Evaluation of a minimally invasive arthrodesis technique for the carpometacarpal joint in horses.
Authors: Panizzi Luca, Barber Spencer M, Lang Hayley M, Allen Andrew L, Woodbury Murray R
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Minimally Invasive Carpometacarpal Joint Arthrodesis in Horses Panizzi and colleagues investigated whether a percutaneous 5.5 mm, three-drill tract technique could reliably achieve fusion of the carpometacarpal joint in horses, a consideration for managing severe joint pathology in this location. Six healthy horses underwent unilateral arthrodesis with lameness assessment via peak vertical ground reaction force measurements, radiographic scoring, and clinical evaluation at regular intervals through to 12 months post-operatively, when joints were examined histologically and through microradiography. Although all horses experienced post-operative lameness, only two demonstrated clinical resolution by 12 months, and critically, bony ankylosis (true fusion) was confirmed in just two of six joints despite significant radiographic changes at four months—suggesting the technique achieved bone bridging but incomplete intra-articular fusion. The authors concluded that this minimally invasive approach was unsuccessful in normal joints and hypothesised that greater articular trauma or application in naturally osteoarthritic joints might improve fusion rates; practitioners should therefore view this technique with caution in sound horses, and consider whether more aggressive techniques or patient selection (targeting degenerative cases) might yield better outcomes.
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Practical Takeaways
- •This minimally invasive technique has a low success rate (33%) in normal healthy horses and should not be routinely recommended for routine CMC joint problems in clinical practice
- •Consider that greater articular surface damage or technique modifications may be necessary to achieve successful fusion, or reserve this approach for horses with pre-existing CMC osteoarthritis rather than primary arthritis
- •Expect persistent lameness and altered weight-bearing for extended periods; careful case selection and client communication about realistic outcomes is essential
Key Findings
- •Only 2 of 6 horses (33%) achieved intraarticular bony ankylosis using the minimally invasive 5.5 mm, 3-drill tract technique
- •All horses demonstrated lameness immediately post-surgery with clinical resolution in only 2 horses by 12 months
- •Peak vertical ground reaction force values remained significantly different between treated and nontreated limbs at all time points through 12 months post-surgery
- •Radiographic changes were evident by day 0 post-surgery and plateaued after 4 months, but did not correlate with successful arthrodesis in most horses