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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.
Developmental Lateral Patellar Luxation in Standardbred Yearlings: Understanding the Condition. To report the incidence, and clinical and pathological findings of developmental lateral patellar luxation in Standardbred yearlings diagnosed with femoropatellar dysplasia (FPD) and demonstrate that osteochondral lesions in the lateral trochlear ridge (LTR) of the femur observed in the affected horses are osteochondral lesions related to patellar maltracking.Retrospective case series. Medical records were retrospectively reviewed for Standardbreds <12 months of age diagnosed with FPD between 2017 and 2023.A total of 10 Standardbred yearlings developed FPD (incidence 6.4 cases per 1,000 foa...
Bacterial contamination of covered versus non-covered plates in a sterile operating room in an equine referral center. Surgical site infections (SSI) are a common postoperative complication of equine orthopedic surgery and often increase morbidity and mortality. This study aimed to determine if covering surgical instruments during surgery decreased bacterial environmental air contamination during early opening of surgical packs (EOSP). The authors hypothesized that covering instruments with sterile surgical towels would reduce the total number of bacterial colonies to which the instruments were exposed. Blood agar plates (BAP) were allocated into two groups (non-covered vs. covered with a sterile huck towel)...
Septic Synovitis and Osteomyelitis in Foals: Current Situation in a French Referral Hospital and Value of Computed Tomography for Diagnosis and Treatment. To describe cases of septic synovitis and osteomyelitis in foals younger than 6 months presented to a single hospital and their management and to report the value of computed tomography in diagnosis and management of these cases. Unassigned: This is a retrospective descriptive study. Unassigned: Sixty-five foals were included in this study. Forty-six foals (71%) survived to discharge. The presence of osteomyelitis ( = 0.16), umbilical infection ( = 0.41), or infection with ( = 1) did not significantly influence survival. However, risk of nonsurvival was significantly increased if ...
Comparative biomechanical analysis of equine accessory carpal bone fracture repair: Cortical screws in lag fashion versus X-plate technique. To compare the feasibility and biomechanical stability of two surgical techniques for fixation of vertical plane fractures of the accessory carpal bone (ACB). Methods: Randomized experimental ex vivo study. Methods: Eight equine accessory carpal bones were included in a control group. A total of 20 equine cadaveric forelimbs were randomly assigned into two groups (n = 10 per group). Methods: Vertical plane fractures were created palmar to the extensor sulcus using an oscillating saw. In Group 1 (CS), fractures were stabilized with two 4.5 mm cortical screws in lag fashion. In Group 2 (XP...
Extracorporeal shock wave therapy for equine musculoskeletal disorders: from biological mechanisms to clinical applications. Musculoskeletal injuries represent a primary cause of suboptimal performance and early retirement in equine athletes. To address this challenge, the veterinary community has long endeavored to develop safer and more effective therapeutic strategies. Extracorporeal shock wave therapy (ESWT), as a treatment for equine musculoskeletal injuries, has garnered substantial attention among equine veterinarians. Focused on the theme ESWT Therapy for Equine Musculoskeletal Disorders: From biological mechanisms to clinical applications, this article systematically reviews existing literature on the biolo...
Metabolomic analysis of synovial fluid from healthy and pathological equine joints and tendon sheaths using high-resolution 1H Nuclear Magnetic Resonance. Joint and tendon sheath diseases are a major cause of lameness and reduced performance in horses. Synovial fluid composition changes in response to pathological processes and metabolomic profiling offers a promising approach to detect these alterations. While equine joint metabolomics has been explored, little is known about the metabolomic profile of tendon sheaths. This study aimed to characterize and compare the synovial fluid metabolomic profiles of healthy and pathological joints and tendon sheaths in horses using high-resolution H Nuclear Magnetic Resonance spectroscopy, and to identify ...
High-metacarpal deep digital flexor tenotomy and Steward clog shoeing for managing chronic refractory laminitis: A retrospective clinical study. To describe outcomes following high-metacarpal deep digital flexor tenotomy (DDFT) combined with Steward clog application in horses and ponies with refractory chronic laminitis. Methods: Retrospective observational study. Methods: Client-owned horses and ponies (7 horses, 8 ponies) with severe refractory laminitis. Methods: Medical records (2018-2019) were reviewed. All underwent standing high-metacarpal DDFT tenotomy proximal to the accessory ligament (AL-DDFT) junction, followed by customized Steward clogs application. Preoperative assessment included radiography and venography. Postoperativ...
