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Veterinary surgery : VS2023; doi: 10.1111/vsu.14004

Computer-assisted surgery for placing toggle constructs across the coxofemoral joints of small equids using a minimally invasive approach-A proof-of-concept cadaveric study.

Abstract: To develop a minimally invasive technique for placing a toggle construct across the coxofemoral joint of small equids using computer-assisted surgery. Methods: Experimental cadaveric study. Methods: Three pilot specimens: One donkey, one Shetland pony and one Warmblood foal. Six main study specimens: Three Shetland ponies, one American Miniature Horse, one Warmblood foal and one donkey. Methods: Experimental surgeries were performed on both coxofemoral joints of each cadaver. Using a minimally invasive surgical approach, 5.5 mm bone canals were drilled through the femur and acetabulum, traversing the coxofemoral joint. Intraoperative guidance was provided by a cone-beam computed tomography (CBCT)-coupled surgical navigation system. A toggle construct was introduced through the bone canals. Surgical accuracy aberrations (SAA) were measured at the femoral entry and exit points and at the acetabular entry point on merged pre- and postoperative CBCT scans. The coxofemoral joint was assessed for articular cartilage damage by gross dissection. Results: A toggle construct was placed across all 18 coxofemoral joints. The overall median SAA in the main study was 2.8 mm (range: 0.4-8.0 mm). No cartilage damage was found in the cadaveric specimens of the main study. Conclusions: The described technique allowed for the placement of a toggle construct across the coxofemoral joint of small equid cadaveric specimens without prior coxofemoral luxation. Conclusions: This technique may serve as an option for surgical stabilization of coxofemoral joints in small equids. Further biomechanical investigations are required to assess optimal implant positioning and toggle constructs.
© 2023 The Authors. Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
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Publication Date: 2023-07-26 PubMed ID: 37496312DOI: 10.1111/vsu.14004Google 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.

Researchers developed a minimally invasive method to place a toggle construct in the hip joint of small horses using computer-assisted surgery. The results suggest this technique could stabilize the hip joint in small horses without causing damage.

Objective

  • Develop a minimally invasive procedure for placing a toggle construct across the coxofemoral joint of small equids using computer-assisted surgery.

Methods

  • Type of Study:
    • Experimental cadaveric study.
  • Specimens Used:
    • Pilot study: One donkey, one Shetland pony, and one Warmblood foal.
    • Main study: Three Shetland ponies, one American Miniature Horse, one Warmblood foal, and one donkey.
  • Procedure:
    • Surgeries were conducted on both hip joints of each cadaver.
    • 5.5mm bone canals were drilled through the femur and acetabulum using a minimally invasive approach.
    • Guidance was provided by a CBCT-coupled surgical navigation system.
    • A toggle construct was inserted through the bone canals.

Measurements

  • Surgical Accuracy Aberrations (SAA):
    • Measured at the femur’s entry and exit points and the acetabulum’s entry point using merged pre- and postoperative CBCT scans.
  • Joint Damage Assessment:
    • The hip joint was examined for articular cartilage damage through gross dissection.

Results

  • Toggle Construct Placement:
    • Successfully placed across all 18 hip joints.
  • Surgical Accuracy:
    • Median SAA in the main study was 2.8mm (range: 0.4-8.0mm).
  • Cartilage Damage:
    • None found in the main study specimens.

Conclusions

  • Efficacy of the Technique:
    • The method allowed for toggle construct placement in the hip joint of small horse cadavers without causing a hip dislocation.
  • Potential Applications:
    • The technique could be an option for surgically stabilizing hip joints in small horses.
  • Recommendations for Future Research:
    • More biomechanical studies are needed to determine optimal implant positioning and effective toggle constructs.

Cite This Article

APA
Claeys I, Van der Vekens E, Kümmerle J, de Preux M, Koch C. (2023). Computer-assisted surgery for placing toggle constructs across the coxofemoral joints of small equids using a minimally invasive approach-A proof-of-concept cadaveric study. Vet Surg. https://doi.org/10.1111/vsu.14004

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English

Researcher Affiliations

Claeys, Ines
  • Division of Equine Surgery, Equine Clinic Bern, Vetsuisse-Faculty, Swiss Institute of Equine Medicine, University of Bern, Bern, Switzerland.
Van der Vekens, Elke
  • Division of Clinical Radiology, Vetsuisse-Faculty, University of Bern, Bern, Switzerland.
Kümmerle, Jan
  • Equine Department Zurich, Vetsuisse-Faculty, University of Zurich, Zurich, Switzerland.
de Preux, Mathieu
  • Division of Equine Surgery, Equine Clinic Bern, Vetsuisse-Faculty, Swiss Institute of Equine Medicine, University of Bern, Bern, Switzerland.
Koch, Christoph
  • Division of Equine Surgery, Equine Clinic Bern, Vetsuisse-Faculty, Swiss Institute of Equine Medicine, University of Bern, Bern, Switzerland.

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Citations

This article has been cited 2 times.
  1. Maurer T, de Preux M, Precht C, Vidondo B, Koch C. Accuracy of computer-assisted drilling of equine cervical vertebral bodies using a purpose-built cervical frame-An experimental cadaveric study. Vet Surg 2025 Jul;54(5):898-908.
    doi: 10.1111/vsu.14271pubmed: 40371965google scholar: lookup
  2. Kleiner L, Wolf N, Precht C, Haenssgen K, Forterre F, Düver P. Feline sacroiliac luxation: comparison of fluoroscopy-controlled freehand vs. computer-navigated drilling in the sacrum-a cadaveric study. Front Vet Sci 2024;11:1510253.
    doi: 10.3389/fvets.2024.1510253pubmed: 39881725google scholar: lookup
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