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.
Short incomplete sagittal fractures of the proximal phalanx in ten horses not used for racing. To describe short incomplete sagittal fractures of the proximal phalanx (type Ia P1 fractures) in horses not used for racing and report outcome. Methods: Retrospective study. Methods: Horses (n=10) with type Ia P1 fractures. Methods: Retrieved data of horses with type Ia P1 fractures were signalment, history and results of orthopedic examination. Radiographs were re-evaluated for position and length of the fracture line, presence of osteoarthritis or subchondral cystic lesions (SCL), periosteal new bone formation and subchondral sclerosis. Conservative treatment (n=4) included box confinement ...
Developmental orthopaedic disease in limbs of foals: between-breed variations in the prevalence, location and severity at weaning. Developmental orthopaedic disease (DOD) affects all breeds and is a common cause of pain and lameness for horses in sports. A thorough knowledge of between-breed variations for the prevalence of DOD, for its distribution among the various joints and for its severity at earlier stages in the disease process is needed in order to improve the relevance and the cost-effectiveness of DOD screening protocols. However, no prevalence study for DOD simultaneously performed on several breeds with similar farming systems and based on radiographic findings (RF) on quite a large number of joints and views,...
Comparison of computer assisted surgery with conventional technique for treatment of abaxial distal phalanx fractures in horses: an in vitro study. To (1) evaluate and compare computer-assisted surgery (CAS) with conventional screw insertion (conventional osteosynthesis [COS]) for treatment of equine abaxial distal phalanx fractures; (2) compare planned screw position with actual postoperative position; and (3) determine preferred screw insertion direction. Methods: Experimental study. Methods: Cadaveric equine limbs (n=32). Methods: In 8 specimens each, a 4.5 mm cortex bone screw was inserted in lag fashion in dorsopalmar (plantar) direction using CAS or COS. In 2 other groups of 8, the screws were inserted in opposite direction. Precisi...
Evaluation of a new strategy to modulate skeletal development in racehorses by imposing track-based exercise during growth: the effects on 2- and 3-year-old racing careers. No data exist on the effects of conditioning exercise at foal age on workload and subsequent clinical injury rate during their 2- and 3-year-old racing careers. Objective: To investigate the effects of subjecting TB foals to conditioning exercise prior to the start of race training on: the workload required to reach a level of fitness sufficient to compete; and the prevalence of orthopaedic injury during the first 2 seasons of their racing careers. Methods: Twenty 18-month-old TBs, 12 subjected to conditioning exercise at foal age (CONDEX) and 8 exercised spontaneously at pasture only (PASTEX)...
The influence of exercise during growth on ultrasonographic parameters of the superficial digital flexor tendon of young Thoroughbred horses. Conditioning by early training may influence the composition of certain musculoskeletal tissues, but very few data exist on its effect during growth on tendon structure and function. Objective: To investigate whether conditioning exercise in young foals would lead to any ultrasonographically detectable damage to the superficial digital flexor tendon or an increase in cross-sectional area (CSA). Methods: Thirty-three Thoroughbred foals reared at pasture were allocated to 2 groups: control (PASTEX) allowed exercise freely at pasture; and CONDEX, also at pasture, began conditioning exercise from ...
Review of genetic aspects of radiological alterations in the navicular bone of the horse. Navicular disease or podotrochlosis has long been known to cause forelimb lameness in horses. It had been proposed that the development of podotrochlosis has similarities to the human osteoarthritis (OA) complex. Alterations of the navicular bone can be made visible early in life only on the basis of radiographs. Reports on the prevalences of navicular disease indicate that radiological alterations in the navicular bone are present in different warmblood populations at frequencies of between 14.9% and 87.6%. Genetic factors play an important role in the development of the radiological signs. E...
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...
Development of a composite orthopaedic pain scale in horses. This study addresses development and validation of a composite multifactorial pain scale (CPS) in an experimental equine model of acute orthopaedic pain. Eighteen horses were allocated to control (sedation with/without epidural analgesia - mixture of morphine, ropivacaine, detomidine and ketamine) and experimental groups: amphotericin-B injection in the tarsocrural joint induced pain and analgesia was either i.v. phenylbutazone administered post-induction of synovitis, or pre-emptive epidural mixture, or a pre-emptive combination of the 2. Inter- and intra-observer reproducibility was good (0....
