Treatment of carpometacarpal osteoarthritis by arthrodesis in 12 horses.
Authors: Barber Spencer M, Panizzi Luca, Lang Hayley M
Journal: Veterinary surgery : VS
Summary
# Carpometacarpal Arthrodesis for Equine Osteoarthritis Carpometacarpal (CMC) joint osteoarthritis is a challenging condition affecting the distal carpal region, and surgical options have historically been limited; this case series evaluated arthrodesis via a percutaneous drilling technique as a potential solution. Twelve horses underwent the procedure, which involved creating 3–5 drill holes through the CMC joint to facilitate bony fusion, with radiographic and clinical follow-up ranging from 8.7 to 28.6 months post-operatively. The majority of horses showed only slight to moderate pain in the immediate postoperative period, and by six months, 92% were markedly improved and capable of returning to work; of the nine limbs with radiographic follow-up, six achieved complete bony ankylosis whilst three had partial fusion. At long-term follow-up, all horses demonstrated reduced lameness severity, 83% were considered sound, and 67% returned to their original level of activity, with all owners rating the procedure highly successful. For equine practitioners managing CMC osteoarthritis, arthrodesis offers a viable surgical alternative with realistic expectations of pain relief and functional return to work, though individual variation in fusion achievement and the fact that not all horses regain their previous activity level warrant careful case selection and owner counselling.
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Practical Takeaways
- •Drilling-induced CMC arthrodesis is a viable surgical option for horses with CMC osteoarthritis that has failed conservative management, with most returning to work
- •Expect moderate pain in the first month post-surgery, but significant improvement by 6 months with realistic expectations for return to original activity in ~67% of cases
- •Radiographic fusion is not always achieved but does not necessarily predict clinical failure—functional outcomes depend on multiple factors beyond bony ankylosis
Key Findings
- •Drilling-induced arthrodesis of the CMC joint achieved bony ankylosis in 6 of 9 limbs (67%) at mean 8.7 months follow-up
- •83% of horses were sound and 67% returned to original activity at long-term follow-up (mean 28.6 months)
- •92% of horses showed marked improvement by 6 months postoperatively and were capable of returning to work
- •All 12 owners rated the arthrodesis procedure as highly successful despite variable radiographic evidence of fusion