Arthroscopic removal of axial osteochondral fragments of the proximoplantar aspect of the proximal phalanx using electrocautery probes in 23 standardbred racehorses.
Authors: Simon Olivier, Laverty Sheila, Bouré Ludovic, Marcoux Marcel, O Szöke Mihaly
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Axial osteochondral fragments on the proximal plantar aspect of the proximal phalanx represent a recognised cause of lameness in racing Standardbreds, yet surgical removal has traditionally required open arthrotomy or conventional arthroscopic techniques. Olivier and colleagues retrospectively evaluated 23 Standardbred racehorses undergoing arthroscopic electrosurgical removal of these fragments using loop and hook electrocautery probes, with horses positioned in dorsal recumbency and the joint maintained under glycine distension. Across 28 metatarsophalangeal joints, 33 fragments were successfully removed without major operative or postoperative complications; importantly, 79% (7 of 8) of horses with prior racing records returned to racing post-operatively, though only 36% of previously non-racing horses subsequently raced. The use of electrocautery probes offers clinicians a technically straightforward arthroscopic alternative to conventional dissection, particularly advantageous when multiple fragments or bilateral disease require management, though practitioners should counsel clients realistically about performance prospects in horses without established racing history prior to presentation.
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Practical Takeaways
- •Arthroscopic electrocautery is a safe and effective surgical technique for removing axial osteochondral fragments from the proximal phalanx in racehorses, with most previously racing horses returning to competition
- •This technique offers advantages over conventional excision methods and allows efficient management of multiple joint involvement in a single procedure
- •Consider this approach for Standardbred racehorses with axial osteochondral fragments affecting racing performance, as a reasonable proportion of non-racing horses may also become viable for competition post-operatively
Key Findings
- •33 axial osteochondral fragments were successfully removed from 28 metatarsophalangeal joints in 23 Standardbred racehorses with no major operative or postoperative complications
- •79% (7/8) of horses that raced before surgery returned to racing after arthroscopic electrosurgical excision
- •36% (4/11) of horses that had not raced before surgery subsequently raced after surgery
- •Dorsal recumbency positioning enabled safe removal of multiple fragments and facilitated multi-joint surgery