Clinical use of computer-assisted orthopedic surgery in horses.
Authors: de Preux Mathieu, Klopfenstein Bregger Micaël D, Brünisholz Hervé P, Van der Vekens Elke, Schweizer-Gorgas Daniela, Koch Christoph
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Computer-Assisted Orthopedic Surgery in Equine Practice Computer-assisted orthopedic surgery (CAOS) coupled with cone beam computed tomography navigation offers equine surgeons precision guidance for complex joint and bone procedures, yet clinical applications in horses remain poorly documented. Between 2016 and 2019, thirteen adult horses underwent CAOS for varied indications including implant placement in carpal, tarsal and femoral sites, transarticular drilling for distal tarsal arthrodesis, articular fragment removal, and osteolytic lesion curettage, with seven cases employing a purpose-built surgical frame to enhance stability and accuracy. All procedures proceeded successfully according to preoperative plans, demonstrating that CAOS is technically feasible across a broad range of equine orthopedic presentations when surgeons are adequately trained in system operation. For optimal clinical workflow, the authors recommend separating operative planning and surgical execution into dedicated teams, whilst specialized equipment such as the custom frame substantially improves efficiency and reproducibility. Given the anatomical complexity of equine joints and the precision demanded in load-bearing structures, CAOS integration into orthopedic practice warrants serious consideration, particularly for cases where traditional approaches may compromise surgical accuracy or recovery prospects.
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Practical Takeaways
- •CAOS with real-time imaging guidance enables precise placement of implants and removal of articular fragments in high-value anatomical locations, potentially improving surgical outcomes in complex cases where conventional techniques would be challenging.
- •Setup requires dedicated planning time, specialized equipment (navigation system, cone beam CT, purpose-built frame), and team training, but surgeons can readily adopt CAOS techniques once familiar with operational principles.
- •This technology expands your surgical capabilities for proximal limb, tarsal, and spinal procedures where traditional fluoroscopy or landmark-based techniques may be limiting.
Key Findings
- •Computer-assisted orthopedic surgery (CAOS) with cone beam CT navigation was successfully applied in 13 horses across diverse anatomical locations and pathologies between 2016-2019.
- •All 13 surgeries were performed successfully and according to preoperative plan, with applications including implant placement (10 cases), transarticular drilling for ankylosis (1 case), fragment removal (1 case), and curettage (1 case).
- •Purpose-built surgical frames improved workflow efficiency and precision in CAOS procedures, with authors recommending separate planning and execution teams to optimize time-efficiency.