Standing myotomy to treat fibrotic myopathy: 22 cases (2004–2016)

Abstract

Objective: To report the clinical and diagnostic findings associated with fibrotic myopathy, describe the surgical procedure for standing fibrotic myotomy and report postoperative outcomes. Study design: Retrospective study. Sample population: Twenty-two horses. Methods: Records were included if a clinical diagnosis of fibrotic myopathy was based on clinical and/or ultrasonographic examination and the horse was treated with myotomy of the affected muscle. Records were reviewed for signalment, preoperative findings, perioperative complications, and outcomes. Follow-up also included a phone survey of owners. Results: Quarter horses represented 14 of 22 horses in this study. Ultrasonographic examination was performed in 14 of 22 horses. The semitendinosus muscle was affected in 17 of 22 horses. Other muscles affected included the semimembranosus, gracilis, and biceps femoris. Four of the 22 horses had a diagnosis of incisional postoperative complications. Eight of 12 formerly athletic horses returned to their intended athletic use. Ten of 16 owners were satisfied with the procedure. Conclusion: Prognosis for long-term comfort after standing fibrotic myotomy was fair with appropriate rehabilitation. Ultrasonographic examination was helpful in identifying the muscles affected and aided in surgical planning. Clinical impact: Standing fibrotic myotomy is a technically straightforward procedure that yields a fair outcome in horses with minimal intraoperative and/or postoperative complications.

Minimally invasive tenotomy of the tibial insertion of the semitendinosus muscle: An ex vivo study in horses

“…3,[6][7][8] Alternative treatments include standing laser fibrotomy, myotomy of the affected muscle, and semitendinosus myotenectomy. 1,8,9 Intraoperative ultrasonographic guidance offers multiple advantages to the surgeon, including identification of relevant anatomical structures and avoidance of iatrogenic damage to these structures. 10 Although other minimally invasive ultrasound-guided techniques for tenotomies have been described in the veterinary literature, including tenotomy of the deep digital flexor tendon or annular ligament desmotomy, 11,12 minimally invasive semitendinosus tenotomy has not been described previously in horses.…”

“…However, researchers in several studies have demonstrated contradictory results in terms of outcomes using the technique in horses with only the semitendinosus muscle affected compared with horses in which the gracilis and/or semimembranosus muscles were also involved 3,6‐8 . Alternative treatments include standing laser fibrotomy, myotomy of the affected muscle, and semitendinosus myotenectomy 1,8,9 …”