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.
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...
In vitro biomechanical comparison of a 4.5 mm narrow locking compression plate construct versus a 4.5 mm limited contact dynamic compression plate construct for arthrodesis of the equine proximal interphalangeal joint. To compare the in vitro biomechanical properties of a 4.5 mm narrow locking compression plate (PIP-LCP) with 2 abaxially located transarticular screws and a 4.5 mm limited contact dynamic compression plate (LC-DCP) with 2 abaxially located transarticular screws using equine pasterns. Methods: Experimental. Paired in vitro biomechanical testing of 2 methods for stabilizing adult equine forelimb PIP joints. Methods: Adult equine forelimbs (n = 8 pairs). Methods: Each pair of PIP joints were randomly instrumented with either a PIP-LCP or LC-DCP plate axially and 2 parasagitally positioned 5.5 mm ...
Retrospective evaluation of facilitated pastern ankylosis using intra-articular ethanol injections: 34 cases (2006-2012). While surgical arthrodesis is the treatment of choice for osteoarthritis of the proximal interphalangeal joint, some clients are unable to pursue surgery due to costs. A more economical technique was sought using intra-articular ethyl alcohol injections to facilitate ankylosis. Objective: To describe the technique and outcome of intra-articular ethyl alcohol injections for facilitated ankylosis of proximal interphalangeal joints with osteoarthritis. Methods: As a retrospective case series, the medical records (2006-2012) of clinical cases diagnosed with proximal interphalangeal joint osteoarth...
The equine pastern. Injuries involving the pastern region are a common source of lameness in many types of performance horses. Knowledge of the common breed- and activity-associated injuries can aid veterinarians in making an accurate diagnosis because injuries of the pastern region are often breed- or use-specific. The differential diagnosis for disorders of the pastern region includes osteoarthritis, osteochondrosis, fractures, infection, and soft tissue injuries. In general, soft tissue injuries of the pastern region can be difficult to diagnose, and affected horses have a reasonable chance of returning to the...
A mechanical comparison of equine proximal interphalangeal joint arthrodesis techniques: an axial locking compression plate and two abaxial transarticular cortical screws versus an axial dynamic compression plate and two abaxial transarticular cortical screws. To compare in vitro monotonic biomechanical properties of an axial 3-hole, 4.5 mm narrow locking compression plate (ELCP) using 5.0 mm locking screws and 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion (ELCP-TLS) with an axial 3-hole, 4.5 mm narrow dynamic compression plate (DCP) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion (DCP-TLS) for equine proximal interphalangeal (PIP) joint arthrodesis. Methods: Experimental. Methods: Cadaveric adult equine forel...
Evaluation of a minimally invasive arthrodesis technique for the carpometacarpal joint in horses. To evaluate a minimally invasive technique for arthrodesis of the carpometacarpal (CMC) joint in horses. Methods: Experimental study. Methods: Healthy horses (n=6). Methods: A 5.5 mm, 3-drill tract arthrodesis technique was evaluated in 1 randomly selected CMC joint in each of 6 normal horses. Peak vertical ground reaction force (GRF) values were recorded before surgery and at 6, 8, and 12 months thereafter. Radiographic and clinical lameness scores were assigned at regular intervals until 12 months after surgery when the horses were euthanatized. Gross and histologic examinations were perfo...
An in vitro biomechanical comparison of equine proximal interphalangeal joint arthrodesis techniques: two parallel transarticular headless tapered variable pitch screws versus two parallel transarticular AO cortical bone screws inserted in lag fashion. To compare the mean number of cycles to failure under axial compression of equine proximal interphalangeal (PIP) joint arthrodesis constructs created by 2 parallel transarticular Acutrak Plus screws (AP-TS) or 2 parallel transarticular 5.5 mm cortical screws inserted in lag fashion (AO-TLS). Methods: Paired in vitro biomechanical testing of 2 methods of stabilizing cadaveric adult equine forelimb PIP joints. Methods: Cadaveric adult equine forelimbs (n=5 pairs). Methods: For each forelimb pair, 1 PIP joint was stabilized with AP-TS and 1 with AP-TLS. The 5 construct pairs were tested for cycli...
Evaluation of ethyl alcohol for use in a minimally invasive technique for equine proximal interphalangeal joint arthrodesis. To determine whether intra-articular 70% ethyl alcohol alone (IAEA) or in combination with 2 percutaneously placed transarticular lag screws (EA-TLS) would result in arthrodesis of the equine proximal interphalangeal (PIP) joint. Methods: Experimental. Methods: Healthy horses (n=6), aged 1.5-3 years, free of lameness, diagonally paired front and hind PIP joints. Methods: Six milliliters 70% ethyl alcohol was injected into randomly selected diagonally paired front and hind PIP joints. Thirty days later, 2 parallel 5.5 mm cortical screws were inserted in lag fashion across the hind PIP joints an...
