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.
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.
In vitro biomechanical comparison of equine proximal interphalangeal joint arthrodesis techniques: prototype equine spoon plate versus axially positioned dynamic compression plate and two abaxial transarticular cortical screws inserted in lag fashion. To compare in vitro monotonic biomechanical properties of an equine spoon plate (ESP) 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 (DCP-TLS) inserted in lag fashion for 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=18 pairs). Methods: For each forelimb pair, 1 PIP joint was stabilized with an ESP (8 hole...
Clinical use of the locking compression plate (LCP) in horses: a retrospective study of 31 cases (2004-2006). Fracture repair and arthrodesis in horses require rigid fixation in order to achieve early post operative comfort. The locking compression plate (LCP) was designed to allow greater stability and less periosteal disruption than conventional plates. Objective: To describe a series of clinical cases in which the LCP was used for fracture stabilisation or arthrodesis. Methods: Medical records, radiographs and follow-up for 31 horses having fracture stabilisation or arthrodesis with the LCP were reviewed. Reasons for treatment included fracture of the olecranon (n = 2), metatarsal III (n = 2), ilia...
3D kinematics of the interphalangeal joints in the forelimb of walking and trotting horses. The objective was to measure 3D rotations of the distal (DIP) and proximal (PIP) interphalangeal joints at walk and trot. 3D trajectories of markers fixed to the proximal phalanx, middle phalanx and the hoof wall of the right forelimb of four sound horses were recorded at 120 Hz. Joint kinematics were calculated in terms of anatomically-based joint coordinate systems between the bone segments. Ranges of motion were similar at walk and trot. Values for the DIP joint were: flexion/extension: 46 +/- 3 degrees at walk, 47 +/- 4 degrees at trot; internal/external rotation: 5 +/- 1 degrees at walk, ...
Proximal interphalangeal joint arthrodesis using a combination plate-screw technique in 53 horses (1994-2003). A method for proximal interphalangeal joint (PIP joint) arthrodesis that provides a stable fixation and minimal duration of cast support is evaluated retrospectively. Objective: Evaluate the clinical use of a combined plate-screw method for PIP joint arthrodesis in a large number of horses. Methods: The records of 53 horses undergoing PIP joint arthrodesis were reviewed. Arthrodesis was performed with a dorsally placed 3-, 4- or 5-hole narrow dynamic compression plate (DCP) with 2 transarticular cortex screws placed in lag fashion either side of the plate. Subject details, clinical presentatio...
Computed tomographic documentation of a comminuted fourth carpal bone fracture associated with carpal instability treated by partial carpal arthrodesis in an Arabian filly. To report treatment of a unilateral comminuted fourth carpal bone (C4) fracture associated with carpal instability by partial carpal arthrodesis (PCA) of the middle carpal joint (MCJ) and carpometacarpal joint (CMCJ). Methods: Case Report. Methods: An 8-month-old Arabian filly. Methods: A C4 slab fracture was diagnosed radiographically; however, fracture comminution was conclusively diagnosed after computed tomographic (CT) imaging. PCA of the MCJ and CMCJ was performed with 2 narrow dynamic compression plates. Results: PCA provided appropriate carpal stability and correct limb alignment immed...
Minimally invasive plate fixation of lower limb injury in horses: 32 cases (1999-2003). Complications of osteosynthesis including superficial and deep infections continue to affect adversely outcome in equine surgery of the lower limb. Objective: To describe a technique for minimally invasive plate fixation in horses and evaluate clinical results of the technique. Objective: Lower complication rates would occur in horses treated with a minimally invasive approach compared with conventional techniques. Methods: Cases of minimally invasive plate fixation from January 1999 to December 2003 were evaluated. Case records, radiographs and race records for horses that sustained distal th...
Use of intra-articular administration of ethyl alcohol for arthrodesis of the tarsometatarsal joint in healthy horses. To evaluate the efficacy and safety of intra-articular administration of ethyl alcohol for arthrodesis of tarsometatarsal joints in horses. Methods: 8 healthy female horses without lameness or radiographic evidence of tarsal joint osteoarthritis. Methods: In each horse, 1 tarsometatarsal joint was treated with 4 mL of 70% ethyl alcohol and the opposite joint was treated with 4 mL of 95% ethyl alcohol. Lameness examinations were performed daily for 2 weeks, followed by monthly evaluations for the duration of the 12-month study. Radiographic evaluations of both tarsi were performed 1 month after...
Arthrodesis of the talocalcaneal joint for the treatment of two horses with talocalcaneal osteoarthritis. Two horses with lameness due to tolocalcaneal osteoarthritis that failed to respond to conservative management were treated by tolocalcaneal arthrodesis using cortex screws placed in lag fashion. The affected joint of one horse was arthrodesed by compressing and stabilizing the medial facet of the joint with three screws. In the second horse, the medial and lateral facets of the affected tolocalcaneal joint were each compressed and stabilized with two screws. The lameness of both horses improved markedly following surgery.