Journal of equine veterinary science2023; 122; 104226; doi: 10.1016/j.jevs.2023.104226

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

Abstract: The aim of this study was to determine the clinical outcomes reported in retrospective studies of proximal interphalangeal arthrodesis (PIA) in horses through a meta-analysis of retrospective studies. CAB Abstracts, PubMed, ScienceDirect, Web of Science, and Scopus were searched. The primary outcomes included survival and surgical site infection (SSI) rates, return to activities, and time of hospital stay and casting. Subgroups were formed for fractures and other conditions. Meta-analyses were performed with fixed and random effects models to estimate proportions, mean values, and effect size by odds ratio (OR) with 95% confidence intervals (CI). Twenty-one full articles were included, totaling 458 horses. The survival rate was 90% (95% CI [86%-93%]), return to activities was 65% (95% CI [61%-70%]), and SSI was 12% (95% CI [8%-16%]). The mean hospitalization was 25 days (95% CI [18-35 days]) and time of casting was 29 days (95% CI [21-42 days]). The OR of survival (P = .769), return to activities (P = .576), and SSI (P = .467) were similar between cases of fractures and other conditions. PIA is an efficient and safe method to treat injuries in the pastern region, with a high survival rate and low SSI. However, the rate of return to soundness for intended use was modest, being potentially lower for fracture cases. Thus, investigations of more efficient interventions are needed to improve this outcome.
Publication Date: 2023-01-14 PubMed ID: 36649830DOI: 10.1016/j.jevs.2023.104226Google Scholar: Lookup
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  • Meta-Analysis
  • Journal Article
  • Review
  • Research Support
  • Non-U.S. Gov't

Summary

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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.

Cite This Article

APA
de Souza AF, Paretsis NF, De Zoppa ALDV. (2023). Proximal Interphalangeal Arthrodesis in Horses: A Meta-Analysis of Retrospective Studies. J Equine Vet Sci, 122, 104226. https://doi.org/10.1016/j.jevs.2023.104226

Publication

ISSN: 0737-0806
NlmUniqueID: 8216840
Country: United States
Language: English
Volume: 122
Pages: 104226
PII: S0737-0806(23)00017-5

Researcher Affiliations

de Souza, Anderson Fernando
  • Departamento de Cirurgia, Faculdade de Medicina Veterinu00e1ria e Zootecnia, Universidade de Su00e3o Paulo, Su00e3o Paulo, SP, Brazil. Electronic address: anderson.fs@usp.br.
Paretsis, Nicole Fidalgo
  • Departamento de Cirurgia, Faculdade de Medicina Veterinu00e1ria e Zootecnia, Universidade de Su00e3o Paulo, Su00e3o Paulo, SP, Brazil.
De Zoppa, Andru00e9 Luis do Valle
  • Departamento de Cirurgia, Faculdade de Medicina Veterinu00e1ria e Zootecnia, Universidade de Su00e3o Paulo, Su00e3o Paulo, SP, Brazil.

MeSH Terms

  • Horses
  • Animals
  • Retrospective Studies
  • Horse Diseases / surgery
  • Arthrodesis / methods
  • Arthrodesis / veterinary
  • Extremities
  • Hospitalization

Citations

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