Arthrodesis of the metacarpophalangeal and metatarsophalangeal joints to treat osteoarthritis in 17 horses.
Authors: Chapman Hannah-Sophie, Richardson Dean W, Ortved Kyla F
Journal: Veterinary surgery : VS
Summary
# Arthrodesis for Fetlock Osteoarthritis: A 13-Year Outcome Review Chronic osteoarthritis of the metacarpophalangeal and metatarsophalangeal joints (fetlocks) often becomes refractory to conventional management, leaving farriers, vets and rehabilitation specialists with limited surgical options. Chapman and colleagues reviewed 17 horses treated between 2004 and 2017 using locking compression plate (LCP) fixation combined with metallic tension band arthrodesis—a technique designed to permanently stabilise the joint and eliminate pain-generating motion. Outcomes were notably favourable: 13 of 17 horses (76%) achieved lameness scores of 4 out of 5 postoperatively, all animals survived to discharge and beyond 6 months without reported long-term complications, and the only notable morbidity consisted of four cases of cast sores during the initial healing period. Perhaps most significantly, horses tolerated unrestricted turnout and one returned to light ridden work, suggesting the procedure doesn't invariably condemn athletic animals to pasture-only status. This retrospective case series indicates that fetlock arthrodesis using dual-implant fixation offers a viable salvage option for OA cases unresponsive to medical therapy, with morbidity and prognosis apparently more favourable than historical outcomes following traumatic suspensory apparatus injuries—making it worth considering in discussion with owners facing end-stage degenerative joint disease.
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Practical Takeaways
- •Fetlock arthrodesis using locking compression plate and tension band is a viable salvage option for horses with end-stage fetlock osteoarthritis unresponsive to medical management, with favorable long-term outcomes
- •Expect most horses to achieve significant lameness improvement and return to pasture soundness; monitor closely during recovery for cast sores but anticipate few serious complications
- •This technique appears to have better outcomes than historical reports of fetlock arthrodesis in traumatic cases, making it worth considering for suitable OA candidates
Key Findings
- •Lameness improved to grade 4/5 in 13 of 17 horses (76%) following MCP/MTP arthrodesis
- •All 17 horses survived to discharge and remained alive >6 months postoperatively with no long-term complications reported
- •No postoperative infections or implant failures occurred; only minor complications were cast sores (n=4)
- •One horse returned to light ridden work and all horses permitted unrestricted turnout, indicating good functional outcomes