Preliminary assessment of the leukocyte coping capacity as a point of care marker in horses with stress associated diseases. Stress represents a serious health and welfare concern; however, its objective assessment remains difficult. The equine gastric ulcer syndrome (EGUS) and orthopedic diseases that cause pain are among stress associated diseases in equine medicine. The leukocyte coping capacity (LCC) quantifies oxygen radical generation of neutrophil granulocytes which is altered under stress. Therefore, LCC could be a novel biomarker for stress in horses and we hypothesized that horses with stress associated diseases would have lower LCC values in comparison to horses without these diseases. Methods: In this ob...
Biomechanical comparison of the bone-screw-fastener to conventional cortical buttress screw in a simulated ex vivo model of equine midbody proximal sesamoid bone fracture repair. To compare implant failure and gap displacement characteristics of simulated medial mid-body proximal sesamoid bone (PSB) fractures repaired with bone-screw-fasteners (BSF) or cortical screws (CS) in single or double screw configurations. Methods: Ex vivo experimental study. Methods: A total of 14 paired equine cadaver forelimbs. Methods: Medial mid-body PSB osteotomies were created in each forelimb. Surgical repair was performed using either: (1) single 3.5 mm BSF (BSF), (2) single 4.5 mm CS (CS), (3) two 3.5 mm BSFs (BSF), or (4) two 3.5 mm cortical screws (CS) (n = 7 repairs/gro...
Effect of Additional Aluminum Filtration on the Image Quality in Cone Beam Computed Tomographic Studies of Equine Distal Limbs Using Visual Grading Characteristics Analysis: A Pilot Study. (1) Background: Cone beam computed tomography (CBCT) is increasingly used in equine practice to diagnose musculoskeletal injuries, including fractures in the distal limb. However, limited detail in the thick cortical bone of the metacarpus/metatarsus hinders accurate diagnosis. In human medicine, the addition of aluminum filters (AF) enhanced image quality while reducing radiation exposure. This study aimed to evaluate the effect of AF on image quality in CBCT scans of equine distal limbs. (2) Methods: Adult equine cadaver limbs were scanned with a mobile CBCT unit using varying tube currents ...
Cellular interactions and gene expression analysis of two equine-derived bone graft materials: an in vitro study. Bone grafting is a surgical procedure that involves the use of bone tissue or bone substitutes to repair damaged bone. In dentistry and maxillofacial surgery, bone graft substitutes from various sources are commonly used. Given their critical role in clinical outcomes, it is essential to thoroughly investigate the biological and mechanical properties of these materials. Methods: In this in vitro study, we evaluated the biological properties of two equine-derived bone graft substitutes in comparison to β-tricalcium phosphate. The materials included one equine-derived graft containing hydrolyze...
Use of preoperative computed tomography (CT) to plan repair of comminuted fractures of the middle phalanx in six Warmblood horses: Configuration, treatment and long-term outcome. To describe the additional information provided by computed tomography (CT) in planning and assisting repair of comminuted fractures of the middle phalanx (MP) in Warmblood horses. Methods: Case series. Methods: Six adult Warmblood horses. Methods: The case records of horses undergoing CT examination prior to internal fixation of comminuted MP fractures were reviewed. All horses underwent radiographic and preoperative CT examination. A standardized fast protocol (SFP) to assess CT images was used. Surgical repair consisted of fracture repair and proximal interphalangeal joint arthrodesis using...
Surgical repair of bilateral lateral patellar luxation in a foal using block-recession trochleoplasty and polypropylene mesh reinforcement: Case report and review of literature. Patellar luxation is a rare orthopedic condition in horses, with congenital lateral patellar luxation being the most frequently reported form. A few sporadic reports have described surgical options for addressing equine patellar luxation. This report details the clinical presentation of a 2-month-old Italian Trotter foal diagnosed with bilateral lateral patellar luxation. Staged surgical correction of both stifles was performed, including block recession trochleoplasty combined with the application of polypropylene mesh for reinforcing medial imbrication sutures. Intra- and post-operative eval...
Orthopaedic Injuries in 272 Dressage Horses: A Retrospective Study. There is limited information regarding orthopaedic injuries in dressage horses. This study assessed the prevalence of injuries in a mixed referral and first opinion population of 272 horses training and competing in dressage, 238 of which were followed up one to five years after injury. Warmblood (55.8%) and Iberian (38.6%) breeds predominated. The median age was 8 years (interquartile range [IQR] 5,11; range 1,21). Horses were examined due to lameness (85.3%) or poor performance (14.7%). The median lameness grade was 2/5 (IQR 2,4; range 0,4). Forelimb lameness was more prevalent than hindlimb...
