Outcomes of diode laser-facilitated ankylosis of the distal tarsal joints in horses: A retrospective study of 64 cases.
Authors: Sanchez-Arjona Rodrigo, Lopez Cruz Carla, Hague Brent A, Jayawickrama Judith, Kamm J Lacy
Journal: Veterinary surgery : VS
Summary
# Diode Laser-Facilitated Ankylosis for Distal Tarsal Osteoarthritis in Horses Distal tarsal osteoarthritis remains a significant cause of lameness in performance horses, and surgical ankylosis—deliberately fusing the affected joints—offers a potential solution to eliminate pain and restore function. Researchers retrospectively reviewed 64 horses treated with diode laser-facilitated ankylosis between 2011 and 2021, comparing three surgical approaches: laser alone (L), laser with periarticular drilling (L+D), and laser with cuboidal bone fenestration (L+F), with a fourth cohort requiring second procedures. At a median 5-year follow-up, 83% of horses showed lameness improvement, and 64% returned to their previous level of athleticism; notably, male horses were 4.25 times more likely to achieve full athletic return than females. The L+F technique yielded competitive outcomes (66.7% return to athleticism) whilst requiring no additional surgical intervention, compared to 20.8% reintervention rates in the laser-only group, suggesting that incorporating bone fenestration may enhance joint ankylosis and reduce revision surgery risk. For practitioners managing tarsal lameness, these findings indicate that diode laser-facilitated ankylosis—particularly when combined with cuboidal fenestration—represents a viable less-invasive option to traditional surgical approaches, though sex-based prognostic differences warrant further investigation to optimise case selection and client counselling.
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Practical Takeaways
- •DLF ankylosis is a reliable less-invasive option for distal tarsal OA with good long-term outcomes (83% improved, 64% back to work at 5+ years)
- •Adding cuboidal bone fenestration to laser treatment reduces reintervention rates while maintaining athletic outcomes—consider this technique to minimize repeat surgery
- •Set realistic expectations based on sex: male horses have better return-to-sport outcomes than females with this procedure
Key Findings
- •83% of horses showed improvement in lameness following diode laser-facilitated ankylosis, with 64% returning to previous athletic level at median 5-year follow-up
- •Laser with cuboidal bone fenestration (L+F) and laser alone (L) achieved 66.7% and 67.9% return to athleticism respectively, versus 50% for laser with periarticular drilling (L+D)
- •Laser with cuboidal bone fenestration and periarticular drilling required 0% reintervention rate compared to 20.8% for laser alone
- •Male horses were significantly more likely to return to athleticism than females (OR: 4.25, p=0.03)