Retrospective analysis of factors associated with outcome of proximal interphalangeal joint arthrodesis in 82 horses including Warmblood and Thoroughbred sport horses and Quarter Horses (1992-2014).
Authors: Herthel T D, Rick M C, Judy C E, Cohen N D, Herthel D J
Journal: Equine veterinary journal
Summary
# Editorial Summary: PIP Joint Arthrodesis Outcomes Across Breed Types Proximal interphalangeal joint arthrodesis has established benefits in Western performance Quarter Horses, yet evidence for its success in sport horse breeds remained limited until this 22-year retrospective analysis of 82 cases. Surgeons employed three fixation methods—three cortex screws in lag fashion, dynamic compression plating with two lag screws, and locking compression plating with two lag screws—with long-term follow-up obtained for all horses to assess return to intended use. Overall success rates were encouraging: 74% of Warmbloods and Thoroughbreds and 87% of Quarter Horses achieved satisfactory outcomes, with 57–63% of high-level athletes across both groups returning to competitive work. Notably, hindlimb arthrodesis showed substantially superior results for performance horses (73% return to competition) compared to forelimb procedures (25%), suggesting limb location significantly influences prognosis independent of breed or discipline. These findings support PIP arthrodesis as a viable management option for sport horses with advanced PIP osteoarthritis when conservative treatment has failed, though practitioners should counsel realistic expectations for forelimb cases and appreciate improved outcomes in horses undergoing hindlimb fixation.
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Practical Takeaways
- •PIP arthrodesis is a viable treatment for osteoarthritis in sport horses across multiple disciplines, with success rates exceeding 74% for return to intended use
- •Horses undergoing hindlimb PIP arthrodesis have substantially better athletic performance outcomes than those with forelimb procedures—consider this when counseling clients on prognosis
- •Multiple fixation techniques (3-screw, DCP, LCP) appear effective, allowing surgeon and owner flexibility based on available resources and anatomical considerations
Key Findings
- •74% of Warmbloods/Thoroughbreds and 87% of Quarter Horses achieved successful post-operative outcomes after PIP joint arthrodesis
- •57% of Warmbloods/Thoroughbreds and 63% of Quarter Horses used for athletic performance returned to successful competition
- •Hindlimb arthrodesis resulted in significantly higher return-to-competition rates (73%) compared to forelimb arthrodesis (25%) in high-level athletic horses (P=0.002)
- •Three surgical techniques were employed: 3-screw fixation (n=41), dynamic compression plate with 2 screws (n=22), and locking compression plate with 2 screws (n=19)