Evaluation of autologous chondrocyte transplantation via a collagen membrane in equine articular defects: results at 12 and 18 months. To evaluate a technique of autologous chondrocyte implantation (ACI) similar to the other techniques using cell-seeded resorbable collagen membranes in large articular defects. Methods: Autologous cartilage was harvested arthroscopically from the lateral trochlear ridge of the femur in fifteen 3-year-old horses. After culture and expansion of chondrocytes the newly created ACI construct (autologous chondrocytes cultured expanded, seeded on a collagen membrane, porcine small intestine submucosa) was implanted into 15mm defects on the medial trochlear ridge of the femur in the opposite femoropat...
Development of an in vitro three dimensional loading-measurement system for long bone fixation under multiple loading conditions: a technical description. The purpose of this investigation was to design and verify the capabilities of an in vitro loading-measurement system that mimics in vivo unconstrained three dimensional (3D) relative motion between long bone ends, applies uniform load components over the entire length of a test specimen, and measures 3D relative motion between test segment ends to directly determine test segment construct stiffness free of errors due to potting-fixture-test machine finite stiffness.Intact equine cadaveric radius bones, which were subsequently osteotomized/ostectomized and instrumented with bone plates were su...
Matrix-encapsulation cell-seeding technique to prevent cell detachment during arthroscopic implantation of matrix-induced autologous chondrocytes. The goal of this study is to evaluate the efficiency of obtaining a large number of viable cells within a construct that will not be detached by high fluid flow during arthroscopic implantation. Methods: Arthroscopic osteochondral biopsy specimens were obtained from the medial femoral trochlea of 8 horses. Chondrocytes were isolated by collagenase digestion and expanded in M199 media until confluency. After 10 to 12 days, cultures were trypsinized and cells resuspended in culture media. Then, 5 x 10(6) cells x mL(-1) were seeded on a culture dish and the same amount in a flask. Once extracellu...
Evidence-based equine nutrition. One of the most difficult problems in equine nutrition research is often the lack of objective and clinically relevant end points. Nevertheless, this article attempts to present the best evidence (or lack thereof) for some of the most common clinical questions pertaining to such topics as the evaluation of glucose and insulin tolerance and factors that may confound results, dietary management of horses prone to laminitis and rhabdomyolysis, nutritional prevention of gastric ulcers and developmental orthopedic disease, the efficacy of commonly used herbal products, and feeding geriatric horses....
Evidence-based musculoskeletal surgery in horses. Musculoskeletal disorders comprise a large portion of the conditions treated by equine veterinarians. Surgical intervention is the treatment of choice in many cases. The body of literature describing and exploring surgical correction of musculoskeletal disorders in horses is steadily growing but still lacking. At this juncture, we can use what information we have with the understanding that as the quality of research advances, we should apply stricter standards to the evidence we use to answer our clinical questions.
Repair of a longitudinal scapular fracture in a horse. To report repair of a longitudinal scapular fracture in a horse. Methods: Case report. Methods: A 2-year-old Paint Horse colt. Methods: A longitudinal scapular fracture was surgically repaired using four 4.5 mm dynamic compression plates. Results: An acute longitudinal scapular fracture repaired surgically returned the horse to soundness within 6 months. Conclusions: Internal fixation of longitudinal scapular fracture is possible with multiple 3-5 hole dynamic compression plates. Conclusions: Longitudinal fractures of the scapula should be considered when there is lateral instability of the sh...
Pharmacological effects of tiludronate in horses after long-term immobilization. Tiludronate, a bisphosphonate, has recently been introduced in veterinary medicine to treat orthopedic conditions in the horse. This study was designed to evaluate its effects on biochemical biomarkers of bone metabolism and on bone density and structure in an experimental model of disuse osteoporosis induced by cast application in horses. Methods: Two groups of eight horses were immobilized during 8 weeks. The first group (P-group) received a placebo, and the second group (T-group) received tiludronate 1 mg/kg by slow IV infusion. Both treatments were administered twice, 28 days apart. Immobi...
