Standing myotomy to treat fibrotic myopathy: 22 cases (2004-2016).
Authors: Noll Charlene V, Kilcoyne Isabelle, Vaughan Betsy, Galuppo Larry D
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Standing Myotomy for Fibrotic Myopathy Fibrotic myopathy—characterised by muscle fibrosis and resulting gait abnormalities—can significantly impair athletic function in horses, yet surgical management options remain relatively understudied. This retrospective analysis examined 22 horses treated with standing myotomy between 2004 and 2016, predominantly Quarter horses (14/22), with ultrasonographic confirmation in 14 cases revealing semitendinosus involvement in 77% of cases, alongside less frequent semimembranosus, gracilis and biceps femoris pathology. Two-thirds of previously athletic horses (8/12) returned to their intended use following surgery with appropriate rehabilitation, though owner satisfaction was moderate at 63% (10/16), and incisional complications occurred in 18% of cases. The fair long-term prognosis associated with this technically straightforward standing procedure suggests it represents a viable option for select cases, with ultrasonographic evaluation proving valuable for identifying affected muscles and guiding surgical planning—though practitioners should counsel clients realistically that whilst comfort may improve, return to full athletic function is not guaranteed and careful postoperative rehabilitation is essential. Standing myotomy warrants consideration in horses with confirmed fibrotic myopathy refractory to conservative management, particularly when muscle involvement is clearly identified preoperatively.
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Practical Takeaways
- •Standing fibrotic myotomy is a technically straightforward procedure for fibrotic myopathy with fair prognosis when combined with appropriate rehabilitation—most athletic horses can return to work
- •Ultrasonography should be used preoperatively to identify affected muscles and plan surgical approach, as semitendinosus is most commonly affected
- •Owner satisfaction is moderate (63%), so set realistic expectations about recovery timeline and potential for incisional complications (18% rate)
Key Findings
- •Semitendinosus muscle was affected in 17 of 22 horses (77%); other affected muscles included semimembranosus, gracilis, and biceps femoris
- •8 of 12 formerly athletic horses (67%) returned to their intended athletic use following standing fibrotic myotomy
- •10 of 16 owners (63%) were satisfied with the surgical procedure
- •4 of 22 horses (18%) experienced incisional postoperative complications; ultrasonographic examination aided in surgical planning