Preanesthetic Administration of Trazodone Does Not Impact Anesthetic Recovery Scores in Horses. Trazodone is administered to hospitalized equine patients to aid in behavioral management, but the effects on the anesthetic recovery period have not been investigated. This study sought to determine if there is an association between trazodone administration and recovery quality, recovery time, need for sedation, or need for reversal agent administration. We hypothesized that there would be no difference in recovery scores, recovery time, additional sedation, or reversal agent administration between horses that received preanesthetic trazodone and horses that did not. Records were reviewed to...
In Vitro Effects of PRP, Ozonized PRP, Hyaluronic Acid, Paracetamol, and Polyacrylamide on Equine Synovial Fluid-Derived Mesenchymal Stem Cells. Musculoskeletal disorders are a major cause of lameness in horses, often necessitating innovative regenerative strategies to restore joint function and improve quality of life. This study investigated the effects of platelet-rich plasma (PRP), ozonized PRP, hyaluronic acid, paracetamol, and polyacrylamide hydrogel (NOLTREX) on the behavior of mesenchymal stem cells (MSCs) derived from equine synovial fluid. Synovial fluid samples were collected under strict cytological criteria to ensure viability, followed by in vitro expansion and phenotypic characterization of MSCs. Cultures were supplement...
Plate fixation of small metacarpal and metatarsal bone fractures in 27 horses. To present fracture cases selected for plate fixation (PF), describe surgical techniques and assess their association with postoperative complications and return-to-work outcomes in horses undergoing PF for small metacarpal/metatarsal (SMCT) fractures. Methods: Multicenter retrospective study. Methods: A total of 27 horses. Methods: Horses treated with PF of a SMCT fracture between 2008 and 2023 across three hospitals were included. Medical records and imaging were reviewed. Long-term outcomes were established by readmission to the hospital, telephone interviews, and/or race records. Univariab...
Ex vivo biomechanical testing of a three-dimensional printed titanium plate and spacer construct and 4.5 mm locking compression plate for ventral cervical fusion of C4-C5 in the horse. To compare the biomechanical properties of a three-dimensional (3D) printed titanium plate and spacer (3DM) and a 4.5 mm broad locking compression plate (LCP) for intervertebral fusion of C4-C5 in the horse. Methods: Ex vivo experimental study. Methods: Twenty-four equine cadaveric cervical spines. Methods: Twenty-four cadaver equine cervical spines were randomly assigned to ventral intervertebral fusion with either 3DM (n = 12) or LCP (n = 12) at C4-C5. Four-point bending tests were performed in flexion (3DM n = 6, LCP n = 6) and extension (3DM n = 6, LCP n = 6) in a sin...
Complications of Equine Musculoskeletal Surgery and Procedures. Complications of equine musculoskeletal procedures and surgery are an inevitable occurrence. This article summarizes complications principally encountered by primary equine veterinarians who perform and manage musculoskeletal procedures and surgeries. Topics discussed include complications of musculoskeletal diagnostic procedures, angular/flexural limb deformities, and muscle, tendon, and ligament surgery; surgery of the foot, orthopedic and arthroscopic surgery, and cast management. Each section lists complications encountered and includes diagnostic and treatment considerations. Awareness of...
Behavioral and orthopedic issues in geldings with Postcastration adhesions: A retrospective study of 35 cases. Limited data is available on the diagnostic and therapeutic methods for pathologies caused by scarring after castration. It is well recognized that specific behaviors or untypical hindlimb lameness may be observed in geldings with gelding scars and adhesions caused by spermatic cord remnants after castration OBJECTIVES: To describe how to diagnose movement disorders associated with excessive adhesions caused by spermatic cord remnant after castration and to present a successful surgical treatment method. Methods: To assess the impact of gelding scars on horses' movement and behavior, medical r...
Multicenter results for C7-T1 ventral interbody fusion in horses using the kerf cut cylinder. To describe the surgical approach used in horses undergoing C7-T1 ventral interbody fusion using a kerf cut cylinder (KCC) implant and report the short- and long-term outcomes. Methods: Observational retrospective study. Methods: A total of 38 client-owned horses. Methods: Medical records of horses that underwent ventral interbody fusion because of C7-T1 cervical vertebral stenotic myelopathy from 2004 to 2024 were reviewed. Preoperative variables included age, sex, breed, and affected site(s). Surgical variables included types of KCC used, intraoperative complications, and anesthesia related ...
