Orthopedics in horses involves the study and treatment of disorders affecting the musculoskeletal system, including bones, joints, ligaments, tendons, and muscles. This field addresses a range of conditions, from developmental disorders and degenerative diseases to traumatic injuries. Common orthopedic issues in horses include fractures, osteoarthritis, tendonitis, and ligament injuries. Diagnostic techniques such as radiography, ultrasonography, and MRI are employed to assess these conditions. Treatment options may include surgical intervention, physical therapy, and pharmacological management. This page compiles peer-reviewed research studies and scholarly articles that explore the diagnosis, treatment, and management of orthopedic conditions in equine patients.
McIlwraith CW.The paper reviews current knowledge on conservative versus surgical options for the treatment of osteochondrosis entities in the horse. Clinical and radiographic signs of each significant osteochondrosis entity in the horse are presented, followed by the value of conservative treatment versus arthroscopic surgery options as well as the results for each option with the various entities. The entities presented in detail include, osteochondritis dissecans (OCD) of the femoropatellar, tarsocrural, metacarpophalangeal and metatarsophalangeal, and glenohumural articulations. The various treatment op...
Tóth P, Horváth C, Ferencz V, Tóth B, Váradi A, Szenci O, Bodó G.Despite the fact that bone mineral density (BMD) is an important fracture risk predictor in human medicine, studies in equine orthopedic research are still lacking. We hypothesized that BMD correlates with bone failure and fatigue fractures of this bone. Thus, the objectives of this study were to measure the structural and mechanical properties of the proximal phalanx with dual energy X-ray absorptiometry (DXA), to correlate the data obtained from DXA and computer tomography (CT) measurements to those obtained by loading pressure examination and to establish representative region of interest (...
De Schauwer C, Van de Walle GR, Van Soom A, Meyer E.In the past decade, mesenchymal stem cells (MSC) have received much attention in equine veterinary medicine. The first therapeutic use of equine MSC was reported in 2003. Since then, the clinical application of MSC has been exploding with thousands of horses now treated worldwide. At present, MSC are mainly used in veterinary medicine to treat musculoskeletal diseases based on their ability to differentiate into various tissues of mesodermal origin. This is in marked contrast to human medicine, where MSC therapies are primarily focused on immune-mediated, inflammatory, and ischemic diseases. I...
Robert C, Valette JP, Jacquet S, Lepeule J, Denoix JM.The possible aetiology of osteochondrosis and, to a lesser extent, other developmental orthopaedic diseases or juvenile osteochondral conditions (JOCC), has been intensively investigated. However, most studies have focused on single factors of this multi-factorial disorder, or have been conducted under experimental conditions. This paper aims to present and discuss the scientific background of the BOSAC (Breeding, Osteochondral Status and Athletic Career) research program, a multi-factorial investigation on JOCC risk factors in field conditions. The epidemiology of JOCC in horses born in Norma...
Jönsson L, Roepstorff L, Egenvall A, Näsholm A, Dalin G, Philipsson J.Soundness of an individual horse is important for animal welfare and owner economy. However, knowledge of health status in normal horse populations is limited due to lack of systematic health recordings. The aim of the investigation was to study the prevalence of veterinary clinical findings in 4-5-year-old Swedish warmblood riding horses, and their influence on overall health scores, where associations to future longevity has been indicated. Results: The prevalence of clinical findings in 8,281 horses examined during 1983-2005 was studied according to a standardised protocol and related to ov...
Nieto JE, Maher O, Stanley SD, Knych HK, Snyder JR.To determine the pharmacokinetics, pharmacodynamics, and safety of zoledronic acid in horses. Methods: 8 healthy horses. Methods: A single dose of zoledronic acid (0.057 mg/kg, IV) was administered during a 30-minute period. Venous blood was collected at several time points. Zoledronic acid concentration in plasma was measured by liquid chromatography-tandem mass spectrometry, and pertinent pharmacokinetic parameters were determined. Plasma was analyzed for total calcium, BUN, and creatinine concentrations and a marker for bone resorption (C-terminal telopeptides of type I collagen). Results: ...
