Retrospective evaluation of facilitated pastern ankylosis using intra-articular ethanol injections: 34 cases (2006-2012).
Authors: Caston S, McClure S, Beug J, Kersh K, Reinertson E, Wang C
Journal: Equine veterinary journal
Summary
# Editorial Summary: Ethanol Injection for Pastern Osteoarthritis Proximal interphalangeal joint osteoarthritis presents a significant management challenge when surgery is financially prohibitive, prompting investigation of intra-articular ethanol injection as a cost-effective alternative to facilitate ankylosis. This retrospective analysis examined 34 horses treated between 2006–2012, with follow-up intervals of at least 6 months, evaluating both clinical soundness and return to work as primary success indicators. Half the cohort (50%) achieved complete soundness, whilst a further 38% showed measurable improvement despite persistent lameness, with median recovery to functional use occurring at 8 months; only one horse showed no progress and three were lost to follow-up, with six experiencing complications (four mild and transient). Whilst ethanol injection does not produce the same reliability as surgical arthrodesis, the technique offers a viable option for owners unable to pursue surgical management, provided realistic expectations are set regarding timescale and outcomes. Practitioners considering this approach should counsel clients that nearly 40% of horses will show only partial improvement, and that the extended 8-month timeline to soundness or work capability differs substantially from conventional lameness interventions.
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Practical Takeaways
- •For clients unable to afford arthrodesis surgery, intra-articular ethanol injection offers a viable lower-cost option with 50% success rate for achieving soundness and 88% achieving soundness or improvement
- •Expect a median 8-month timeline before horses return to work; counsel clients on realistic recovery expectations
- •Complication rate is low (18%), with most being mild and self-limiting, making this a relatively safe alternative technique
Key Findings
- •50% of horses (17/34) achieved soundness following intra-articular ethanol injection, with 38% (13/34) showing improvement but remaining unsound
- •Median time to soundness or return to work was 8 months post-treatment
- •Complications occurred in 6 horses (18%), with 4 being mild and transient
- •Intra-articular ethanol injection represents a cost-effective alternative to surgical arthrodesis when surgery is not economically feasible