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Topic:Orthopedics
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.
The equestrian sport-related injury workload of a regional doctor-led air ambulance unit. 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...
Musculoskeletal disease and injury, now and in the future. Part 1: fractures and fatalities. Orthopaedic injury is common in the racing Thoroughbred and is a cause of both economic loss to the industry, as well as being an obvious welfare issue. Fatal injuries sustained during racing are an obvious major concern and it is important that all is done to reduce their frequency. As a consequence of the importance of these causes of horse morbidity and mortality, the Horserace Betting Levy Board in the UK has invested considerable resources into research in recent years in this area in an attempt to decrease the frequency of such injuries. This review summarises current knowledge relating ...
Osteochondrosis and osteochondral fragments in Standardbred trotters: prevalence and relationships. Developmental orthopaedic diseases (DOD) such as osteochondrosis (OC)/osteochondrosis dissecans (OCD), palmar/plantar osteochondral fragments (POF), ununited palmar/plantar eminences (UPE) and dorsoproximal first phalanx fragments are well recognised in the horse. Aetiopathogeneses are controversial and molecular genetic screening of DNA has recently been employed for their elucidation. Precise phenotypic definition and knowledge of breed-specific prevalence and interrelations are essential for the interpretation of following genomic studies in Standardbred trotters. Objective: To assess the p...
Complications after two transphyseal bridging techniques for treatment of angular limb deformities of the distal radius in 568 Thoroughbred yearlings. Surgical correction of carpal angular limb deformities by growth retardation is commonly undertaken with a screws and tension band wire loop technique (S&W) or a single transphyseal screw (STS). This study compares complications after S&W and STS bridging in the distal radius of Thoroughbred yearlings. Objective: To compare the prevalence of complications serious enough to require follow-up radiographs following either S&W or STS surgery for growth manipulation in the distal radius of Thoroughbred yearlings. Methods: Medical records and radiographs from Thoroughbred yearlings (age ...
Stem cell-based therapies for bone repair. This article provides an overview of the cellular and molecular events involved in bone repair and the current approaches to using stem cells as an adjunct to this process. The article emphasizes the key role of osteoprogenitor cells in the formation of bone and where the clinical applications of current research may lend themselves to large animal orthopaedics. The processes involved in osteogenic differentiation are presented and strategies for bone formation, including induction by osteogenic factors, bioscaffolds, and gene therapy, are reviewed.
Genome-wide association studies for osteochondrosis in French Trotter horses. A genome-wide association study for osteochondrosis (OC) in French Trotter horses was carried out to detect QTL using genotype data from the Illumina EquineSNP50 BeadChip assay. Analysis data came from 161 sire families of French Trotter horses with 525 progeny and family sizes ranging from 1 to 20. Genotypes were available for progeny (n = 525) and sires with at least 2 progeny (n = 98). Radiographic data were obtained from progeny using at least 10 views to reveal OC. All radiographic findings were described by at least 2 veterinary experts in equine orthopedics, and severity indices (scores...
Isolation and characterization of multipotent mesenchymal stromal cells from the gingiva and the periodontal ligament of the horse. The equine periodontium provides tooth support and lifelong tooth eruption on a remarkable scale. These functions require continuous tissue remodeling. It is assumed that multipotent mesenchymal stromal cells (MSC) reside in the periodontal ligament (PDL) and play a crucial role in regulating physiological periodontal tissue regeneration. The aim of this study was to isolate and characterize equine periodontal MSC. Tissue samples were obtained from four healthy horses. Primary cell populations were harvested and cultured from the gingiva, from three horizontal levels of the PDL (apical, midtoo...
Correction of Lower Limb Deformities Using Ilizarov’s Technique. India accounts for approximately 10 million orthopaedically handicapped children and adults with limb deformity. Ilizarov ring fixator could treat most of these deformities. Methods: Twenty cases of deformities of lower limb managed with Ilizarov technique during period between March 2001 and February 2003 were studied. Results: 55% were in the age group of 11-30 years. Out of the 20 cases studied, 6 were congenital talipes equino varus, 8 were fixed flexion deformity of knee, 4 were equines deformity of the ankle and 2 were malunited fracture shaft of tibia.4 patients who had recurrence were ...
Risk factors for the presence and extent of Developmental Orthopaedic Disease in the limbs of young horses: Insights from a count model. Developmental Orthopaedic Disease (DOD) in limb joints is frequent, can cause lameness and is a major cause of economic losses for the horse breeding industry. Studies on risk factors for DOD usually dichotomise the outcome to presence/absence without considering the extent of the disease, which can be appreciated by the number or the severity of the lesions. The aim of this study was to assess the effects of growth, exercise conditions and feeding practices on the number of radiographic findings (RF) of DOD in a cohort of horses, assuming that the risk factors associated with the presence of ...
