Proximal Interphalangeal Arthrodesis in Horses: A Meta-Analysis of Retrospective Studies.

Authors: de Souza Anderson Fernando, Paretsis Nicole Fidalgo, De Zoppa André Luis do Valle

Journal: Journal of equine veterinary science

DOI: 10.1016/j.jevs.2023.104226 PubMed: 36649830Log in to save

Summary

# Proximal Interphalangeal Arthrodesis in Horses: A Meta-Analysis of Retrospective Studies Proximal interphalangeal arthrodesis (PIA) remains a surgical option for managing pastern injuries in horses, yet clinicians need robust evidence on realistic outcomes to guide their recommendations. De Souza and colleagues synthesised 21 retrospective studies encompassing 458 horses to establish reliable benchmarks for survival, infection rates, return to work, and recovery timelines across both fracture and degenerative cases. The analysis revealed a 90% survival rate with relatively low surgical site infection at 12%, but the 65% return to activities figure warrants careful discussion with owners—particularly those pursuing fracture cases, where outcomes trended lower than other indications despite statistical similarity between groups. Hospital stays averaged 25 days with casting periods around 29 days, providing practical expectations for managing post-operative rehabilitation. Whilst PIA demonstrates safety and efficacy as a salvage procedure, the modest functional recovery suggests exploring complementary or alternative interventions may be warranted for horses where return to their previous level of performance is the primary goal.

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Practical Takeaways

•PIA is a reliable salvage procedure with high survival rates and low infection risk, suitable for horses with severe pastern joint pathology when other treatments fail
•Owners should expect modest return-to-work rates (~65%) even with successful surgery—this is not a performance restoration procedure for most cases
•Plan for extended recovery: approximately 4 weeks hospitalization and casting required; fracture cases may have slightly lower functional outcomes than osteoarthritis cases

Key Findings

•PIA achieved 90% survival rate (95% CI 86-93%) across 21 studies with 458 horses
•Return to activities was 65% (95% CI 61-70%), with no significant difference between fracture and non-fracture cases
•Surgical site infection rate was low at 12% (95% CI 8-16%), demonstrating safety profile
•Mean hospitalization was 25 days and casting duration was 29 days

Conditions Studied

proximal interphalangeal joint fracturesproximal interphalangeal joint arthritispastern region injuries

Related References

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).

Herthel T D, Rick M C, Judy C E, Cohen N D, Herthel D J(2016)Equine veterinary journal

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