Postoperative management following equine orthopedic surgery: a survey of diplomates of the ACVS and ACVSMR.
Authors: Jacobs Carrie, Schnabel Lauren Virginia, Redding Horne Caitlyn, Tufts Sara, Martin Emily Gray Medlin, Love Kim
Journal: Frontiers in veterinary science
Summary
# Editorial Summary Understanding how veterinary surgeons currently manage equine orthopedic cases after surgery is crucial for developing evidence-based rehabilitation protocols, yet published guidelines remain sparse in equine practice. Jacobs and colleagues surveyed 85 diplomates of the ACVS and ACVSMR regarding postoperative recommendations for four common scenarios: simple arthroscopy, septic arthritis, deep digital flexor tendon tears, and neurectomy with fasciotomy. All four surgical types shared common management foundations—NSAIDs, bandaging, hand-walking, and small paddock turnout formed the cornerstone of early postoperative care—but progression timelines differed significantly, with deep digital flexor tendon cases requiring substantially extended periods of hand-walking and restricted turnout compared to the other three scenarios, and intrathecal therapies being reserved predominantly for tendon injuries. Notably, specialists in sports medicine and rehabilitation (ACVSMR) were more inclined to recommend structured rehabilitation modalities across certain scenarios, suggesting differences in philosophy between general surgical and rehabilitation-focused practitioners. These findings provide a snapshot of current practice patterns and highlight both areas of consensus and meaningful variation that warrant further investigation to establish which postoperative protocols optimise outcomes and return to function.
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Practical Takeaways
- •Post-orthopedic surgery protocols vary significantly by procedure type—particularly with deep digital flexor tendon repairs requiring substantially longer conservative management phases (hand-walking and paddock rest) before return to work.
- •NSAIDs, proper bandaging, and controlled hand-walking form the foundation of postoperative care across all common equine orthopedic surgeries, with rehabilitation specialists recommending additional structured modalities more frequently than general surgeons.
- •Establish case-specific timelines for return to turnout and ridden exercise rather than applying a one-size-fits-all approach; tendon repairs need longer management than arthroscopic procedures.
Key Findings
- •NSAIDs, bandaging, hand-walking, and small paddock turnout were most commonly recommended across all four surgical scenarios.
- •Deep digital flexor tendon tear cases required longer periods of hand-walking and small paddock turnout compared to other procedures.
- •Return to full turnout and ridden exercise was recommended significantly sooner for simple arthroscopy, septic arthritis, and neurectomy cases than for deep digital flexor tendon tear cases.
- •ACVSMR diplomates were more likely to recommend formal rehabilitation modalities for certain surgical scenarios than ACVS diplomates.