Sonographic anatomy of the palmarodistal aspect of the equine digit. Although ultrasonography is widely used in equine orthopedics, its use in the distal portion of the digit is still limited. The purpose of this descriptive study was to document the normal ultrasonographic appearance of the palmarodistal aspect of the digital area imaged between the bulbs of the heels. Ultrasonographic images were obtained with a 7.5 MHz microconvex transducer in 10 fresh equine cadaver forelimbs and five soundhorses. Sagittal, parasagittal, and transverse images were obtained from the proximal aspect of the middle phalanx to the distal sesamoid bone. Anatomic sections were ob...
Osteochondral fragments involving the dorsomedial aspect of the proximal interphalangeal joint in young horses: 6 cases (1997-2006). To determine clinical and diagnostic imaging findings in young horses with osteochondral fragments involving the dorsomedial aspect of the proximal interphalangeal (PIP) joint. Methods: Retrospective case series. Methods: 6 horses. Methods: Medical records were reviewed. Follow-up information was obtained through telephone conversations with owners or trainers or by examining race records. Results: Horses were between 1 and 4 years old. Three had bilateral osteochondral fragments in the forelimbs (n = 2 horses) or hind limbs (1). Radiographically, all but 1 fragment seemed to originate from th...
Tilt table recovery of horses after orthopedic surgery: fifty-four cases (1994-2005). To describe an assisted anesthetic recovery technique using a tilt table for horses after high-risk orthopedic-related procedures and to evaluate outcome. Methods: Retrospective study. Methods: Anesthetic recoveries (n=54) for 36 horses. Methods: Medical records (April 1994-October 2005) for horses that had high-risk orthopedic surgery and recovery from general anesthesia on a tilt table were reviewed. Information about the surgical procedure, anesthetic and recovery period was analyzed. Results: Of 54 anesthetic recoveries, 1 horse (1.9%) had complete failure of internal fixation during recov...
Metabolic and clinical traits in horses undergoing feed deprivation for elective orthopaedic surgery. The objective of this study was to investigate some metabolic and clinical effects of feed deprivation in horses that were submitted for orthopaedic surgery. The effects of preoperative feed restriction were investigated in 20 horses submitted for elective orthopaedic surgery. The patients were fasted from 12 hours before until 4 hours after surgery. Serum free amino acids, glucose,free fatty acids (FFA), white blood cell counts, creatine kinase (CK) and aspartate aminotransferase (AST) were determined 24 hours before surgery, 2 hours after the end of anaesthesia and 24 and 72 hours after surg...
Association of type of sport and performance level with anatomical site of orthopaedic injury diagnosis. Although anecdotal reports of increased orthopaedic injury risk in equine sports exist, there is little scientific evidence to support this. Objective: To test whether horses undertaking a single competitive sport have increased risk of specific injuries compared to those used for general purpose riding (GP); and whether injury type varies with sport category and performance level. Methods: Data from 1069 records of horses undergoing orthopaedic evaluation (1998-2003) and meeting inclusion criteria were reviewed. Sport category (GP, showjumping, dressage, eventing, racing), level (nonelite or ...
Raising heels of hind hooves changes the equine coffin, fetlock and hock joint angle: a kinematic evaluation on the treadmill at walk and trot. Raised heels are commonly recommended for various equine orthopaedic conditions. However, the simultaneous effect of raised heels on the different joint angles of the equine hindlimb throughout the motion cycle has not been previously evaluated. Objective: To document the simultaneous effect of raised heels on the joint angles of the equine hindlimb coffin, fetlock and hock joints. Methods: Eight sound, adult, Warmblood horses were evaluated barefoot and with a heel wedge of 8 or 16 degrees, walking and trotting on a horizontal treadmill. Markers placed on the dorsal and cranial aspect of the ...
Abnormal radiographic findings in 865 French standardbred trotters and their relationship to racing performance. Developmental orthopaedic lesions are commonly found in French Standardbred horses. One of the main questions asked by trainers, owners and veterinarians is what impact these lesions have on the racing career and racing performances of horses. Objective: To study the prevalence and distribution of developmental orthopaedic lesions in young French Standardbred trotters and to relate them to racing performance. Methods: Feet, fetlock, tarsus and stifle regions were radiographed in 865 two-year-old French Standardbred trotters. Abnormal radiographic findings (ARF) were evaluated for 12 anatomical...