Holden-Douilly L, Pourcelot P, Desquilbet L, Falala S, Crevier-Denoix N, Chateau H.Longitudinal sliding of horse's hooves at the beginning of stance can affect both performance and orthopaedic health. The objective of this study was to compare two measurement methods for quantifying hoof slip distances at training trot. The right front hoof of four French Trotters was equipped with an accelerometer (10 kHz) and kinematic markers. A firm wet sand track was equipped with a 50 m calibration corridor. A high-frequency camera (600 Hz) was mounted in a vehicle following each horse trotting at about 7 m/s. One of the horses was also trotted on raw dirt and harrowed dirt tracks. Lon...
Jönsson L, Näsholm A, Roepstorff L, Egenvall A, Dalin G, Philipsson J.Soundness is important for welfare and utility of the riding horse. Musculoskeletal disorders are the most common causes of interruption in training and of culling. Despite great importance, heritability of a majority of health traits in horses has previously not been estimated. The objective was to perform genetic analyses of medical and orthopaedic health traits in young riding horses, including estimates of heritability and genetic correlations between health traits, and to reveal possibilities for genetic evaluation of stallions for progeny health. Results: The heritability of health trait...
Verwilghen DR, Janssens S, Busoni V, Pille F, Johnston C, Serteyn D.Few reports are available on the relationship between developmental orthopaedic diseases (DOD) and future performances in Warmblood horses. Objective: To investigate the relationship between performance and the presence of DOD lesions. Methods: Records of Warmblood stallions for which radiographic and performance data were available were collected. Showjumping performances were expressed as scores derived from the final ranking of horses in each competition. These scores are available in an established performance database. The relationship between radiographic findings and both performance sc...
Burk J, Badylak SF, Kelly J, Brehm W.Pioneering clinical stem cell research is being performed in the horse, a recipient of cutting edge veterinary medicine as well as a unique animal model, paving the way for human medical applications. Although demonstrable progress has been made on the clinical front, in vitro characterization of equine stem cells is still in comparatively early stages. To translate the promising results of clinical stem cell therapy in the horse, advances must be made in the characterization of equine stem cells. Aiming to improve communication between veterinarians and other natural scientists, this review g...
MacFarlane PD, Mosing M.This case series is the first report of the use of CPAP (continuous positive airway pressure) ventilation in adult horses. Two horses and 3 ponies anesthetized for orthopedic procedures in lateral recumbency received 10 cm H(2)O CPAP. During anesthesia, arterial oxygen partial pressure tended to increase and arterial carbon dioxide pressure tended to increase despite increased minute ventilation index. The measured cardiovascular parameters were within physiologic limits. Cette série de cas est le premier rapport sur l’utilisation de la ventilation spontanée en pression positive continue ...
McD￮ LA.Stem cell therapy and cell-based therapies using other progenitor cells are becoming the treatment of choice for many equine orthopedic lesions. Important criteria for obtaining autogenous equine progenitor cells in vitro for use in clinical cell-based therapy include the ability to isolate and expand cells repeatedly to high numbers (millions) required for therapy, in a clinically relevant time frame. Cells must also maintain their ability to differentiate into the tissue type of choice. The objective of this study was to compare isolation and expansion techniques for preparation of periostea...
Spaas JH, Guest DJ, Van de Walle GR.Tendon injuries are one of the most common orthopaedic problems in both human and equine athletes. When a damaged tendon heals naturally, it loses a substantial part of the original strength and elasticity. Therefore, tendons recover structurally (reparation) but not functionally (regeneration) after conservative medical or surgical treatment. Since the structure and matrix composition of human and equine tendons share many similarities, the nature of tendon injuries are also strongly comparable in both species. Therefore, the evaluation of regenerative therapies in horses may have application...