Arthrodesis of the equine proximal interphalangeal joint: a biomechanical comparison of 3-hole 4.5 mm locking compression plate and 3-hole 4.5 mm narrow dynamic compression plate, with two transarticular 5.5 mm cortex screws. To compare the biomechanical characteristics of 2 arthrodesis techniques for the equine proximal interphalangeal joint (PIP) using either a 3-hole 4.5 mm locking compression plate (LCP) or 3-hole 4.5 mm narrow dynamic compression plate (DCP), both with 2 transarticular 5.5 mm cortex screws. Methods: Experimental. Methods: Cadaveric adult equine forelimbs (*n=6 pairs). Methods: For each forelimb pair, 1 limb was randomly assigned to 1 of 2 treatment groups and the contralateral limb by default to the other treatment group. Construct stiffness, gap formation across the PIP joint, and rotation ab...
Transfixation cast technique for arthrodesis of the distal interphalangeal joint of horses. Surgical arthrodesis of the distal interphalangeal (DIP) joint by transfixation casting was used to salvage a three-year-old filly and a yearling filly that were chronically lame because of infection of the DIP joint for breeding. Unlike previously described techniques for arthrodesis of the DIP joint, the technique used did not require insertion of implants across the joint, which may have contributed to the successful outcome.
Effect of a collateral ligament sparing surgical approach on mechanical properties of equine proximal interphalangeal joint arthrodesis constructs. To (1) compare the effect of a collateral ligament sparing surgical approach with an open surgical approach on mechanical properties of proximal interphalangeal joint (PIPJ) arthrodesis, and (2) to determine the percentage of articular cartilage surface removed by transarticular (TA) drilling with different diameter drill bits. Methods: Randomized paired limb design. Methods: Cadaveric equine limbs (n=76). Methods: Cadaveric PIPJ were drilled using a 3.5, 4.5, or 5.5 mm drill bit at 80-84° to the dorsal plane to remove articular cartilage and subchondral bone from the distal articular surface...
Orthopedic infections in equine long bone fractures and arthrodeses treated by internal fixation: 192 cases (1990-2006). To determine the rate of postoperative infection (POI) for internal fixation repaired equine long bone fractures and arthrodeses and identify associated risk factors. Methods: Case series. Methods: Horses (n=192) with fracture repair of the third metacarpal and metatarsal bones, radius, ulna, humerus, tibia, and femur, or arthrodesis with internal fixation. Methods: Medical records (1990-2006) were reviewed for signalment, anatomic location, fracture classification and method of repair, technique and surgical duration, bacterial species isolated, postoperative care, onset of POI, and outcome. ...
Arthrodesis of the proximal interphalangeal joint in the horse: a cyclic biomechanical comparison of two and three parallel cortical screws inserted in lag fashion. To compare the biomechanical cyclic fatigue properties of 2 and 3 parallel transarticular 5.5 mm cortical screws used in arthrodesis of the proximal interphalangeal (PIP) joint. Methods: Randomized block design, for horse, fixation method (2 versus three 5.5 mm cortical screws), side (right, left) and end (front, hind) in cadaveric equine limbs. Methods: Cadaveric adult equine fore- and hindlimbs (n=5 pairs each). Methods: Two parallel 5.5 mm cortical screws were inserted in lag fashion, transarticularly through the PIP joint in 1 limb of a pair, and in the contralateral limb, three 5.5 mm cor...
A technique for laser-facilitated equine pastern arthrodesis using parallel screws inserted in lag fashion. To report a technique for laser-facilitated, minimally invasive proximal interphalangeal joint (PIJ) arthrodesis in horses. Methods: Case series. Methods: Horses (n=6); 5 thoracic and 2 pelvic limb PIJ. Methods: PIJ osteoarthritis (OA) diagnosis was confirmed by radiography. A diode laser was used to apply 2000 J of energy to the joint followed by insertion of 3 parallel 5.5 mm screws in lag fashion through stab incisions to achieve PIJ arthrodesis. After anesthetic recovery, limbs were maintained in bandages (n=2) or bandage casts (5) for 3 weeks. Horses were allowed exercise or turnout by 3 ...
An in vitro biomechanical comparison of equine proximal interphalangeal joint arthrodesis techniques: an axial positioned dynamic compression plate and two abaxial transarticular cortical screws inserted in lag fashion versus three parallel transarticular cortical screws inserted in lag fashion. To compare in vitro monotonic biomechanical properties of an axial 3-hole, 4.5 mm narrow dynamic compression plate (DCP) using 5.5 mm cortical screws in conjunction with 2 abaxial transarticular 5.5 mm cortical screws inserted in lag fashion (DCP-TLS) with 3 parallel transarticular 5.5 mm cortical screws inserted in lag fashion (3-TLS) for the equine proximal interphalangeal (PIP) joint arthrodesis. Methods: Paired in vitro biomechanical testing of 2 methods of stabilizing cadaveric adult equine forelimb PIP joints. Methods: Cadaveric adult equine forelimbs (n=15 pairs). Methods: For each fore...
