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.
Clinical uses of hyaluronan. The availability of elastoviscous solutions of highly purified hyaluronan has created two new therapeutic methods in human and veterinary medicine: viscosurgery and viscosupplementation. Viscosurgical tools and implants are widely used in ophthalmology and have been suggested for use in otology. Visco-supplementation of joint fluid using elastoviscous hyaluronan solutions is widely used in the treatment of equine traumatic arthritis. It was also suggested for use in idiopathic osteoarthritis in humans, but this application has not received wide acceptance. Cross-linked forms of hyaluronan have...
Arthrodesis of the equine distal tarsal joints by perforated stainless steel cylinders. Perforated stainless steel cylinders filled with autogenous cancellous bone were implanted in the distal tarsal joints of four horses. Graft cell survival was poor two weeks after surgery in one horse. In two horses, at 10 months there was partial arthrodesis of the joints with incorporation of the implants into the osseous union. The implants were filled with vascularised woven bone. These two horses were sound nine months after surgery. One horse fractured its third tarsal bone and was still positive to a hock flexion test 12 months after surgery.
Review of pathogenesis and treatment of degenerative joint disease. Treatment of degenerative joint disease (osteoarthritis) is discussed in relationship to pathogenesis of five clinical entities, defined to facilitate discussion:-1) occurring in high motion joints and associated with synovitis; 2) associated with low motion joints; 3) "non-progressive" articular cartilage erosion; 4) secondary to other identified problems (intra-articular fractures, ligamentous damage, wounds, septic arthritis, osteochondrosis); and 5) chondromalacia of the patella. In addition to direct damage to articular cartilage, synovitis and capsulitis and depletion of matrical glycosa...
A modified Cloward’s technique for arthrodesis of the normal metacarpophalangeal joint in the horse. A modified Cloward's technique was performed for arthrodesis of one metacarpophalangeal (MCP) joint in eight horses. Dorsal arthrotomies were performed medial and lateral to the common digital extensor tendon and two 16 mm holes were drilled through the joint. A perforated cylindrical stainless steel basket filled with cancellous bone was impacted into each hole. The limbs were supported in casts for 8 weeks. The joints were examined and radiographed at 4 weeks, 8 weeks, 6 months, and 10 months. One horse was euthanatized at week 14 to assess the progress of the arthrodesis. In the other seven...
Arthrodesis of the scapulohumeral joint in a miniature horse. Scapulohumeral arthrodesis was performed successfully as treatment for severe degenerative arthritis in a 62-kg miniature horse. Using an approach similar to that used for a dog, this horse's scapulohumeral joint was opened, the cartilage was removed, and the site was stabilized, using an 11-hole narrow dynamic compression plate. Fusion was uncomplicated. The stallion became a successful pasture-breeding animal.
Use of a bone plate for treatment of middle phalangeal fractures in horses: seven cases (1979-1984). Four adult horses and 3 foals with middle phalangeal fractures were treated by arthrodesis of the proximal interphalangeal joint, using a bone plate. Six of the 7 horses survived greater than 2 years; 2 of the 6 horses had intermittent lameness after hard work, and 4 horses didn't have evidence of lameness. The use of a bone plate for arthrodesis of the proximal interphalangeal joint was a successful treatment alternative for middle phalangeal fractures in horses.
Use of an external skeletal fixation device and bone graft for arthrodesis of the metacarpophalangeal joint in horses. Arthrodesis of the metacarpophalangeal joint was attempted in 9 adult horses, using a new external skeletal fixation device and autogenous cancellous bone graft. Four horses had excellent results, 2 horses had fair results, arthrodesis failed in 2 horses, and 1 horse fractured the third metacarpal bone. The advantages of the technique included minimal surgical trauma to the area of injury, immediate rigid fixation of the metacarpophalangeal joint, and access for treatment of soft-tissue lesions at the site of injury. Although pin loosening and pin-track infection were complications when the de...
Surgical arthrodesis for the treatment of osteoarthrosis of the proximal intertarsal, distal intertarsal and tarsometatarsal joints in 30 horses: a comparison of four different techniques. Over a period of seven years, 30 horses were treated by surgical arthrodesis for lameness resulting from osteoarthrosis of the proximal intertarsal, distal intertarsal and tarsometatarsal joints (bone and occult spavin). Twenty-five horses were affected in one hock only and five were affected bilaterally. Four different techniques for achieving arthrodesis were used. Fourteen out of 18 horses (78 per cent) with involvement of the distal intertarsal and tarsometatarsal joints only and six out of 11 horses (55 per cent) in which the proximal intertarsal joint was also involved became sound follo...