Albert R, Vásárhelyi G, Bodó G, Kenyeres A, Wolf E, Papp T, Terdik T, Módis L, Felszeghy S.One of the most promising applications for the restoration of small or moderately sized focal articular lesions is mosaicplasty (MP). Although recurrent hemarthrosis is a rare complication after MP, recently, various strategies have been designed to find an effective filling material to prevent postoperative bleeding from the donor site. The porous biodegradable polymer Polyactive (PA; a polyethylene glycol terephthalate - polybutylene terephthalate copolymer) represents a promising solution in this respect. A histological evaluation of the longterm PA-filled donor sites obtained from 10 exper...
Malda J, Benders KE, Klein TJ, de Grauw JC, Kik MJ, Hutmacher DW, Saris DB, van Weeren PR, Dhert WJ.Articular cartilage defects are common after joint injuries. When left untreated, the biomechanical protective function of cartilage is gradually lost, making the joint more susceptible to further damage, causing progressive loss of joint function and eventually osteoarthritis (OA). In the process of translating promising tissue-engineering cartilage repair approaches from bench to bedside, pre-clinical animal models including mice, rabbits, goats, and horses, are widely used. The equine species is becoming an increasingly popular model for the in vivo evaluation of regenerative orthopaedic ap...
Seabaugh KA, Hubert JD, Kawcak CE, McGilvray KC, Santoni BG, Rao S, Baxter GM.To quantify changes in biomechanical stability and stiffness within the equine carpus after removal of 50%, 80%, and 100% of the second metacarpal bone (MC2). Methods: In vitro biomechanical study. Methods: Cadaveric equine forelimbs (n = 16) were evaluated. Intact constructs were loaded in axial compression from 0 to 5000 N and compression + torsion (5000 N ± 20°) for 5 cycles. This was repeated after removal of 50%, 80%, and 100% of MC2. The primary biomechanical outcome variables were the compressive stiffness and compressive + torsional stiffness of the carpus. Relative kinematic motion ...
Quinteros DD, García-López JM, Abuja GA, Tarkanian M, Maranda LS, Bubeck K, Kowaleski MP.To determine if the mechanical properties (strength and stiffness) of a new prototype 4.5 mm broad locking plate (NP-LP) are comparable with those of a traditional 4.5 mm broad limited-contact self compression plate (LC-SCP), and to compare the bending and torsional properties of the NP-LP and LC-SCP when used in osteotomized equine third metacarpal bones (MC3). Methods: The plates alone were tested in four-point bending single cycle to failure. The MC3-plate constructs were created with mid-diaphyseal osteotomies with a 1 cm gap. Constructs were tested in four-point bending single cycle to fa...
Kelmer G, Bell GC, Martin-Jimenez T, Saxton AM, Catasus C, Elliot SB, Meibohm B.Previous studies have shown that regional limb perfusion (RLP) using the palmar digital (PD) vein delivers therapeutic concentration of amikacin to the distal limb. Our hypothesis was that using the cephalic and saphenous veins for RLP will enable delivery of therapeutic concentrations of amikacin to the distal limb. Nineteen healthy horses participated in the study. The cephalic, saphenous, or PD vein was used to perfuse the limb with amikacin. Two grams of amikacin was used for RLP using the saphenous and the cephalic veins, and one gram was used in the PD vein. Synovial samples were collect...
Clegg PD.Tendon and ligament injuries continue to be one of the most frequent causes of orthopaedic injury and early retirement in the Thoroughbred racehorse. In the UK, the Horserace Betting Levy Board has invested considerable research funding in the last decade in order to investigate aspects of tendon epidemiology, biology and therapy, in order to decrease both the welfare and economic consequence of such injuries. This review summarises key aspects of this research effort and identifies specific research directions for the future.