Use of a parathyroid hormone peptide (PTH(1-34))-enriched fibrin hydrogel for the treatment of a subchondral cystic lesion in the proximal interphalangeal joint of a warmblood filly. To describe the treatment of a subchondral bone cyst in the proximal phalanx with parathyroid hormone peptide-enriched fibrin hydrogel in a warmblood filly. The cyst was localized with computer-assisted orthopaedic surgery, then curetted and finally filled with parathyroid hormone fragment peptide 1-34 (PTH(1-34)) covalently attached to a fibrin hydrogel. The cyst healed quickly without any complications. This result supports the hypothesis that PTH(1-34) delivered locally in a fibrin hydrogel may improve the postoperative prognosis of surgical management of subchondral bone cysts in horses. S...
The effect of conformation on orthopaedic health and performance in a cohort of National Hunt racehorses: preliminary results. There is a lack of scientific data and studies on the effect of conformation on performance or on orthopaedic health. Objective: To investigate the relationship between conformation, injury and performance in racehorses used for racing over fences. Methods: Over 2 years, 108 National Hunt racehorses were followed and their medical and performance data recorded. Conformation was measured in 3D with a computerised motion analysis system. Linear multiple regression models were used to evaluate the effect of conformation on measures of race performance and stepwise forward logistic regression mode...
Reliability of conformational measurements in the horse using a three-dimensional motion analysis system. The importance of a reliable method for conformation studies is generally acknowledged, but there are only limited data on the accuracy and precision of current assessment methods. Objective: To assess (1) the accuracy and repeatability of marker placement, (2) influence of stance of the horse on conformational parameters, (3) practicality of a computerised motion analysis system and (4) to compare the computerised motion analysis system to photographic systems of assessment. Methods: Twenty-eight reflective markers placed over anatomical landmarks were located in 3D using a computerised motio...
Image fusion of computed tomographic and magnetic resonance images for the development of a three-dimensional musculoskeletal model of the equine forelimb. Biomechanical models that compute the lengths and forces of muscle-tendon units are broadly applicable to the study of factors that promote injury and the planning and effects of orthopedic surgical procedures in equine athletes. A three-dimensional (3D) generic musculoskeletal model of the equine forelimb comprised of bony segment, muscle-tendon, and ligament information, was developed based on high-resolution computed tomographic (CT) and T1-weighted magnetic resonance (MR) images from an isolated forelimb of a Thoroughbred racehorse. Image fusion was achieved through coregistration of CT an...
Computer-assisted surgery for screw insertion into the distal sesamoid bone in horses: an in vitro study. To compare the precision of computer-assisted surgery with a conventional technique (CV) using a special guiding device for screw insertion into the distal sesamoid bone in horses. Methods: In vitro experimental study. Methods: Cadaveric forelimb specimens. Methods: Insertion of a 3.5 mm cortex screw in lag fashion along the longitudinal axis of intact (non-fractured) distal sesamoid bones was evaluated in 2 groups (8 limbs each): CV and computer-assisted surgery (CAS). For CV, the screw was inserted using a special guiding device and fluoroscopy, whereas for CAS, the screw was inserted using ...
Comparison of radiography and computed tomography to evaluate metacarpo/metatarsophalangeal joint pathology of paired limbs of thoroughbred racehorses with severe condylar fracture. To compare the orthogonal radiographic (OR) and computed tomographic (CT) appearance of paired Thoroughbred racehorse limbs with severe condylar fracture. Methods: In vitro study. Methods: Cadaveric paired limbs with severe condylar fracture (n=11 horses). Methods: Four standard radiographic and multiple transverse CT images were obtained of the fractured and contralateral limbs centering on the metacarpo/metatarsophalangeal (fetlock) joints. Radiographs and CT images were graded by 4 raters, and interobserver agreement was calculated. Imaging evaluations were supplemented by fetlock joint dis...