Computer-assisted surgery for placing toggle constructs across the coxofemoral joints of small equids using a minimally invasive approach-A proof-of-concept cadaveric study.
Authors: Claeys Ines, Van der Vekens Elke, Kümmerle Jan, de Preux Mathieu, Koch Christoph
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Hip dysplasia and chronic coxofemoral instability present significant challenges in small equid orthopaedics, yet surgical options remain limited and often require joint luxation. Claeys and colleagues developed a minimally invasive, computer-assisted surgical technique for placing toggle constructs across the hip joint in donkeys, miniature horses and ponies, using cone-beam CT guidance to navigate 5.5 mm bone canals drilled through the femur and acetabulum. Across 18 cadaveric joints (nine specimens), the team achieved a median surgical accuracy deviation of 2.8 mm (range 0.4–8.0 mm) at the entry and exit points, with no articular cartilage damage observed during subsequent dissection, demonstrating that accurate implant placement is anatomically feasible without prior hip luxation. Whilst this proof-of-concept work is purely cadaveric, the technique offers potential as a stabilisation option for small equids with chronic hip disease and warrants progression to biomechanical testing and in vivo evaluation to determine optimal toggle construct design and positioning for load-bearing function. Practitioners managing small equids with degenerative hip conditions should monitor emerging research in this area, as successful validation could provide a less invasive alternative to current management strategies.
Read the full abstract on PubMed
Practical Takeaways
- •A minimally invasive option for hip stabilization in small equids may be feasible, avoiding extensive soft tissue damage associated with traditional approaches
- •Computer-assisted navigation provides submillimeter surgical guidance for accurate implant placement in complex joint anatomy
- •This proof-of-concept requires biomechanical testing and clinical validation before application in live animals with hip instability
Key Findings
- •Toggle constructs were successfully placed across coxofemoral joints in all 18 cadaveric joints (9 cadavers) using minimally invasive computer-assisted surgical technique
- •Median surgical accuracy aberration was 2.8 mm (range 0.4-8.0 mm) at measurement points on pre/post-operative CBCT scans
- •No articular cartilage damage was observed in any cadaveric specimens following the procedure
- •The technique achieved joint stabilization without requiring prior coxofemoral luxation, reducing surgical trauma