Clinical and ultrasonographic findings in horses with desmopathy of the palmar/plantar abaxial ligaments of the proximal interphalangeal joint: 20 cases. To describe the clinical and ultrasonographic findings in horses with desmopathy of the abaxial palmar/plantar ligament (APL) of the proximal interphalangeal joint and the prevalence of concurrent musculoskeletal injuries in the pastern and foot. Unassigned: Horses presenting to New Bolton Center between March 2017 and November 2022 with an age ranging from 5 to 20 years that underwent lameness evaluation in which lameness was localized to the distal limb and had an ultrasonographic diagnosis of APL desmopathy. Unassigned: Horses included were those that (1) presented for a lameness examinatio...
Comparison of Two Surgical Techniques for the Treatment of Equine Hindlimb Proximal Suspensory Desmopathy. Suspensory desmopathy is a frequently documented cause of lameness in performance horses; proximal suspensory desmopathy is the most frequent site of injury in dressage horses [...].
Scoping review of comminuted fractures of the proximal phalanx in horses. Comminuted fractures of the proximal phalanx (CFPP) occur in adult horses. Various treatments have been described. It remains uncertain which is the best therapeutic option. Objective: This study aims to review systematically the existing literature on CFPP in horses, evaluate treatment modalities, synthesise outcomes to assess treatment efficacy and survival rates, and identify knowledge gaps for future research. Methods: Scoping review. Methods: A literature search was conducted using online databases. The bias quality of each article was evaluated. Chi-squared analysis was used to detect di...
Flow-controlled expiration improves gas exchange in anaesthetised horses undergoing orthopaedic surgery. Flow-controlled expiration (FLEX) has been shown to significantly enhance oxygenation in horses under laboratory conditions. Objective: This study aims to corroborate these findings by evaluating the effects of FLEX on gas exchange in a randomised clinical trial involving a large population of clinical horses undergoing orthopaedic surgery. Methods: Prospective randomised clinical trial. Methods: A total of 406 healthy adult horses scheduled for elective orthopaedic procedures were recruited for this prospective clinical trial. Horses were randomly assigned to FLEX or VCV (volume-controlled ve...
Lateromedial and oblique radiographs detect most fetlock pathologies as effectively as a full series in horses. Radiographic protocols for the metacarpo-/tarsophalangeal joint during pre-purchase examinations (PPE) vary internationally, but their impact on pathology detection remains unclear. Optimising imaging protocols is essential to balance diagnostic accuracy with workflow efficiency and radiation exposure. Objective: To evaluate the effect of different radiographic view combinations on fetlock pathology detection and observer agreement in a PPE context; hypothesising that detection rates vary with view selection. Methods: Retrospective observational study. Methods: Two observers reviewed fetlock r...
Intervertebral fusion for the repair of articular cervical fractures in three horses. To report successful stabilization of three cervical fracture types with articular involvement using different ventral cervical intervertebral fusion constructs. Methods: A 9-year-old French sport pony gelding, a 5-year-old Anglo-Arabian gelding and a 2-year-old French Warmblood mare. Methods: Short case series. Methods: Ventral cervical intervertebral fusion was performed in three cervical fracture cases: A vertebral body, a vertebral arch and a unilateral facet joint fracture. Selected implants for this purpose were an 11-hole 4.5/5.0 LCP, a three-dimensional (3D)-printed titanium cervical i...
Clinical Updates on Superficial Digital Flexor Tendon Injuries: Insights on Diagnostic and Therapeutic Advancements. Superficial digital flexor tendinopathy is one of the most common orthopedic soft tissue injuries in horses. The veterinary challenge for this condition is less related to identifying the presence of the injury (as it is usually readily evident clinically) but more related to improving the healing process so that the healed tendon is more like normal tendon in biology and function in order to reduce reinjury, which is the key adverse consequence of the injury. Diagnostic imaging has improved in recent years to aid with treatment choices and monitoring the healing process.
In Silico Analysis of Stress Distribution in Proximal Interphalangeal Joint Arthrodesis in Horses Using a Locking Compression Plate. This study aimed to compare the stress distribution in proximal interphalangeal joint arthrodesis with locking compression plate in horses based on the type and method of screw implantation in the proximal hole and partial or total removal of implants after fusion.Finite element analysis.Proximal interphalangeal joint arthrodesis was simulated using a 3-hole, 4.5-mm narrow locking compression plate combined with two 5.5-mm transarticular screws. Models were created according to the type (cortex or locking) and method of implantation (uni- or bicortical) of the screw in the proximal hole of the...
