Comparison of intra‐articular drilling and diode laser treatment for arthrodesis of the distal tarsal joints in normal horses

Abstract

Summary Reasons for performing study: Anecdotal reports suggest that laser‐facilitated arthrodesis of the distal tarsal joints improves the prognosis compared with intra‐articular drilling but no objective comparisons have been performed. Objectives: To evaluate intra‐articular drilling and laser‐facilitated arthrodesis using in situ and in vivo techniques. Methods: Fourteen cadaver limbs were evaluated in situ for chondrocyte viability after both surgical techniques. In vivo, one randomly selected limb was subjected to laser‐facilitated arthrodesis and the other underwent intra‐articular drilling in 6 normal horses. Clinical examinations were performed at 1, 3 and 5 months. Two horses were subjected to euthanasia at 1, 3 and 5 months. Results: Significantly more chondrocyte death was observed with laser‐facilitated arthrodesis compared to drilling, but the overall degree suggested only a focal effect. In vivo, both groups demonstrated minimal post operative morbidity. There was more evidence of arthrodesis seen at all time points with intra‐articular drilling. Conclusions: This study demonstrated that changes associated with ultimate arthrodesis occur earlier after intra‐articular drilling of the distal tarsal joints than laser‐facilitated arthrodesis, although clinically affected horses may respond differently. Potential relevance: Intra‐articular drilling may provide earlier arthrodesis of the distal tarsal joints, but not necessarily a better long‐term result.

Tiludronate infusion in the treatment of bone spavin: A double blind placebo‐controlled trial

“…1988), screws and/or a ‘T’‐plate (Wyn‐Jones and May 1986; Auer 1992). Arthrodesis with diode laser has also been described (Scruton et al . 2005).…”

“…Other treatments include a variety of methods to arthrodese the joints such as drilling to remove cartilage (Adams 1970;Edwards 1982), drilling combined with implants such as stainless steel transfixion pins (Mackay and Liddell 1972), stainless steel baskets containing autogenous cancellous bone grafts (Archer et al 1988), screws and/or a 'T'-plate (Wyn-Jones and May 1986;Auer 1992). Arthrodesis with diode laser has also been described (Scruton et al 2005). Other techniques include subchondral fenestration to relieve the increased pressure in the distal tarsal bones (Sonnichsen and Svalastoga 1985) and partial neurectomy of the tibial and neurectomy of deep peroneal nerves (Imschoot et al 1995).…”

A Technique for Laser-Facilitated Equine Pastern Arthrodesis Using Parallel Screws Inserted in Lag Fashion

“…Previous experimental studies on the use of a laser for facilitated ankylosis of the distal tarsal joints have confirmed some degree of cartilage destruction post lasing, though neither experimental study confirmed solid bony fusion 12,21 . Without a nonlased control group in a prospective randomized clinical trial, it is impossible to know to what degree the laser‐induced loss of remaining articular cartilage.…”

Assessment of Low‐cost Teleradiology for Grading Elbow Dysplasia

“…Radiographic scales can be either qualitative or quantitative. A quantitative scale attributes a numeric score to radiographic abnormalities according to their perceived severity 13 . In a study of equine distal limb arthrodesis, a dichotomous rating scale was proposed according to the presence of radiographic changes 14 .…”

“…A quantitative scale attributes a numeric score to radiographic abnormalities according to their perceived severity. 13 In a study of equine distal limb arthrodesis, a dichotomous rating scale was proposed according to the presence of radiographic changes. 14 When assessing an ab-normal radiographic sign in terms of presence or absence of the lesion, there is a very high accuracy and agreement between observers.…”