Ex vivo study of minimally invasive procedures for cartilage removal from the metacarpophalangeal or metatarsophalangeal joint and for fetlock tension band application.
Authors: Farfan Maëlle, Genton Martin, Rossignol Fabrice
Journal: Veterinary surgery : VS
Summary
Arthrodesis of the fetlock joint remains a valuable salvage procedure for severe degenerative joint disease, but traditional open approaches carry significant morbidity and prolonged recovery times. Farfan and colleagues used twelve cadaveric equine limbs to develop and validate minimally invasive techniques for the two critical components of fetlock fusion: cartilage removal and tension band stabilisation. Joint distraction via a 5.5-mm cortical screw followed by articular drilling through four stab incisions removed approximately 67% of cartilage from the metacarpal/metatarsal and proximal phalangeal surfaces, with slightly lower removal (59.5%) from the sesamoid bones; a specially designed cannula then enabled accurate tension band positioning without requiring joint luxation, all assessed radiographically post-procedure. This work demonstrates that minimally invasive fetlock arthrodesis is technically feasible and repeatable, offering equine practitioners a potential pathway to improved outcomes in selected cases where joint fusion is indicated—particularly valuable given the reduced soft tissue trauma, faster rehabilitation and lower infection risk compared with conventional open techniques. The techniques merit clinical validation in live horses where variables such as soft tissue compliance and healing responses can be properly evaluated.
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Practical Takeaways
- •This minimally invasive approach to fetlock arthrodesis may reduce surgical trauma and recovery time compared to open techniques, making it suitable for selected clinical cases
- •The procedure achieves reliable cartilage removal (66-68% on main joint surfaces) necessary for successful fusion through small stab incisions rather than large surgical approaches
- •Surgeons can accurately place tension bands without fully dislocating the joint, potentially preserving soft tissue integrity and reducing postoperative complications
Key Findings
- •Minimally invasive articular drilling removed 66.8% ± 7.6% of cartilage from metacarpal/metatarsal surfaces and 67.9% ± 8.6% from proximal phalanx surfaces using a 4.5-mm drill through four stab incisions
- •Tension band placement through stab incisions using a specialized cannula was accurate and repeatable on cadaveric limbs without requiring joint luxation
- •Cartilage removal from sesamoid bones averaged 59.5% ± 1% using the distraction and drilling technique