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  Discussion on Research Study: Improved Pastern Fusion (Arthrodesis) Technique
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DrO

Posted on Thursday, Jul 16, 2009 - 8:35 am:

Fusing the pastern joint (arthrodesis) is a tough surgery that in the past has required mechanical fixation to stabilize the disarticulated joint. Here a technique is described that allows for athrodesis without disarticulation and simplifies surgery with a similar outcome to the more involved procedure. Hopefully this will allow the procedure to become less expensive and more widely available.
DrO

Vet Comp Orthop Traumatol. 2009;22(4):303-8. A limited surgical approach for pastern arthrodesis in horses with severe osteoarthritis.

Jones P, Delco M, Beard W, Lillich J, Desormaux A.

Phillip Jones, DVM, MS, Kansas State University, College of Veterinary Medicine, 1800 Denison Ave Mosier Hall, Manhattan, Kansas 66506, USA, Phone: +1 918 224 6867, E-mail: pjones@vet.k-state.edu.

Osteoarthritis of the proximal interphalangeal joint (PIPJ) is a common cause of chronic lameness in the horse that requires surgical arthrodesis when medical management is no longer able to alleviate pain. Surgical principles for successful PIPJ arthrodesis include articular cartilage debridement and rigid fixation. To completely debride articular cartilage, the collateral ligaments and extensor tendon are transected, disarticulating the joint. The purpose of this study was to demonstrate that in chronically lame horses with periarticular new-bone formation and osteoarthritis, successful arthrodesis occurs without joint disarticulation and complete articular cartilage debridement. We hypothesised that complete articular debridement is not necessary, thus allowing for a less invasive surgical approach that decreases surgical time and hospitalisation with comparable success rates to previous reports. Medical records from 2000-2007 were reviewed for PIPJ disease. Information regarding lameness, surgical time and hospitalisation were retrieved from 11 horses (12 limbs). Follow-up information was obtained via a telephone interview and a re-evaluation. Average hospital and surgery times were shorter than previous reports at 19 days and 111 minutes respectively. Lameness decreased at least one grade in 92% of limbs. 73% of owners would elect to operate again. The data suggests that successful arthrodesis occurs without joint disarticulation and complete articular cartilage debridement.
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