Arthrodesis of the equine centrodistal and tarsometatarsal joints using a single modified kerf-cut cylinder

Biedrzycki AH, Grant BD, Nemke B, Markel MD, Morello SL. Vet Comp Orthop Traumatol. 2016 May 18; 29 (3): 227-31.

OBJECTIVES: To describe a technique for surgical placement of a modified kerf-cut cylinder for the purpose of arthrodesis across the equine centrodistal and tarsometatarsal joints.

METHODS: Each horse (n = 4) underwent unilateral placement of a single kerf-cut cylinder spanning the centrodistal and tarsometatarsal joints with the placement of an autologous cancellous bone graft. Horses were evaluated via lameness examination and radiography postoperatively and euthanatization of each horse was performed at four different time points up to 12 weeks post-surgery to evaluate for lameness, implant stability and success with integration in the surrounding bone.

RESULTS: Implants were placed successfully in three of four horses. In one horse, due to technical error, the implant was misaligned with the joint spaces. Although the horse exhibited minimal pain, it was euthanatized at the two week follow-up. Implant placement in the remaining three horses was successfully achieved. At eight weeks, radiographically there was evidence of osseous union across the joint spaces. No change in lameness was detected at any point after surgery. At 12 weeks post-surgery, histologically the implants were filled with mineralized osteoid and demonstrated integration with the surrounding tissue.

CLINICAL SIGNIFICANCE: The surgical approach and placement of modified kerf-cut cylinders for arthrodesis of the centrodistal and tarsometatarsal joints were successfully achieved with minimal signs of postoperative pain and a short rehabilitation time period in normal horses.