesis or total knee arthroplasty is the treatment of choice. We report a case of a 65-year-old woman who presented with Charcot arthropathy in both knees, after a spinal fracture 35 years ago, which caused cauda equine syndrome with diminished sensation of both legs. She underwent bilateral total kne...
Arthrodesis of the equine proximal interphalangeal joint: a biomechanical comparison of 2 different LCP systems. This study compares the mechanical stability and surgical usability of 2 locking plate systems (Kyon ALPS-20 and Synthes PIP-LCP system) for arthrodesis of the equine proximal interphalangeal joint (PIJ). Methods: The experimental ex vivo study included 6 pairs of cadaver distal limbs (n = 12). All specimens were derived from Warmblood horses of various ages that were euthanized for non-orthopedic reasons. Of the 12 limbs collected, 3 left and 3 right distal limb specimens were randomly assigned to each system for implantation. Two abaxial 4.5-mm cortical screws were inserted transarticularly ...
Ex vivo study of minimally invasive procedures for cartilage removal from the metacarpophalangeal or metatarsophalangeal joint and for fetlock tension band application. To describe reliable minimally invasive procedures for (1) removing cartilage by joint distraction and articular drilling for equine metacarpophalangeal (MCP)/metatarsophalangeal (MTP) arthrodesis; (2) applying a palmar/plantar tension band without MCP/MTP joint luxation. Methods: Experimental study. Methods: Cadaveric equine limbs (n = 12). Methods: All limbs were used to evaluate the drilling technique. First the MCP/MTP joint was distracted with a 5.5-mm cortical screw. Then, through four stab incisions, articular cartilage was removed with a 4.5-mm drill. Six randomly chosen limbs were the...
Arthrodesis of the metacarpophalangeal and metatarsophalangeal joints to treat osteoarthritis in 17 horses. To describe arthrodesis of the metacarpophalangeal (MCP) or metatarsophalangeal (MTP) joint with a locking compression plate (LCP) and a metallic tension band and report the outcome of horses treated for osteoarthritis (OA) with this technique. Methods: Retrospective case series. Methods: Seventeen horses with OA of the MCP or MTP joint treated with arthrodesis. Methods: Medical records (2004-2017) of horses treated for OA with arthrodesis of the MCP or MTP joint with an LCP and metallic tension band were reviewed. Preoperative variables included age, sex, breed, affected limb, and lameness gr...
Surgical site infection associated with equine orthopedic internal fixation: 155 cases (2008-2016). To determine the prevalence of surgical site infection (SSI) after internal fixation and to identify risk factors for SSI and nonsurvival. Methods: Retrospective study. Methods: One hundred fifty-five horses with long bone fractures or arthrodesis treated by internal fixation at 1 hospital between 2008-2016. Methods: Signalment, diagnosis, surgical repair, surgeon, surgical time, antimicrobial use, SSI onset, bacterial identification, and adjunct treatments were recorded. Perioperative variables were analyzed to identify risk factors associated with outcomes. Results: Surgical-site infection w...
A Standing Percutaneous Technique for Proximal Interphalangeal Joint Arthrodesis in Twelve Horses (2014-2017). This report describes the use of a minimally invasive standing pastern arthrodesis technique for the treatment of osteoarthritis in horses and documents its clinical outcome in 12 horses. Methods: Medical records and radiographs of horses diagnosed with proximal interphalangeal joint osteoarthritis that underwent standing pastern arthrodesis using transarticular screws were reviewed. Follow-up information for determination of outcome was obtained via phone interview with the owners. Results: Twelve horses (15 limbs) were included in the study. Radiographical findings revealed severe o...
