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Home / Equine Research Bank / Vet Surg / Computed tomographic imaging and surgical management of dist...
Veterinary surgery : VS2023; 52(8); 1228-1236; doi: 10.1111/vsu.14025

Computed tomographic imaging and surgical management of distal insertional avulsion fragments of the caudal cruciate ligament in four horses.

Abstract: To describe cases with caudal cruciate ligament (CdCL) avulsion fragments diagnosed based on computed tomography (CT) examination and report on arthroscopic fragment removal. Methods: Four Warmblood horses with hindlimb lameness and osseous fragments located in the caudal medial femorotibial joint (mFTJ). Methods: Short case series. Methods: CT and arthroscopic evaluation of the caudal mFTJ were performed. The caudal mFTJ and the insertion of the CdCL on the tibia were assessed and removal of the avulsion fragments was attempted in three horses using a cranial intercondylar approach. Results: The fragment was not accessible via caudomedial approaches in one horse. A cranial intercondylar approach was used in three horses, allowing removal of the intra-articular fragment in two horses, and removal of two-thirds of the proximal fragment in the last horse. Acute, profuse, arterial bleeding occurred in this horse during surgery with transient postoperative soft tissue swelling. Comorbidities included medial femoral condyle cartilage defects (3), cranial cruciate ligament lesions (2), and medial collateral ligament lesions (2). Horses were followed up for 16 months (median, range 11-28 months), at which point all were back in ridden exercise; owners' satisfaction was good. Conclusions: CT examination confirmed the diagnosis and allowed evaluation of the stifle joint for comorbidities. A cranial intercondylar arthroscopic approach facilitated the removal of CdCL insertional avulsion fragments, although not always complete. Conclusions: A cranial intercondylar approach can allow access to CdCL avulsion fragments, but complications and incomplete removal remain possible.
© 2023 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
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Publication Date: 2023-09-13 PubMed ID: 37702039DOI: 10.1111/vsu.14025Google Scholar: Lookup
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Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research article presents the successful use of a specific surgical approach, known as the cranial intercondylar approach, for the removal of caudal cruciate ligament avulsion fragments in horses’ hindlimbs, based on the results of a study conducted on four Warmblood horses. This technique, however, may not always lead to complete removal of the fragments and complications remain possible.

Methodology and Cases

  • The study consisted of a short case series performed on four Warmblood horses presenting with hindlimb lameness and osseous fragments located in the caudal medial femorotibial joint (mFTJ).
  • Computed tomography (CT) and arthroscopic evaluation of the caudal mFTJ were carried out.
  • The researchers attempted to assess the caudal mFTJ and the insertion of the caudal cruciate ligament (CdCL) on the tibia and remove the avulsion fragments from three of the horses using a cranial intercondylar approach.

Results and Findings

  • The fragment removal was unsuccessful when using the caudomedial approaches in one horse.
  • The cranial intercondylar approach was used in three horses, which allowed removal of the intra-articular fragment in two of them, and two-thirds of the proximal fragment from the third horse.
  • Complications during the surgery involved acute, profuse, arterial bleeding, and transient postoperative soft tissue swelling in one horse.
  • Additional findings included several other conditions affecting these horses, such as medial femoral condyle cartilage defects, cranial cruciate ligament lesions, and medial collateral ligament lesions.
  • After 16 months of follow-up, all the horses were back in ridden exercise, and their owners expressed satisfaction with the outcomes.

Conclusions and Considerations

  • CT examination played a significant role in finalizing the diagnosis and evaluating the stifle joint for any other conditions.
  • Despite the potential complications, a cranial intercondylar arthroscopic approach was largely successful in facilitating the removal of CdCL insertional avulsion fragments.
  • However, the study highlighted that while this approach can allow access to CdCL avulsion fragments, full fragment removal is not always possible, and complications can occur.

Cite This Article

APA
Bolz NM, Ehrle A, Mählmann K, Lischer CJ. (2023). Computed tomographic imaging and surgical management of distal insertional avulsion fragments of the caudal cruciate ligament in four horses. Vet Surg, 52(8), 1228-1236. https://doi.org/10.1111/vsu.14025

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 52
Issue: 8
Pages: 1228-1236

Researcher Affiliations

Bolz, Nico Michael
  • Equine Clinic, Surgery and Radiology, Freie Universität Berlin, Berlin, Germany.
Ehrle, Anna
  • Equine Clinic, Surgery and Radiology, Freie Universität Berlin, Berlin, Germany.
Mählmann, Kathrin
  • Equine Clinic, Surgery and Radiology, Freie Universität Berlin, Berlin, Germany.
Lischer, Christophorus Johannes
  • Equine Clinic, Surgery and Radiology, Freie Universität Berlin, Berlin, Germany.

MeSH Terms

  • Horses
  • Animals
  • Arthroscopy / veterinary
  • Arthroscopy / methods
  • Stifle / diagnostic imaging
  • Stifle / surgery
  • Stifle / pathology
  • Anterior Cruciate Ligament / pathology
  • Tomography, X-Ray Computed
  • Tibia / pathology
  • Fractures, Bone / veterinary
  • Joint Diseases / veterinary
  • Horse Diseases / surgery

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This article includes 20 references
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