Proximal Interphalangeal Arthrodesis in Horses: A Meta-Analysis of Retrospective Studies.

The study is a meta-analysis of previous research on proximal interphalangeal arthrodesis (PIA), a common surgical procedure for horses, primarily focusing on outcomes like survival rates, surgical site infection rates, return to activity, and duration of hospital stay and casting.

Objective of the Study

• The study’s objective was to compile and analyze the results of existing research on the effectiveness and safety of proximal interphalangeal arthrodesis (PIA) in horses. This meta-analysis of retrospective studies aimed to provide a comprehensive look at the survival and surgical site infection (SSI) rates, return to activities, and hospital stay durations and casting times associated with PIA treatment.

Research Methodology

• Researchers conducted an extensive literature search through CAB Abstracts, PubMed, ScienceDirect, Web of Science, and Scopus databases to source relevant studies.
• Meta-analyses were performed using fixed and random effects models to estimate proportions, mean values, and effect sizes based on odds ratios (OR), all presented with a 95% confidence interval.
• Subgroups were also created for horses with fractures and other conditions to compare the outcomes of PIA treatment in these two categories separately.

Study Findings

• A total of 21 full articles were reviewed, which included data for 458 horses. The survival rate post-PIA surgery was found to be 90%, and the surgical site infection (SSI) rate was 12%.
• The rate of return to activities was estimated at 65%.
• The average duration of hospitalization and casting were 25 days and 29 days, respectively.
• Fractures and other conditions had similar odds of survival, return to activities, and SSI, indicating that PIA provides consistent outcomes regardless of the specific condition being treated.

Conclusions and Implications

• The study concluded that proximal interphalangeal arthrodesis (PIA) is a generally efficient and safe method to treat injuries in the pastern region of horses, as it offers a high survival rate and a low risk of surgical site infection.
• However, the ability of treated horses to return to their intended use was modest and potentially lower in cases of fractures, suggesting a need for further exploration to improve this outcome.