Goniometry: is it a reliable tool to monitor passive joint range of motion in horses? Simple objective assessment tools are essential to monitor the clinical efficacy of therapeutic interventions used in equine orthopaedics and rehabilitation. In human medicine, goniometry is a validated tool to quantify restrictions in joint range of motion (ROM); however, the technique is not validated in horses. Objective: To validate 2 different goniometry techniques for the measurement of passive flexion of the fetlock, carpus and hock by examining; 1) the intra- and inter-tester reliability; 2) the differences between 2 goniometry techniques and 3) differences between standing and anaesth...
Equine hospital data as a source for study of prevalence and heritability of osteochondrosis and palmar/plantar osseous fragments of Swedish Warmblood horses. Disturbances in skeletal development, primarily osteochondrosis (OC) and palmar/plantar osseous fragments (POF), have been commonly reported as problems in young horses. However, there are few reports of such findings for epidemiological analyses or breeding purposes. Objective: To evaluate equine hospital data as a possible source of information for genetic evaluations by estimating prevalence and heritability of OC in the stifle, hock and fetlock joints and of POF in the fetlock. Methods: Data on Swedish Warmblood (SWB) horses were obtained from a large equine hospital in south Sweden. Preva...
Variation in frontal plane joint angles in horses. Conformation in horses is often considered an indicator of athletic ability, performance and resistance to orthopaedic disease. Evaluation is performed in the standing horse and repeatability influenced by stance. Ground reaction forces increase in the moving horse as speed increases. Objective: To determine the effect of locomotion on equine carpus, tarsus, metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints in the frontal plane. Objective: Valgus/varus angulation will change when moving. Methods: Kinematic data were collected standing, walking and trotting for 2 groups of horses. ...
A pilot study on factors influencing the career of Dutch sport horses. Welfare concerns over the reasons for interruption or termination of a sporting career in horses have been expressed. Objective: To study the career of competition horses and factors that influence career length. Methods: In 2004, 46,576 rider-horse combinations were registered with the Dutch National Equestrian Federation (KNHS) in dressage, show jumping, eventing and endurance. From this population, approximately 1% of horses in each discipline were selected at random and all recorded competition data from the KNHS registration system collected and supplemented by detailed rider/owner teleph...
Horizontal moment around the hoof centre of pressure during walking on right and left circles. Recent research indicates that the digital joints experience some degree of extrasagittal motion during stance and that the moments under the hoof are asymmetric in horses walking in a straight line. On a circle, these have not been defined. Objective: To quantify the amplitude and symmetry of horizontal twisting moments around the vertical axis through the hoof's centre of pressure on left and right circles at walk. Methods: Six Thoroughbred horses were led at walk across a Kistler force platform on a left and a right circle of 5 m radius. The resultant moment around the hoof was calculated f...
In vitro biomechanical comparison of dynamic compression plates with a rough contact surface and a polished contact surface for fixation of osteotomized equine third metacarpal bones. To compare the number of cycles to failure of 4.5 mm broad dynamic compression plates (DCP), 4.5 mm broad limited-contact dynamic compression plates (4.5-LC-DCP), and 5.5 mm broad limited-contact dynamic compression plates (5.5-LC-DCP) having a rough (denoted by a prefix R-) versus a standard smooth contact surface for the fixation of osteotomized equine 3rd metacarpal (MC3) bones. Methods: Experimental. Methods: Fifteen pairs of adult equine cadaveric MC3 bones. Methods: Fifteen pairs of equine MC3 were divided into 3 test groups (5 pairs each) for comparison of (1) R-DCP fixation with DCP fi...
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...
Computed tomographic anatomy of the equine stifle joint. To provide a detailed computed tomography (CT) reference of the anatomically normal equine stifle joint. Sample-16 hind limbs from 8 equine cadavers; no horses had evidence of orthopedic disease of the stifle joints. Methods: CT of the stifle joint was performed on 8 hind limbs. In all limbs, CT was also performed after intra-articular injection of 60 mL of contrast material (150 mg of iodine/mL) in the lateral and medial compartments of the femorotibial joint and 80 mL of contrast material in the femoropatellar joint (CT arthrography). Reformatted CT images in the transverse, parasagittal, an...
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...
The regenerative medicine laboratory: facilitating stem cell therapy for equine disease. This article focuses on the emerging field of equine regenerative medicine with an emphasis on the use of mesenchymal stem cells (MSCs) for orthopedic diseases. We detail laboratory procedures and protocols for tissue handling and MSC isolation, characterization, expansion, and cryopreservation from bone marrow, fat, and placental tissues. We provide an overview of current clinical uses for equine MSCs and how MSCs function to heal tissues. Current laboratory practices in equine regenerative medicine mirror those in the human field. However, the translational use of autologous and allogeneic M...
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...
The effect of sequence selection and field strength on detection of osteochondral defects in the metacarpophalangeal joint. Six cadaver forelimbs were imaged in two high-field magnetic resonance (MR) systems and one low-field MR system following the creation of osteochondral defects on the palmar distal aspect of the third metacarpal bone. The following sequences were performed using all three systems: proton density (PD) turbo spin echo, T2* gradient echo (GRE), T2-weighted fast spin echo, and short tau inversion recovery. In addition, 3D T1 GRE sagittal standard and motion insensitive sequences were obtained using the low-field system. PD fat saturated and 3D T1-weighted spoiled GRE images with and without fat su...
