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.
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.
Arthroscopically assisted arthrodesis of the distal interphalangeal joint with transarticular screws inserted through a dorsal hoof wall approach in a horse. A 16-year-old Thoroughbred gelding was examined because of chronic right forelimb lameness. Results: On radiographs of the right front foot, the distal interphalangeal (DIP) joint space was narrow, and osteophytes and periarticular bony proliferation indicative of severe osteoarthritis were seen. Arthrodesis of the right DIP joint was recommended to improve the horse's comfort on the limb. Results: The horse was anesthetized, and palmar and dorsal arthroscopic approaches were used to remove as much of the articular cartilage as was accessible. Holes were then drilled through the dorsal aspect ...
Arthrodesis techniques in horses. When medical therapy and surgical treatments of an injured joint fail to return the animal to athletic performance or comfortable use of the limb, arthrodes is is a final option for some joints. Arthrodesis refers to the surgical fusion of a joint, resulting in bony ankylosis. Successful arthrodesis requires debridement of the articular cartilage through the calcified cartilage layer, exposing the subchondral bone; alignment of the joint into a weight-bearing position; and stabilization. The methods by which these steps are accomplished are variable, depending on the individual joint. There ar...
Comparison of three methods for arthrodesis of the distal intertarsal and tarsometatarsal joints in horses. To evaluate the effects of diode laser surgery (LS), surgical drilling (SD), and intraarticular sodium monoiodoacetate (MIA) as methods for fusing the distal intertarsal (DIT) and tarsometatarsal (TMT) joints in horses. Methods: Experimental study. Methods: Adult horses (15) without radiographic signs of osteoarthritis (OA) of the DIT and TMT joints. Methods: Group 1 (n=3) had LS performed bilaterally on DIT and TMT joints; 1 horse was evaluated for 1 week and 2 horses were evaluated for 2 weeks. Group 2 (n=6) had LS on DIT and TMT joints of 1 tarsus and MIA administration into the contralater...
Arthrodesis of the equine proximal interphalangeal joint: a mechanical comparison of 2 parallel 5.5 mm cortical screws and 3 parallel 5.5 mm cortical screws. To compare the biomechanical characteristics and mode of failure of 2 techniques using parallel 5.5 mm screws for pastern joint arthrodesis in horses. Methods: Randomized block design, for horse (1-5), method of fixation (two 5.5 mm screws versus three 5.5 mm screws), side (right, left), and end (front, hind). Constructs were tested to failure in 3-point bending. Methods: Twenty limbs (5 cadavers). Methods: A combined aiming device was used to facilitate screw placement. Two parallel 5.5 mm screws were inserted in lag fashion in 1 limb of a pair, and three 5.5 mm screws were inserted in the co...
Ex vivo investigation of the use of hydrothermal energy to induce chondrocyte necrosis in articular cartilage of the metacarpophalangeal and metatarsophalangeal joints of horses. To evaluate the use of hydrothermal ablation of articular cartilage for arthrodesis in horses through investigation of the effects of joint lavage with physiologic saline (0.9% NaCI) solution (80 degrees C) for various treatment times on chondrocyte viability in the articular cartilage of the metacarpophalangeal and metatarsophalangeal joints of cadaveric horse limbs. Sample Population-7 pairs of metacarpophalangeal and 8 pairs of metatarsophalangeal joints from 8 Thoroughbreds. Methods: The horses were euthanatized for reasons unrelated to musculoskeletal disease. On a random basis, 1 joint o...
Comparison of intra-articular drilling and diode laser treatment for arthrodesis of the distal tarsal joints in normal horses. Anecdotal reports suggest that laser-facilitated arthrodesis of the distal tarsal joints improves the prognosis compared with intra-articular drilling but no objective comparisons have been performed. Objective: To evaluate intra-articular drilling and laser-facilitated arthrodesis using in situ and in vivo techniques. Methods: Fourteen cadaver limbs were evaluated in situ for chondrocyte viability after both surgical techniques. In vivo, one randomly selected limb was subjected to laser-facilitated arthrodesis and the other underwent intra-articular drilling in 6 normal horses. Clinical exami...