Nicholson CL, Firth EC, Waterland MR, Jones G, Ganesh S, Stewart RB.Although bone fracture has become a serious global health issue, current clinical assessments of fracture risk based on bone mineral density are unable to accurately predict whether an individual is likely to suffer a fracture. There is increasing recognition that the chemical structure and composition, or microstructure, of mineralized tissues has an important role to play in determining the fracture resistance of bone. The objective of this preliminary study was to evaluate the use of specular reflectance Fourier transform infrared (SR FT-IR) microspectroscopy in conjunction with discriminan...
Cohen JM, Southwood LL, Engiles J, Leitch M, Nunamaker DM.To examine the efficacy and biocompatibility of a thiolated gelatin-thiolated carboxymethyl hyaluronan (CMHA-SGX) sponge as an osteoconductive device in an equine second and fourth metacarpal bone defect model. Methods: Seven millimetre segmental ostectomies were created bilaterally in the second and fourth metacarpal bones of four horses. The left and right metacarpal defects were randomly assigned to (1) be filled with a CMHA-SGX sponge (treated) or (2) were left unfilled (control). The duration of the study was nine weeks. Bone healing was evaluated using serial radiology, as well as histol...
Chiaradia E, Pepe M, Tartaglia M, Scoppetta F, D'Ambrosio C, Renzone G, Avellini L, Moriconi F, Gaiti A, Bertuglia A, Beccati F, Scaloni A.Osteoarthritis (OA) and osteochondrosis (OC) are two of the main challenges in orthopedics, whose definitive diagnosis is usually based on radiographic/arthroscopic evidences. Their early diagnosis should allow preventive or timely therapeutic actions, which are generally precluded from the poor relationships occurring between symptomatologic and radiographic evidences. These limitations should be overcome by improving the knowledge on articular tissue metabolism and on molecular factors regulating its normal homeostasis, also identifying novel OA and OC biomarkers suitable for their earlier d...
Sherlock CE, Eggleston RB, Howerth EW.A 7-year-old Quarter Horse gelding was evaluated because of sudden onset of severe left forelimb lameness of 4 days' duration. Results: Clinical evaluation and diagnostic perineural analgesia localized the lameness to the distal portion of the left forelimb. Radiography revealed a transverse fracture of the distal phalanx of the left forelimb. Results: The horse was treated conservatively with stall rest and stabilization of the hoof with fiberglass cast material and an elevated heel support. These treatments improved the lameness considerably. Over the following 4 months, the horse was exerci...
Virgin JE, Goodrich LR, Baxter GM, Rao S.To determine the incidence of support limb laminitis among horses treated with half limb, full limb or transfixation pin casts and determine potential risk factors. Methods: Medical records of 113 horses treated with half limb, full limb or transfixation pin casts at an equine referral hospital from 2000 to 2009 were reviewed. Associations between potential risk factors and development of support limb laminitis were evaluated by bivariable and multivariable logistic regression analyses. Results: Of the 113 horses that received casts, 14 (12%) developed confirmed support limb laminitis. The bod...
Lescun TB, Frank EA, Zacharias JR, Daggy JK, Moore GE.To compare the bone temperature and final hole dimensions associated with sequential overdrilling (SO) and single 6.2-mm drill bit (S6.2DB) methods used to create transcortical holes in the third metacarpal bones (MCIIIs) of horse cadavers. Methods: 60 MCIIIs from 30 horse cadavers. Methods: In phase 1, hole diameter, tap insertion torque, peak bone temperature, and postdrilling bit temperature for 6.2-mm-diameter holes drilled in the lateral or medial cortical region of 12 MCIIIs via each of three 2-bit SO methods with a single pilot hole (diameter, 3.2, 4.5, or 5.5 mm) and the S6.2DB method ...
Lönnell C, Roepstorff L, Egenvall A.Lameness is the most commonly diagnosed condition in equine veterinary practice. To examine whether variations in management and husbandry strategies in riding schools could influence wastage due to orthopaedic injury schools with high (HUIO) or low (LUIO) insurance claims for orthopaedic injuries (as an indirect measure of wastage) were compared epidemiologically using an extensive questionnaire and field study visits. Schools differed in management strategies and these influence injury rate and longevity. For horses in the LUIO schools a significantly longer time period had elapsed since acq...