Use of a locking compression plate for equine proximal interphalangeal joint arthrodesis: 29 cases (2008-2014). OBJECTIVE To describe clinical use of a locking compression plate (LCP) for proximal interphalangeal joint (PIPJ) arthrodesis in horses and compare outcomes for horses that underwent the procedure as treatment for fracture of the middle phalanx (P2) versus other causes. DESIGN Retrospective case series. ANIMALS 29 client-owned horses. PROCEDURES Medical records of 2 veterinary teaching hospitals from 2008 through 2014 were reviewed to identify horses that underwent PIPJ arthrodesis of 1 limb. Signalment, surgical, and outcome-related variables were recorded. Owners were contacted from 1 to 6 y...
Pancarpal and partial carpal arthrodesis with 3 locking compression plates in 6 horses. To report the outcome of horses after pancarpal or partial carpal arthrodesis with 3 locking compression plates (LCP). Methods: Case series. Methods: Six horses ranging in age from 8 months to 16 years and weighing 227-580 kg with severe carpal pathology including acute fractures, chronic osteoarthritis, and chronic angular limb deformity. Methods: Pancarpal or partial carpal arthrodesis was performed with 3 LCP. Autologous cancellous bone grafts were used in 5 of 6 cases to facilitate joint arthrodesis. Results: External coaptation was maintained for 4 to 6 weeks after surgery. Radiographic...
Double plate fixation for the management of proximal interphalangeal joint instability in 30 horses (1987-2015). Double plate fixation has been reported in a small number of horses with comminuted fractures of the middle phalanx. There are no published reports using this technique in the management of other injuries that destabilise the proximal interphalangeal joint (PIJ), including biaxial palmar/plantar eminence fractures and disruption of the palmar/plantar soft tissue support structures of the PIJ. Furthermore, there is a paucity of information on the long-term prognosis for horses undergoing double plate fixation to manage destabilising injuries of the PIJ. Objective: To document further the clinic...
Arthrodesis of the equine centrodistal and tarsometatarsal joints using a single modified kerf-cut cylinder. To describe a technique for surgical placement of a modified kerf-cut cylinder for the purpose of arthrodesis across the equine centrodistal and tarsometatarsal joints. Methods: Each horse (n = 4) underwent unilateral placement of a single kerf-cut cylinder spanning the centrodistal and tarsometatarsal joints with the placement of an autologous cancellous bone graft. Horses were evaluated via lameness examination and radiography postoperatively and euthanatization of each horse was performed at four different time points up to 12 weeks post-surgery to evaluate for lameness, implant stability a...
Retrospective analysis of factors associated with outcome of proximal interphalangeal joint arthrodesis in 82 horses including Warmblood and Thoroughbred sport horses and Quarter Horses (1992-2014). Outcomes associated with arthrodesis of the proximal interphalangeal (PIP) joint in Quarter Horses used for Western performance activities are well documented but little is known regarding outcomes for other types of horses. Objective: To identify factors associated with outcomes, including breed and activity, after arthrodesis of the PIP joint in Warmbloods, Thoroughbreds and Quarter Horses. Methods: Retrospective case series. Methods: Surgical case records of 82 Quarter Horses principally engaged in Western performance and Thoroughbred or Warmblood breeds principally engaged in showing, show...
Comparison of limited-contact dynamic compression plate and locking compression plate constructs for proximal interphalangeal joint arthrodesis in the horse. This study compared in vitro monotonic and cyclic mechanical properties of equine proximal interphalangeal joint arthrodeses stabilized using an open or closed technique combined with axial 4.5 mm narrow limited-contact dynamic compression plate (LC-DCP) or 4.5 mm narrow locking compression plate (LCP). Ten forelimb pairs were randomly assigned to LCP or LC-DCP groups. One limb in each pair was assigned to either open or closed technique. Limbs were tested for cyclic fatigue at 20 000 cycles and then single-cycle to failure under 3-point dorsopalmar bending. There was no significant difference...