Arthrodesis of the pastern joint in the horse. Arthrodesis of the pastern joint was performed in six horses with a history of acute trauma and in 10 horses with a history of chronic lameness of one to six months duration. Five surgical techniques were employed: curettage of the joint, lag screw compression and immobilisation in a plaster cast; curettage, compression using a T plate and immobilisation; drilling, lag screw compression and immobilisation; lag screw compression and immobilisation; and curettage and immobilisation. Pre- and postoperative clinical course are described together with significant radiographical findings. The best r...
Long-term results and complications of proximal interphalangeal arthrodesis in horses. A retrospective study was made of 21 horses in which proximal interphalangeal arthrodesis had been performed. The right hindlimb was the most often affected (52%). Acute trauma was the most common reason for performing the surgery (62%). Follow-up data were obtained from the owners regarding return to serviceability . When available, follow-up radiographs and clinical examinations were reviewed. Of the 20 horses on which follow-up information was available, 16 were serviceable . Of the horses in which a hindlimb was arthrodesed , 86% were serviceable , whereas 67% of the horses affected in the...
Complications during treatment of traumatic disruption of the suspensory apparatus in Thoroughbred horses. A total of 19 Thoroughbred horses were treated for traumatic disruption of the suspensory apparatus, using either external support of the injured limb, removal of fractured proximal sesamoid bone fragments, metacarpophalangeal arthrodesis, compression screw fixation of the fractured proximal sesamoid bones, application of a cast-brace attached to a transfixation pin inserted through the third metacarpal bone, or combinations thereof. Major complications during the treatment of traumatic disruption of the suspensory apparatus were infection (9 of 19 horses, 47%), large cast sores (10 of 14 trea...
Degenerative joint disease with osteochondrosis of the proximal interphalangeal joint in young horses. Degenerative joint disease of the proximal interphalangeal joint was diagnosed in 9 joint of 6 horses. All of the horses were 3 years old or younger and the affected joints were in the hindlimbs. Radiographic evidence of osteochondrosis involving the distal end of the proximal phalanx was apparent in 5 joints. Lameness and local soft tissue swelling were prominent in all cases. In 1 horse euthanatized tissues because of lameness, histologic examination of joint tissues revealed osteochondrosis as well as severe osteoarthritis. Surgical arthrodesis of the affected joint was performed on 2 horse...
Surgical arthrodesis for the treatment of bone spavin in 20 horses. During a 3 year period 20 horses with bone spavin were treated by surgical arthrodesis of the affected joints. The horses chosen for surgery were those with osteoarthritis, but with little or no evidence of periostitis. Whenever possible they were examined periodically during the postoperative period to evaluate the lameness and to assess the progress of ankylosis by radiography. Three of the horses were still lame 12 months later. The remainder returned to normal work, although one subsequently developed spavin in the other hock and was destroyed. The earliest return to soundness was 3 1/2 mo...
Current concepts in equine degenerative joint disease. Current concepts of pathogenesis, diagnosis, and treatment of equine degenerative joint disease are presented on the basis of recently acquired experimental and clinical knowledge. A number of concepts of pathogenesis need modification and the rationale of some of the newer treatments requires definition. Synovitis and other soft tissue changes are important components of the pathogenesis in addition to direct trauma to the articular cartilage. Loss of glycosaminoglycans constitutes an important biochemical "lesion" in the articular cartilage, making it weak and susceptible to trauma. Recognit...
Comparison of two surgical procedures for arthrodesis of the proximal interphalangeal joint in horses. Arthrodesis of the proximal interphalangeal joint in horses, with 2 screws crisscrossing the joint, was compared with arthrodesis achieved by placement of 3 screws crossing the joint parallel to the long axis of the bone. The comparison was made by means of radiography, gross and histologic examinations, and motion evaluation. Additionally, the fused 1st and 2nd phalanges resulting from each method were subjected to breaking forces. Motion evaluation and direct examination of the fused area demonstrated that either procedure can be used to achieve arthrodesis consistently, and the breaking pro...
An experimental approach to surgery of the equine fetlock and its associated structures. An illustrated approach to the medial aspect of the equine fetlock joint is described, whereby the collateral ligaments are transected. This approach is suggested as a possible technique for metatarsal or metacarpal bone fracture repair by retrograde pinning, arthrodesis of the fetlock joint and other joint and sesamoid bone surgery. The histological evidence of satisfactory healing is presented and the advantages and disadvantages are discussed.