Corbin LJ, Blott SC, Swinburne JE, Sibbons C, Fox-Clipsham LY, Helwegen M, Parkin TD, Newton JR, Bramlage LR, McIlwraith CW, Bishop SC, Woolliams JA....Osteochondrosis is a developmental orthopaedic disease that occurs in horses, other livestock species, companion animal species, and humans. The principal aim of this study was to identify quantitative trait loci (QTL) associated with osteochondritis dissecans (OCD) in the Thoroughbred using a genome-wide association study. A secondary objective was to test the effect of previously identified QTL in the current population. Over 300 horses, classified as cases or controls according to clinical findings, were genotyped for the Illumina Equine SNP50 BeadChip. An animal model was first implemented...
Owens SD, Burges J, Johns JL, Carrade DD, Galuppo LD, Librach F, Borjesson DL.The therapeutic use of bone marrow-derived mononuclear cells (MNCs) and mesenchymal stem cells for the treatment of soft tissue and orthopedic injuries in equine patients is expanding. After collection, bone marrow must be reduced in volume and depleted of RBCs for immediate therapeutic use or to prepare cells for culture or cryopreservation and storage. The MarrowXpress (MXP) System is an automated, closed, sterile system designed to process human bone marrow samples. Objective: The purpose of this study was to evaluate the capacity of the MXP System to process equine bone marrow to reduce vo...
Licka TF.The differentiation of ataxia and orthopedic disease can be facilitated by the use of several additional tests, not commonly part of either neurologic or orthopedic examination protocols. However, a full neurologic and orthopedic examination and suitable diagnostic imaging will of course also be necessary in such cases. The common association of orthopedic and neurologic disease makes it even more necessary to correctly attribute movement or posture abnormalities to potentially treatable structures.
Baxter GM.Orthopedic infections-those involving bones, joints, tendon sheaths, or bursae-are some of the most difficult problems for equine surgeons to treat successfully. Sources of the infection are usually hematogenous, traumatic, or iatrogenic and knowledge of the most likely causative bacteria is very useful in selecting the most appropriate antimicrobial(s) to either prevent or treat these infections in horses. This article discusses the clinical findings, diagnosis, treatment, and prevention of orthopedic infections in horses. More recent treatment methods such as synovial drainage techniques (ar...
Hedenström UO, Wattle OS.Ossification of the ungular cartilages (OUC) in the foot of horses has been studied for more than 100 years. There is a high heritability of this condition but its clinical relevance has remained questionable. Nevertheless, modern equine orthopedic literature ranks OUC as one of top 10 causes of lameness in cold-blooded trotters and stallions of these breeds are excluded from breeding if they have more than mild levels of side bones. Cold-blooded trotters have been used for racing for many decades and official sports data have been available since 1923. A decreased performance is often the onl...
Hinkle FE, Selberg KT, Frisbie DD, Barrett MF.Comparison of radiography to magnetic resonance imaging (MRI) can help objectively assess the value and limitations of radiographs in orthopaedic disease processes. The tarsus and proximal suspensory origin of the metatarsus are commonly imaged regions for lameness. The knowledge gained by comparison between imaging modalities will aid in improving accuracy of radiographic interpretation. Objective: To compare the radiographic and MRI findings of the proximal third metatarsal bone (MTIII) and proximal suspensory ligament using MRI as the gold standard. Methods: Retrospective observational stud...