Comparison of three drilling techniques for carpometacarpal joint arthrodesis in horses. To evaluate 3 drilling techniques for arthrodesis of the equine carpometacarpal (CMC) joint. Methods: Experimental study. Methods: Cadaveric equine forelimbs (n=15). Methods: Limbs were divided into 3 groups (5 limbs each) to evaluate 3 drilling techniques: (1) use of a 4.5 mm drill bit inserted into the joint through 4 entry points and moved in a fanning motion; (2) a 5.5 mm drill bit inserted through 2 entry points to create 3 nonfanned drill tracts (3 drill technique); and (3) a 4.5 mm drill bit used in a 3 drill technique. The CMC joint was disarticulated after drilling, and cartilage and ...
Treatment of carpometacarpal osteoarthritis by arthrodesis in 12 horses. To evaluate arthrodesis as a treatment for carpometacarpal joint osteoarthritis (CMC-OA). Methods: Case series. Methods: Horses (n=12) with CMC-OA. Methods: Arthrodesis was facilitated by insertion and fanning of a drill bit into the CMC joint at several (3-5) locations in 15 limbs. Follow-up radiographs were obtained for 7 horses (9 limbs). Outcome was determined by telephone survey of owners based on postoperative pain, return to use, appearance of the limb, and success of treatment. Results: Postoperative pain was slight or moderate in 10 of 12 (83%) horses during the first 30 days, and 11 ...
Arthrodesis of the equine proximal interphalangeal joint: a biomechanical comparison of two parallel headless, tapered, variable-pitched, titanium compression screws and two parallel 5.5 mm stainless-steel cortical screws. To compare the biomechanical characteristics, failure mode, and effects of side (left or right limb) and end (forelimb or hindlimb) of different screws in 2-screw, parallel-screw proximal interphalangeal joint arthrodesis constructs in horses. Methods: In vitro experimental study. Methods: Twenty limbs from 6 cadavers (4 complete limb sets, 2 partial sets-total of 4 forelimb and 6 hindlimb pairs). Methods: Two parallel 5.5 mm cortical (AO) screws were inserted in lag fashion in 1 randomly allocated limb of a pair, and 2 parallel headless, tapered, variable-pitched, titanium compression screws ...
A limited surgical approach for pastern arthrodesis in horses with severe osteoarthritis. Osteoarthritis of the proximal interphalangeal joint (PIPJ) is a common cause of chronic lameness in the horse that requires surgical arthrodesis when medical management is no longer able to alleviate pain. Surgical principles for successful PIPJ arthrodesis include articular cartilage debridement and rigid fixation. To completely debride articular cartilage, the collateral ligaments and extensor tendon are transected, disarticulating the joint. The purpose of this study was to demonstrate that in chronically lame horses with periarticular new-bone formation and osteoarthritis, successful arth...
Locking compression plates for pancarpal arthrodesis in a Thoroughbred filly. To report treatment of a comminuted ulnar carpal (UC) bone fracture associated with carpal instability by pancarpal arthrodesis using 2 locking compression plates (LCP). Methods: Case report. Methods: A 2-year-old Thoroughbred filly. Methods: An UC fracture and luxation of the proximal row of carpal bones was diagnosed radiographically. Pancarpal arthrodesis was performed with 2 LCP positioned dorsolaterally and dorsomedially and centered over the carpus through a single skin incision. The filly was maintained in a full limb cast for 15 days, followed by a tube cast for 14 days, and subsequent...
Clinical evaluation of the locking compression plate for fetlock arthrodesis in six thoroughbred racehorses. To report use of a locking compression plate (LCP) for fetlock arthrodesis in Thoroughbred racehorses after catastrophic disruption of the suspensory apparatus. Methods: Retrospective case study. Methods: Racing Thoroughbreds (n=6) with a catastrophic breakdown injury of the suspensory apparatus. Methods: Medical records (2004-2006) of horses that had fetlock arthrodesis using an LCP were reviewed. Preoperative recorded variables were: age, gender, affected limb, injury type and occurrence, limb support used and time to surgery. Recorded surgical variables were: implants used and cost, surgery...
Less invasive techniques for equine fracture repair and arthrodesis. To repair equine fractures successfully, surgeons traditionally have done aggressive open approaches with maximal internal fixation to achieve adequate stability and comfort. Although the need for stability is unquestionable, newer technologies and imaging modalities have allowed improvement in the biology of internal fixation in selected fractures and arthrodeses.