Ultrasound-guided, minimally invasive, biceps brachii tenotomy in a standing horse.

Summary

# Editorial Summary: Ultrasound-Guided Biceps Brachii Tenotomy in Standing Horses Chronic shoulder lameness secondary to biceps brachii tendinopathy and bursitis can prove refractory to conservative management, particularly when concurrent bone pathology—such as humeral tubercle fractures—compromises soft tissue healing. Marques and colleagues present a case of a 17-year-old Tennessee Walking Horse gelding with precisely this presentation, who underwent a standing, ultrasound-guided, minimally invasive biceps brachii tenotomy performed under sedation and local anaesthesia rather than general anaesthesia. The procedure delivered immediate and substantial improvement in lameness, with the horse progressing through a multimodal rehabilitation protocol combining systemic analgesia, local corticosteroid injections, and physiotherapy exercises. At 21 months post-operatively, the gelding achieved pasture soundness with no incisional complications, demonstrating that this minimally invasive approach offers a practical alternative for managing refractory biceps pathology in standing patients. For practitioners managing shoulder lameness cases unresponsive to traditional therapies, this technique warrants consideration as a lower-risk surgical option that maintains the horse's ability to tolerate standing procedures and facilitates rapid mobilisation during recovery.

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Key Findings

• •Ultrasound-guided minimally invasive biceps brachii tenotomy performed standing under sedation and local anesthesia resulted in substantial immediate improvement in lameness
• •Horse achieved pasture soundness at 21 months post-surgery with no incisional complications
• •Combined approach of surgery, pain management, physiotherapy, and periodic corticosteroid injections maintained long-term functional outcome

Conditions Studied