Robert C, Valette JP, Jacquet S, Lepeule J, Denoix JM.The possible aetiology of osteochondrosis and, to a lesser extent, other developmental orthopaedic diseases or juvenile osteochondral conditions (JOCC), has been intensively investigated. However, most studies have focused on single factors of this multi-factorial disorder, or have been conducted under experimental conditions. This paper aims to present and discuss the scientific background of the BOSAC (Breeding, Osteochondral Status and Athletic Career) research program, a multi-factorial investigation on JOCC risk factors in field conditions. The epidemiology of JOCC in horses born in Norma...
Clothier J, Small A, Hinch G, Brown WY.The long-term effects of gestational immaturity in the premature (defined as < 320 days gestation) and dysmature (normal term but showing some signs of prematurity) foal have not been thoroughly investigated. Studies have reported that a high percentage of gestationally immature foals with related orthopedic issues such as incomplete ossification may fail to fulfill their intended athletic purpose, particularly in Thoroughbred racing. In humans, premature birth is associated with shorter stature at maturity and variations in anatomical ratios, linked to alterations in metabolism and timing of...
Seabaugh KA, Hubert JD, Kawcak CE, McGilvray KC, Santoni BG, Rao S, Baxter GM.To quantify changes in biomechanical stability and stiffness within the equine carpus after removal of 50%, 80%, and 100% of the second metacarpal bone (MC2). Methods: In vitro biomechanical study. Methods: Cadaveric equine forelimbs (n = 16) were evaluated. Intact constructs were loaded in axial compression from 0 to 5000 N and compression + torsion (5000 N ± 20°) for 5 cycles. This was repeated after removal of 50%, 80%, and 100% of MC2. The primary biomechanical outcome variables were the compressive stiffness and compressive + torsional stiffness of the carpus. Relative kinematic motion ...
Moreno CR, Santschi EM, Younkin JT, Larson RL, Litsky AS.To determine the failure method of simulated equine medial femoral condyle (MFC) subchondral bone defects under compression and the influence of screw placement on failure resistance. Methods: In vitro study. Methods: Composite disks (CD) simulating the moduli of yearling bone in the MFC. Methods: Four CD conditions were tested, all with a 12.7 mm void (n = 6 per condition): intact (no void), void only, void with a 4.5 mm screw placed in neutral fashion, and void with a 4.5 mm screw placed in lag fashion. Composite disks of each condition were tested under monotonic compression to 6000...
Haseler CJ, Jarvis GE, McGovern KF.Intrasynovial corticosteroid injections are commonly used in the treatment of equine orthopaedic disease, but corticosteroid administration is widely considered a risk factor for the development of laminitis. Despite a list of putative mechanisms and a number of case reports of steroid-induced laminitis, no case-control or cohort studies investigating the association between use of intrasynovial corticosteroids and acute laminitis have been published. Objective: To quantify the risk of laminitis posed by intrasynovial triamcinolone acetonide (TA) administration in a mixed population of horses....
Hicks RB, Glass KG, Watkins JP.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...
Seiler GS, Campbell N, Nixon B, Tsuruta JK, Dayton PA, Jennings S, Redding WR, Lustgarten M.Vascular alterations play important roles in many orthopedic diseases such as osteoarthritis, tendonitis, and synovitis in both human and equine athletes. Understanding these alterations could enhance diagnosis, prognosis, and treatment. Contrast-enhanced ultrasound (CEUS) could be a valuable method for evaluation of blood flow and perfusion of these processes in the equine distal limb, however no reports were found describing feasibility or safety of the technique. The goal of this prospective, experimental study was to describe the feasibility and safety of distal limb CEUS in a sample of si...
Andritzky J, Rossol M, Lischer C, Auer JA.To compare the precision obtained with computer-assisted screw insertion for treatment of mid-sagittal articular fractures of the distal phalanx (P3) with results achieved with a conventional technique. Methods: In vitro experimental study. Methods: Thirty-two cadaveric equine limbs. Methods: Four groups of 8 limbs were studied. Either 1 or 2 screws were inserted perpendicular to an imaginary axial fracture of P3 using computer-assisted surgery (CAS) or conventional technique. Screw insertion time, predetermined screw length, inserted screw length, fit of the screw, and errors in placement wer...