Minimally invasive proximal interphalangeal joint arthrodesis using a locking compression plate and tissue engineering in horses: a pilot study. This pilot study assessed the efficacy of 2 minimally invasive techniques for proximal interphalangeal (PIP) joint arthrodesis in horses. The PIP joints of both forelimbs (n = 6) were stabilized with locking compression plates (LCP) using a minimally invasive technique (LCP technique). Subsequently, for 1 randomly selected PIP joint of each horse, surgical drilling (SurD) was performed and tissue engineering (TE) was applied (LCP/SurD/TE technique). Minimally invasive PIP joint arthrodesis with LCP demonstrated low postoperative infection rates. Gross and histological evaluations revealed cons...
Ex vivo evaluation of carpal flexion after partial carpal arthrodesis in horses. To determine degrees of flexion after arthrodesis of the antebrachiocarpal (ABC) joint, middle carpal (MC), and carpometacarpal (CMC) joints combined (MC/CMC), and carpometacarpal (CMC) joint alone. Methods: Ex vivo study. Methods: Forelimbs (n = 9) from 2- to 10-year-old Quarter Horses (5), Thoroughbred (2), and American Paint Horse (2). Methods: Using 2 locking compression plates, 3 partial carpal arthrodesis techniques were performed. Cables and deadweights were connected to limbs and each angle of flexion determined 3 times using a protractor and then averaged. Control measurements were ob...
Second carpal bone slab fracture and subluxation of the middle carpal joint in a horse subsequent to arthrodesis of the carpometacarpal joint. To report complications of arthrodesis of the carpometacarpal (CMC) joint using a drilling technique in an adult horse. Methods: Case report. Methods: Horse (n = 1). Methods: A 12-year-old Quarter Horse mare with CMC osteoarthritis (CMC-OA) had arthrodesis under general anesthesia in right lateral recumbency. Under fluoroscopic guidance, a 4.5 mm drill bit was inserted at 3 drilling sites 5-6 cm into the CMC joint and was fanned 30-45° in the plane of the joint and 5-10° in the long axis of the limb to destroy articular cartilage and expose the subchondral bone. Results: The horse pr...
Unusual mechanism of injury resulting in a thoracic chance fracture in a rodeo athlete: a case report. To introduce the characteristics of a Chance fracture and increase awareness of the mechanism of injury that may occur during athletic activity. Background: A T12 Chance fracture was diagnosed in an 18-year-old male rodeo athlete. The rider was forced into extreme lumbothoracic hyperflexion when the horse bucked within the chute, pinning the rider's legs to his chest. Methods: Burst fracture, abdominal organ rupture, spinal dislocation, spinal cord injury, disk herniation, pars interarticularis fracture, spinal nerve injury, paralysis. Methods: The patient underwent an open reduction and fixat...
In vitro biomechanical comparison of a 5-hole 4.5 mm locking compression plate and 5-hole 4.5 mm dynamic compression plate for equine proximal interphalangeal joint arthrodesis. To compare the biomechanical properties of a 5-hole 4.5 mm narrow locking compression plate (LCP) and 5-hole 4.5 mm narrow dynamic compression plate (DCP) for equine proximal interphalangeal (PIP) joint arthrodesis. Methods: Experimental mechanical study. Methods: Cadaveric adult equine forelimbs (n = 6 pair). Methods: For each forelimb pair, 1 PIP joint was stabilized with LCP and the contralateral PIP joint with DCP. The 6 construct pairs were tested using a single-cycle, 3-point dorsopalmar bending system. PIP joints were evaluated with pre- and post-test radiography. Results: The L...
Area of cartilage accessible to curettage for subsequent arthrodesis of the equine proximal interphalangeal joint. Comparison of conventional and collateral ligament sparing approaches. This study compared the areas of cartilage accessible for curettage in arthrodesis of the equine proximal interphalangeal joint using the conventional and collateral ligament sparing approaches. For this purpose, forelimbs and hindlimbs of six equine cadavers without radiographic evidence of proximal interphalangeal joint disease were used. One limb of each pair of limbs was randomly assigned to a dissection using a standard approach to the proximal interphalangeal joint including transection of the collateral ligaments, while each contralateral limb was exposed using the same approach but lea...