Arthroscopically assisted arthrodesis of the distal interphalangeal joint with transarticular screws inserted through a dorsal hoof wall approach in a horse.

The research article revolves around a successful surgical procedure carried out on a 16-year-old Thoroughbred gelding suffering from chronic lameness in the right forelimb due to severe osteoarthritis. A technique of arthroscopic removal of articular cartilage along with placement of cortical screws via a dorsal hoof wall approach was used to fuse the distal interphalangeal (DIP) joint. Successful fusion was observed 8 months after the surgery.

Identification and Diagnosis

• The 16 year old thoroughbred horse exhibited chronic lameness in the right forelimb.
• The radiography of the right front foot revealed a narrow distal interphalangeal (DIP) joint space.
• Other indications of severe osteoarthritis such as osteophytes and periarticular bony proliferation were also observed.

Proposed Solution

• It was suggested that a surgical intervention, specifically an arthrodesis of the right DIP joint, be performed to alleviate the horse’s discomfort.

Surgery Procedure

• The horse first underwent anesthetization.
• Arthroscopic approaches from both palmar and dorsal were utilized to remove a substantial percentage of the articular cartilage.
• Holes were created in the dorsal part of the hoof wall to prepare for the placement of transarticular cortical screws.
• Three 5.5-mm cortical screws were then placed in a lag fashion through these holes across the distal phalanx and into the middle phalanx.
• Lastly, the drill holes in the hoof wall were filled with gentamicin-infused polymethyl methacrylate plugs and were sealed off using cyanoacrylate.

Post Surgery Results

• The horse demonstrated signs of recovery, and fusion of the distal interphalangeal joint was witnessed in X-rays performed eight months after the surgery.
• The horse was able to walk without any signs of lameness.

Conclusion

• The technique of arthroscopically guided cartilage removal and transarticular placement of cortical screws through a dorsal hoof wall approach seems to be an effective procedure for the fusion of the DIP joint in horses suffering from osteoarthritis.