Read EK, Chandler D, Wilson DG.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...
Al Naem M, Litzke LF, Geburek F, Failing K, Hoffmann J, Röcken M.In a laminitic horse, the maximal loading of the toe region occurs during the breakover phase. To date, no kinetic data demonstrates the effect of supportive orthopaedic therapy in horses with laminitis on breakover phase. Thus, the purpose of this study was to examine the effect of heel elevation on the breakover phase. Eight horses with acute laminitis treated medically as well as with application of a hoof cast with heel wedge (HCHW) were included in this study. Immediately following cessation of clinical signs of acute laminitis, two measurements using the Hoof™ System were taken: the fi...
O'Callaghan MW.There is increasing demand on equine practitioners to provide confirmation of their diagnoses. For obscure lameness and for many of the more difficult locomotory problems presented in referral hospitals, the question to be answered is not only how to make the most accurate diagnosis but also how to document the findings so that there is less doubt in the mind of the client. This article describes a quasi algorithmic approach to choosing the best combinations of the increasingly sophisticated imaging methods available for evaluation of orthopedic disease.
Bleetman D.The Great Western Ambulance Service Air Support Unit (ASU) was established in July 2007. The helicopter carries a doctor, providing a Helicopter Emergency Medical Service (HEMS) model of care. Equestrian sport-related injuries account for 6.8% of the unit's total attended case load. Horse riding has a higher rate of severe injury than motorcycle racing and 45% of patients admitted with equestrian injuries require surgical intervention. Orthopaedic injuries to the extremities are commonest, superseding head injuries since the introduction of protective headwear. The majority of equestrian sport...
Ortved KF.Osteochondrosis is common in young, athletic horses. Some lesions respond to conservative therapy. Surgical management is the mainstay of treatment. Arthroscopic debridement is useful in the femoropatellar joint, tarsocrural joint, fetlock joint, and shoulder joint. Debridement is associated with good outcomes, except in the shoulder joint. Osteochondrosis lesions in the elbow may be difficult to access arthroscopically, thereby transosseous debridement. Surgical management of subchondral cystic lesions of the medial femoral condyle consists of debridement, debridement with grafting, transcond...
Jenner F, Ross MW, Martin BB, Richardson DW.To review the outcome of equine shoulder osteochondrosis (OC) with surgical or conservative treatment. Methods: Retrospective study of 32 horses, less than two years of age, with scapulohumeral joint (SHJ) OC. The lesion severity was graded based on measurements taken from lateromedial radiographs. Follow-up information was obtained from racing records or telephone conversations with owners. Successful outcome was defined as the ability of the horse to perform its intended use. Results: Sixteen of 32 horses were affected bilaterally (48 joints). Eleven of 16 horses with bilateral OC underwent ...
Stock KF, Distl O.To determine whether selection schemes accounting for orthopedic health traits were compatible with breeding progress in performance parameters in Hanoverian Warmblood horses. Methods: 5,928 horses. Methods: Relative breeding values (RBVs) were predicted for osseous fragments in fetlock (metacarpo- and metatarsophalangeal) and tarsal joints, deforming arthropathy in tarsal joints, and pathologic changes in distal sesamoid bones. Selection schemes were developed on the basis of total indices for radiographic findings (TIR), dressage (TID), and jumping (TIJ). Response to selection was traced ove...
Mosichuk AP, Smith JS, Tatarniuk DM, Troy JR, Kreuder AJ.Septic synovitis is a critical orthopedic condition in horses. Early intervention is key, with antibiotic therapy typically initiated prior to culture and susceptibility reports becoming available. The pharmacokinetics of several antibiotics have been studied in horses for use in intravenous regional limb perfusion (IVRLP) for septic synovitis, including the carbapenem antibiotic, meropenem. For a variety of factors, some veterinary clinicians may select IVRLP meropenem as therapy for these cases. Meropenem is a vital antibiotic in human medicine, making veterinary use divisive. However, verif...
