Clinical use of computer‐assisted orthopedic surgery in horses

Abstract

ObjectiveTo describe clinical applications of computer‐assisted orthopedic surgery (CAOS) in horses with a navigation system coupled with a cone beam computed tomography unit.Study designRetrospective clinical case series.AnimalsThirteen adult horses surgically treated with CAOS.MethodsMedical records were searched for horses that underwent CAOS between 2016 and 2019. Data retrieved included signalment, diagnosis, lameness grade prior to surgery, surgical technique and complications, anesthesia and surgery time, and information pertaining to the perioperative case management and outcome.ResultsIn 10 cases, surgical implants were placed in the proximal phalanx, third metatarsal bone, ulna, or medial femoral condyle. In one case, navigated transarticular drilling was performed to promote ankylosis of the distal tarsal joints. In another case, an articular fragment of the middle phalanx was removed with the help of CAOS guidance. In the final case, a focal osteolytic lesion of the calcaneal tuber was curetted with the aid of CAOS. In seven cases, a purpose‐built frame was used for the surgical procedure. All surgeries were performed successfully and according to the preoperative plan.ConclusionComputer‐assisted orthopedic surgery can be an integral part of the clinical case management in equine surgery. To optimize workflow and time‐efficiency, the authors recommend designating one team for operative planning and another for the execution of the surgical plan. Specialized equipment, such as the purpose‐built frame, will further improve CAOS applications in equine surgery.Clinical significanceAfter they have become familiar with the operational principles, equine surgeons can readily apply CAOS for a broad spectrum of indications.

Feasibility, indications, and radiographically confirmed diagnoses of standing extremity cone beam computed tomography in the horse

“…It is surprisingly well tolerated by the horses, likely because of speed of acquisition, low noise, and lack of movement of the gantry. It is used even more frequently for the imaging of head and neck in standing sedated horses and also for intraoperative purposes 21 …”

“…It is used even more frequently for the imaging of head and neck in standing sedated horses and also for intraoperative purposes. 21 This retrospective study is based on imaging findings in clinical horses, so the findings could not be correlated with pathologic or histologic examinations, and they are not validated by a gold standard. The fact that one study group was based on suspected diagnosis may have induced a bias, and the results may also have been affected by the fact that the acquisitions were not evaluated in a blinded manner.…”

Influence of a purpose‐built frame on the accuracy of computer‐assisted orthopedic surgery of equine extremities

“…These features make it an ideal tool for CAOS applications in horses. The authors have gained considerable first hand expertise with this technology at their veterinary teaching hospital 16 . The manufacturer of the surgical navigation system used in the present study demonstrated a positional accuracy with a mean error ≤ 2 mm 17 .…”

Highlights of recent clinically relevant papers

“…In this retrospective study Mathieu de Preux and colleagues in Switzerland described clinical applications of computer‐ assisted orthopaedic surgery (CAOS) in horses with a navigation system coupled with a cone beam computed tomography unit.…”