Facilitated ankylosis of the distal interphalangeal joint in a foal. A 3-month-old Quarter Horse colt sustained a penetrating injury over the coronary band on the right forelimb resulting in an articular bone sequestrum and septic arthritis of the distal interphalangeal joint. Despite aggressive treatment for septic arthritis, severe osteoarthritis and ongoing sepsis resulted in persistent lameness. Facilitated ankylosis of the distal interphalangeal joint was performed using a combination of open surgical debridement, placement of an autogenous cancellous bone graft and stabilisation within a transfixation cast. Bony ankylosis of the joint was observed radiogr...
Chemical arthrodesis of the distal tarsal joints using sodium monoiodoacetate in 104 horses. To evaluate chemical arthrodesis using sodium monoiodoacetate for treatment of degenerative joint disease of the tarsometatarsal and distal intertarsal joints. Methods: Retrospective clinical study. Methods: Horses were diagnosed with degenerative joint disease of one or more of the tarsometatarsal or distal intertarsal joints based on history, lameness examination, radiographic findings and, in some cases, response to intra-articular anaesthesia or medication. Intra-articular injections of sodium monoiodoacetate were performed using 23 gauge needles in the sedated, standing horse. Positive co...
Use of a three-drill-tract technique for arthrodesis of the distal tarsal joints in horses with distal tarsal osteoarthritis: 54 cases (1990-1999). To assess the long-term clinical outcome of horses with distal tarsal osteoarthritis (OA) in which a 3-drill-tract technique was used to induce arthrodesis of the affected joints, identify any preoperative or operative factors associated with outcome, and describe any complications associated with the technique. Methods: Retrospective study. Methods: 54 horses. Methods: Medical records were reviewed for information on signalment, use, history, physical and lameness examination findings, surgical technique, and postoperative care. Radiographs were examined, and severity of OA was graded. Follow...
An in vitro biomechanical comparison of a prototype intramedullary pin-plate with a dynamic compression plate for equine metacarpophalangeal arthrodesis. To compare the biomechanical properties of a prototype intramedullary pin-plate (IMPP) implant specifically designed for equine metacarpophalangeal (MCP) arthrodesis with a dynamic compression plate (DCP) system. Methods: In vitro biomechanical testing of paired cadaveric equine forelimbs with a simulated traumatic disruption of the suspensory apparatus, stabilized by one of two methods for MCP arthrodesis. Methods: Twenty-one pairs of adult equine cadaveric forelimbs. Methods: Each forelimb had the distal sesamoidean ligaments severed to create a disrupted suspensory apparatus. For each forel...
Scapulohumeral arthrodesis in miniature horses. To describe surgical arthrodesis of the scapulohumeral joint and to evaluate its efficacy in reducing morbidity associated with severe shoulder dysfunction in miniature horses. Methods: Retrospective study. Methods: Four miniature horses. Methods: Medical records and radiographs were reviewed for history, physical examination findings, lameness evaluation, radiographic evaluation, surgical techniques, postoperative complications, and outcome. A 10- or 11-hole, 4.5-mm narrow dynamic compression plate and 4.5-mm cortical screws were applied to the cranial surface of the scapula and cranial surfa...
Arthrodesis of the equine proximal interphalangeal joint: a biomechanical comparison of two 7-hole 3.5-mm broad and two 5-hole 4.5-mm narrow dynamic compression plates. To compare the biomechanical characteristics and mode of failure of two different dynamic compression plate (DCP) techniques for proximal interphalangeal joint (PIPJ) arthrodesis in horses. Methods: Randomized block-design blocking on horse (1-5), method of fixation (two 7-hole, 3.5-mm broad DCP vs two 5-hole, 4.5-mm narrow DCP), side (left, right), and end (front, hind). Constructs were loaded to failure in 3-point bending in a dorsal-to-palmar (plantar) direction. Methods: Ten paired limbs from 5 equine cadavers. Methods: Two 7-hole, 3.5-mm broad dynamic compression plates (bDCP) were used i...
Proximal interphalangeal joint arthrodesis in 34 horses using two parallel 5.5-mm cortical bone screws. To report clinical experience with arthrodesis of the proximal interphalangeal joint in horses using two parallel 5.5-mm cortical bone screws placed in lag fashion. Methods: Retrospective, clinical study. Methods: Thirty-four horses, aged 1 to 19 years. Methods: Medical records for all horses admitted (1991-1997) for pastern arthrodesis using two 5.5-mm ASIF cortical bone screws, in parallel orientation, and placed in lag fashion by use of a combined aiming device to facilitate accuracy were reviewed. Signalment, lameness diagnosis, duration of lameness, limb(s) involved, and outcome were reco...