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...
Computed tomography to identify preoperative guidelines for internal fixation of the distal sesamoid bone in horses: an in vitro study. To assess the reliability of computed tomography (CT) to identify the direction of implant insertion for cortical screws along the longitudinal axis of intact (nonfractured) distal sesamoid bones. Methods: In vitro study. Methods: Cadaveric paired equine forelimbs (n=16). Methods: Insertion of a cortical screw in lag fashion along the longitudinal axis of intact (nonfractured) distal sesamoid bones was evaluated in 2 groups (3.5 and 4.5 mm) of 8 paired limbs. In each group, the direction of the distal sesamoid bone was determined by CT (Equine XTC 3000 pQCT scanner). Screw placement was verifi...
Parameter study for the finite element modelling of long bones with computed-tomography-imaging-based stiffness distribution. Four radii of different horses were tested in three-point bending and in pure torsion. Detailed finite element (FE) models of these long bones were established by means of computed-tomography (CT) images and tests simulated for both load cases. For the allocation of the local isotropic material stiffness, individual exponential functions were applied whose factor and exponent were determined solely by fitting them to the measured torsional stiffness and bending stiffness of the entire bones. These stiffness functions referring directly to the CT number and having exponents between 1.5 and 2 we...
An in vitro biomechanical comparison of a locking compression plate fixation and kerf cut cylinder fixation for ventral arthrodesis of the fourth and the fifth equine cervical vertebrae. To (1) define mechanical properties in flexion, extension, and left lateral bending of cadaveric equine 4th and 5th cervical (C4-C5) articulations, (2) compare biomechanical properties of C4-C5 when stabilized with a kerf cut cylinder (KCC) compared with a ventrally placed 4.5 mm locking compression plate (LCP). Methods: In vitro biomechanical investigation. Methods: Cadaveric adult equine cervical vertebral columns (n=54). Methods: Cervical vertebrae aged by horse dentition and size measured from radiographs were divided into 3 age groups then randomly allocated to 3 groups. The C4-C5 articul...
Orthopaedic health status of horses from 8 riding schools–a pilot study. Orthopaedic injury is the most common reason for lameness and wastage in sport and leisure horses. Studies on racehorses have shown differences in injury risk between trainers and training strategies. The aim was to study between riding school variation in orthopaedic health status by clinical examination and horses age, and control for change of examiner, in schools with previous high (n = 4) and low (n = 4) insurance utilisation. Methods: Horses (n = 99) at 8 riding schools were examined for conformation, movement in all gaits, standing flexion tests and palpation by two veterinary surgeons ...
Concentrated bone marrow aspirate improves full-thickness cartilage repair compared with microfracture in the equine model. The purpose of this study was to compare the outcomes of treatment with bone marrow aspirate concentrate, a simple, one-step, autogenous, and arthroscopically applicable method, with the outcomes of microfracture with regard to the repair of full-thickness cartilage defects in an equine model. Methods: Extensive (15-mm-diameter) full-thickness cartilage defects were created on the lateral trochlear ridge of the femur in twelve horses. Bone marrow was aspirated from the sternum and centrifuged to generate the bone marrow concentrate. The defects were treated with bone marrow concentrate and mic...
In vitro biomechanical comparison of a modified 5.5 mm locking compression plate fixation with a 5.5 mm locking compression plate fixation of osteotomized equine third metacarpal bones. To compare number of cycles to failure for palmarodorsal 4-point bending of a modified 5.5 mm broad locking compression plate (M5.5-LCP) fixation with a 5.5 mm broad LCP (5.5-LCP) fixation used to repair osteotomized equine third metacarpal (MC3) bones. Methods: In vitro biomechanical testing. Methods: Adult equine cadaveric MC3 bones (n=6 pairs). Methods: An 8-hole, M5.5-LCP, obtained by having a 1.0 mm thickness removed from the bone contact portion of the 5.5-LCP, was applied to the dorsal surface of 1 randomly selected MC3 from each pair, and an 8-hole, 5.5-LCP was applied dorsally to the ...
In vitro comparison of a novel external fixator and traditional full-limb transfixation pin cast in horses. To compare the mechanical properties and failure modes of a standardized short oblique distal radial metaphyseal osteotomy stabilized using either a transfixation pin cast (TPC), a modular-sidebar external skeletal fixator (ESF), or a solid-sidebar ESF (modular- or solid-ESF, respectively) using static or cyclic axial loading to failure. Methods: In vitro study. Methods: Equine cadaver forelimbs. Methods: A 30 degrees oblique distal radial osteotomy was created and stabilized using 1 of the 3 fixation methods: (1) TPC, (2) modular-ESF, or (3) solid-ESF. Limbs were tested using static (TPC, mod...