Steckel RR.Bone scanning to help diagnose orthopedic disease has been used in human patients for over two decades. The value of this diagnostic tool has been well established in helping to identify a variety of musculoskeletal conditions. It has only recently been used by veterinarians for more accurate characterization of equine musculoskeletal disease. The technique offers the major advantage of increased sensitivity over standard radiographic imaging. The case material illustrated here shows that except for consistent identification of bone cysts, most of the pathologic changes to the horse's musculos...
McD￮ LA, Stover SM, Taylor KT.To determine cyclic biomechanical properties of gap osteotomized adult equine tibiae stabilized with an equine interlocking nail (EIN). Methods: In vitro experimental biomechanical investigation. Methods: Thirteen adult equine cadaveric tibiae. Methods: Adult equine tibiae with transverse, midshaft, 1-cm gap osteotomies, stabilized with an equine interlocking nail, underwent cyclic biomechanical testing in vitro under axial compression, 4-point bending, and torsion. Different specimens were subjected to different load levels that represented estimated in vivo loads at 2 Hz for 740,000 cycles. ...
Hammersley E, Duz M, Marshall JF.Triamcinolone is commonly used in equine practice for the treatment of orthopaedic conditions. A serious potential adverse effect of triamcinolone is laminitis. However, evidence for the risk of laminitis associated with triamcinolone use is limited. Objective: To determine the risk of laminitis within 90 days of triamcinolone administration and compare with the risk of laminitis in a veterinary-attended horse population. Methods: Retrospective study of clinical records. Methods: Text mining and data extraction was performed using content analysis software (SimStat-WordStat v.6) on a database ...
Sod GA, Riggs LM, Mitchell CF, Hubert JD, Martin GS.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...
Crawley GR, Grant BD, White KK, Barbee DD, Gallina AM, Ratzlaff MH.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...
Cohen JM, Southwood LL, Engiles J, Leitch M, Nunamaker DM.To examine the efficacy and biocompatibility of a thiolated gelatin-thiolated carboxymethyl hyaluronan (CMHA-SGX) sponge as an osteoconductive device in an equine second and fourth metacarpal bone defect model. Methods: Seven millimetre segmental ostectomies were created bilaterally in the second and fourth metacarpal bones of four horses. The left and right metacarpal defects were randomly assigned to (1) be filled with a CMHA-SGX sponge (treated) or (2) were left unfilled (control). The duration of the study was nine weeks. Bone healing was evaluated using serial radiology, as well as histol...
Bertone AL, McIlwraith CW.Arthroscopic approaches to the scapulohumeral joint were developed in four clinically normal, live horses (5 limbs) to determine their usefulness for evaluation and potential surgical treatment of intraarticular lesions. The articular surface of the entire glenoid, cranial humeral head (medial and lateral) and caudolateral humeral head, as well as the synovial membrane, could be closely examined from an arthroscopic portal cranial to the infraspinatus tendon. The caudomedial humeral head could be examined partially. Cranial and caudal instrument portals allowed good surgical access to the enti...
Watt BC, Edwards RB, Markel MD, McCabe R, Wilson DG.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...
Sod GA, Riggs LM, Mitchell CF, Martin GS.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...
Peham C, Licka T, Girtler D, Scheidl M.The aim of this study was to compare supporting forelimb lameness determined by a motion analysis system with the subjective grading of a trained equine orthopaedic surgeon. Trotting on a treadmill, 29 individuals with a supporting forelimb lameness were measured with the SELSPOT II system and judged by the clinician. The vertical motion of the head was measured, analysed using Fourier transform, and the percentages of symmetry determined. The veterinarian evaluated the lameness and graded it according to a clinical routine. Veterinarian and system for motion analysis assigned the lameness to ...
Wolker RR, Carmalt JL, Wilson DG.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 ...
