Treatment of a large osseous defect in a feline tarsus using a stem cell-seeded custom implant.

The aim of this study is to describe the treatment of an infected segmental bone defect in a cat using a novel, custom-designed titanium implant seeded with adipose-derived stem cells (AdMSCs) to facilitate osseous ingrowth and preserve limb function. Large bone defects occur secondary to trauma, infection, or neoplasia and often result in amputation. We established a novel autologous AdMSC-impregnated trabecular metal spacer made using 3D printing, to bridge the distal tibia and metatarsal bones in the left pelvic limb of a cat that had previously undergone right pelvic limb amputation. Six months postoperatively, there was radiographic evidence of bone growth and implant integration. A titanium spacer seeded with AdMSCs successfully encouraged bone ingrowth in a large defect site and successfully preserved limb function. However, further studies are needed to justify the use of differentiated stem cell impregnated mesh as a framework to bridge large bone defects.

Injuries involving the central tarsal bone in nonracing dogs: Short-term outcomes and prognostic factors.

OBJECTIVE: To describe traumatic injuries involving the central tarsal bone (Tc) in nonracing dogs. STUDY DESIGN: Retrospective multicenter study. ANIMALS: Thirty-two client-owned dogs. METHODS: Medical records from January 2010 to December 2016 were searched for dogs with Tc injury. Fracture classification, concurrent tarsal fractures, treatment, and perioperative management were tested for association with postoperative complications and short-term outcome. Outcome measures consisted of the latest lameness score reported in the record. RESULTS: The most common injuries consisted of type V fractures (22) and luxation of the Tc (8). Other injuries included 1 case each of type III and type IV fractures. Twenty-two concurrent fractures involved other tarsal bones. Complications were diagnosed in 18 (62.1%) dogs, consisting of 13 minor, 4 major, and 1 catastrophic complication. Lameness at final follow-up (median 7 weeks) in 28 dogs was scored as 0 of 5 in 14 (50.0%) dogs, 1 of 5 in 7 (25.0%) dogs, 2 of 5 in 4 (14.3%) dogs, 4 of 5 in 1 (3.5%) dogs, and 5 of 5 in 2 (7.1%) dogs. Major complications were associated with the presence of multiple tarsal fractures (risk ratio [RR] 3.94, 95% CI 0.80-19.37, P = .13), specifically when the calcaneus was involved (RR 5.78, 95% CI 1.53-21.88, P = .05). CONCLUSION: The most common diagnosis in this population of nonracing dogs consisted of type V Tc fractures. Fractures affecting other tarsal bones were common and were associated with a higher risk of major complications, especially those affecting the calcaneus. CLINICAL SIGNIFICANCE: Short-term outcomes seem favorable in nonracing dogs with isolated Tc fractures, but dogs with concomitant tarsal fractures are predisposed to major complications.

Biomechanical evaluation of 6 transarticular tibiotarsal immobilization methods in canine cadaveric limbs.

OBJECTIVE: To determine the effects of 6 types of transarticular immobilization techniques on tibiotarsal joint angles during stimulated weight bearing. STUDY DESIGN: Canine ex vivo biomechanical study. SAMPLE POPULATION: Canine cadaveric pelvic limbs (n = 15). METHODS: A validation study was conducted to determine tibiotarsal flexion before and after transection of the superficial digital flexor tendon in 5 canine cadaveric limbs without tibiotarsal joint immobilization. Six transarticular tibiotarsal immobilization techniques were tested sequentially in 10 canine cadaveric pelvic limbs. The tibiotarsal joint angles were measured from lateral projection radiographs before and during axial loading of 200 N. Mixed linear models were applied to determine the effects of the immobilization techniques on change in tibiotarsal joint angle under loading. RESULTS: There was no change of tibiotarsal joint angle between extended digits and flexed digits under both unloaded and loaded conditions. Change in tibiotarsal joint angles did not differ among any of the immobilization techniques tested here (mean change 1.36°, range 0-5). The main contributor to variance in angle explained by the final model was associated with the random effect for limb. CONCLUSION: Changes in tibiotarsal joint angles during single static loading in canine cadaveric limbs for the 6 immobilization techniques were minimal. CLINICAL SIGNIFICANCE: The 6 techniques appear equally effective at limiting tibiotarsal joint flexion during single axial loading of 200 N. Cyclic mechanical testing of these techniques is recommended to support our findings and validate their clinical application.

Repair of a Tibiotarsal Fracture in a Pomeranian Goose ( Anser anser) With a Locking Plate.

A 2-year-old Pomeranian goose ( Anser anser) weighing 8.1 kg was examined because of non-weight-bearing lameness of the right limb. A closed, transverse, diaphyseal fracture of the distal third of the right tibiotarsus with a craniolateral displacement of the distal fragment was diagnosed radiographically. Surgery under general anesthesia was performed to repair the fracture with a 14-hole, 2.7-mm locking plate fixed with 6 screws in a bicortical manner. Two days later, the bird was fully weight-bearing on the leg. Radiographs performed 4 and 8 weeks after surgery showed good healing of the affected bone with an appropriate callus formation bridging the fracture line. Sixteen weeks after surgery, the patient was readmitted because of lameness exhibited while staying outside exposed to subzero (°C) temperatures. On the basis of this finding, heat conduction was postulated as the possible cause of lameness because it disappeared after implant removal. To the best our knowledge, this case represents the first report of a surgical repair of a tibiotarsal fracture with a locking plate in waterfowl.

