Tenotomy of the semitendinosus muscle under standing sedation versus general anesthesia: Outcomes in 20 horses with fibrotic myopathy.
Authors: Suarez-Fuentes David G, Tatarniuk Dane M, Caston Stephanie S, Kersh Kevin D, Gillen Alex M, Hays Ashley M
Journal: Veterinary surgery : VS
Summary
# Fibrotic Myopathy of the Semitendinosus: Standing Sedation as a Viable Surgical Alternative Fibrotic myopathy of the hindlimb causes a characteristic gait abnormality that significantly impacts ridden and athletic horses, yet surgical management options require clarification regarding optimal anaesthetic protocols. Researchers retrospectively analysed 20 horses treated with semitendinosus tenotomy between 2002 and 2015, comparing outcomes in 8 animals sedated standing against 12 undergoing general anaesthesia, with follow-up extending from 9 months to 10 years post-operatively. Gait improvement occurred in 75% of horses with isolated semitendinosus involvement and 67% when both semitendinosus and semimembranosus muscles were affected, with no statistically significant difference between the two anaesthetic approaches (standing sedation: 75% improved; general anaesthesia: 50% improved; P = 0.4473). Amongst athletic horses, 83% in the standing sedation group and 67% in the general anaesthesia group returned to their preinjury level of performance, whilst standing sedation notably eliminated incisional complications entirely compared to two post-operative drainage cases in the general anaesthesia cohort. These findings suggest standing tenotomy offers comparable functional outcomes to general anaesthesia with reduced surgical morbidity, making it an appealing option for practitioners managing cases where general anaesthesia carries elevated risk or where client convenience is a consideration.
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Practical Takeaways
- •Semitendinosus tenotomy is an effective treatment for fibrotic myopathy, with approximately 60-75% of horses showing gait improvement regardless of anesthetic method
- •Standing sedation offers a viable alternative to general anesthesia with superior incisional healing and no compromise in functional outcomes
- •Most athletic horses (67-83%) can return to preinjury performance levels, making this a worthwhile salvage procedure for valuable animals
Key Findings
- •Gait improved in 8 of 14 horses (57%) when semitendinosus alone was affected and in 4 of 6 horses (67%) when both semitendinosus and semimembranosus were involved
- •6 of 8 horses (75%) under standing sedation and 6 of 12 horses (50%) under general anesthesia showed improvement in fibrotic gait
- •5 of 6 athletic horses (83%) treated under standing sedation and 6 of 9 athletic horses (67%) under general anesthesia returned to preinjury athleticism
- •Standing sedation had zero incisional complications versus 2 of 12 horses (17%) with incisional drainage under general anesthesia