Proximal interphalangeal arthrodesis in 22 horses. The purpose of this study was to evaluate a new method of internal fixation technique for pastern arthrodesis. Pastern arthrodeses are performed commonly in horses with chronic osteoarthritis of the pastern joint or, in cases of acute traumatic injury to the pastern, in which the weightbearing bony column must be restored. Chronic osteoarthritis of the pastern is a frequent cause of lameness in the equine athlete and is evidenced by chronic lameness localised to the pastern joint, and supported radiographically by periosteal proliferation and loss of joint space. Nonsurgical and surgical treat...
Arthrodesis of the equine proximal interphalangeal joint: a biomechanical comparison of three 4.5-mm and two 5.5-mm cortical screws. To compare the biomechanical characteristics and mode of failure of 2 parallel-screw techniques for proximal interphalangeal joint arthrodesis in horses. Methods: Randomized block design, blocking for horse (1-5), method of screw fixation (three 4.5-mm vs two 5.5-mm), side (left limb vs right limb), and end (front limb vs hind limb). Constructs were loaded to failure in 3-point bending in a dorsal-to-palmar (plantar) direction. Methods: Twenty limbs (10 limb pairs) from 5 equine cadavers. Methods: A combined aiming device was used to facilitate consistent screw placement. Three parallel 4.5-mm...
Surgical arthrodesis of distal tarsal joints in 17 horses clinically affected with osteoarthritis. To evaluate the outcome of 17 horses that underwent surgical arthrodesis of the tarsometatarsal and distal intertarsal joints for treatment of lameness due to osteoarthritis. Methods: Retrospective clinical study using client-owned animals. Methods: Horses with hindlimb lameness were diagnosed with osteoarthritis of the distal tarsal joints following relief of lameness after intra-articular anaesthesia or intra-articular corticosteroid injection. Surgery to stimulate ankylosis was performed on 27 hocks by placing 3 diverging 3.2 mm drill holes approximately 3 cm through the tarsometatarsal and...
An evaluation of chemical arthrodesis of the proximal interphalangeal joint in the horse by using monoiodoacetate. The use of monoiodoacetate (MIA) for arthrodesis of the proximal interphalangeal joint (PIJ) and the effect of exercise on the degree of fusion were investigated. Eight horses received 3 injections (Weeks 0, 3, 6) of MIA (2 mL; 60 mg/mL) into the right or left front PIJ. Peri-operatively, the horses received phenylbutazone, butorphanol, and abaxial sesamoidean nerve blocks to relieve pain. During the study, the horses were monitored for general health, lameness, and swelling around the injection area. Radiographs were taken biweekly to evaluate bony fusion. Horses were randomly divided into no...
Arthrodesis of the proximal interphalangeal joint affected with septic arthritis in 8 horses. Arthrodesis was performed to treat septic arthritis of the proximal interphalangeal joint of 8 horses. Records of the horses were reviewed to determine outcome and possible factors that influenced success or failure. All horses were female. Seven horses had 1 joint treated and 1 horse was treated for bilateral pelvic limb involvement. The duration of sepsis before surgery ranged from 1 to 66 days. Bone lysis and production was radiographically apparent in 7 horses before surgery. Six horses had multiple bacterial organisms cultured from bone or synovial tissues; 2 horses had single isolates id...
Double-plate fixation of comminuted fractures of the second phalanx in horses: 10 cases (1985-1993). To determine the technique used, and the outcome for, double-plate fixation of comminuted fractures of the second phalanx of horses. Methods: Retrospective analysis of medical records. Methods: 10 horses with comminuted fractures of the second phalanx that were treated by use of double-plate fixation. Methods: Two 4- to 6-hole dynamic compression plates were abaxially placed to achieve arthrodesis of the proximal interphalangeal joint and fixation of the fracture of the second phalanx. Results: Arthrodesis and fracture healing were detected in all horses. Conclusions: Horses with comminuted fr...