Pantarsal arthrodesis in cats using orthogonal plating.

Case series summary Pantarsal arthrodesis (PTA) was performed in seven tarsi of six cats, using orthogonal (dorsal and medial) veterinary cuttable plates (VCPs) without postoperative external coaptation. Short-term outcomes, arthrodesis progression and complications were assessed using a retrospective review of case notes (veterinary examination) and radiographs. Long-term outcomes were assessed via owner questionnaire (Feline Musculoskeletal Pain Index [FMPI]). Mean angle of PTA was 136° (range 116-166°). Intraoperative complications were recorded in two cases, both involving failure of the drill bit during drilling for calcaneotibial screws. Postoperative complications were encountered in a case of bilateral single-session PTA. These included gastrocnemius myotendinopathy on the right, and long-term protrusion of a screw head from the skin on the left. Both complications were resolved surgically, through resection of the implicated gastrocnemius tendon of insertion and removal of the plate, respectively. FMPI assessment was performed for all six cats a mean of 8.8 months (range 6-16 months) following surgery. Mean score for the first part (assessing ability to perform normal activities) was 92.2% (range 80.9-97.1%). Mean score for the second part (owner perception of pain) was 95.8% (range 87.5-100%). Mean overall score (mean score for parts 1 and 2 combined) was 92.3% (range 81.6-97.4%). PTA may be performed in cats using orthogonal VCPs to treat severe tarsal injuries. It may be prudent to avoid single-session bilateral PTA in cats. Relevance and novel information This case series documents a novel technique as an alternative for PTA in cats with talocrural injuries. Long-term outcome and complications presented in this case series are evaluated and discussed.

Angular Limb Deformities: Growth Retardation.

Angular limb deformities are common in foals; however, the importance of the deformity and if treatment is required depend on the degree of deformity relative to normal conformation for stage of growth, the breed and discipline expectations, age, and response to conservative therapies. This article addresses the importance of the foal conformation examination to determine which foals need surgical intervention to correct an angular deformity and when. Techniques for surgical growth retardation include the transphyseal staple, screw and wire transphyseal bridge, and transphyseal screw. Appropriate timing for intervention for each location and complications associated with each procedure are discussed.

Arthroscopic approach and intra-articular anatomy of the dorsal and plantar synovial compartments of the bovine tarsocrural joint.

OBJECTIVE: To determine arthroscopic approaches to the dorsal and plantar synovial compartments of the tarsocrural joint in adult cattle, and to describe the arthroscopic intra-articular anatomy from each approach. STUDY DESIGN: Ex vivo study. ANIMALS: Fresh adult bovine cadavers (n = 7). METHODS: Two tarsocrural joint were injected with latex to determine arthroscopic portal locations and arthroscopy of the tarsocrural joint of 12 tarsi was performed. The dorsolateral approach was made through the large pouch located between the long digital extensor and peroneus longus tendons. The dorsomedial approach was made just medial to the common synovial sheath of the tibialis cranialis, peroneus tertius, and long digital extensor tendons. The plantarolateral and plantaromedial approaches were made lateral and medial to the tarsal tendon sheath, respectively. RESULTS: Each approach allowed visualization of the distal tibia articulating with the proximal trochlea of the talus. Consistently observed structures included the distal intermediate ridge of the tibia, and the medial and lateral trochlear ridges and trochlear groove of the talus. Lateral and medial malleoli were best assessed from dorsal approaches. From the lateral approaches evaluation of the abaxial surface of the lateral trochlear ridge allowed visualization of the fibulocalcaneal joint. From the plantar approaches additional observed structures included the coracoid process of the calcaneus, plantar trochlea of the talus, and plantar talotibial and talofibular ligaments. CONCLUSION: In cattle, the dorsolateral and plantarolateral approaches allowed for the best evaluation of the dorsal and plantar aspects of the tarsocrural joint, respectively.

Slab fractures of the third tarsal bone: Minimally invasive repair using a single 3.5 mm cortex screw placed in lag fashion in 17 Thoroughbred racehorses.

REASONS FOR PERFORMING THE STUDY: A technique for minimally invasive repair of slab fractures of the third tarsal bone has not previously been reported. Results of third tarsal bone slab fracture repair in Thoroughbred racehorses are lacking. OBJECTIVES: To report the outcomes of repair of uniplanar frontal slab factures of the third tarsal bone using a single 3.5 mm cortex screw in lag fashion. STUDY DESIGN: Retrospective case series. METHODS: Case records of horses that had undergone this procedure were reviewed. RESULTS: Seventeen horses underwent surgery. Eighteen percent of cases had wedge shaped third tarsal bones. A point midway between the long and lateral digital extensor tendons and centrodistal and tarsometatarsal joints created a suitable entry site for implants. The fracture location, configuration and curvature of the third tarsal bone and associated joints requires a dorsolateral proximal-plantaromedial distal trajectory for the screw, which was determined by preplaced needles. There were no complications and fractures healed in all cases at 4-6 months post surgery. Seventy-nine percent of horses returned to racing and, at the time of reporting, 3 are in post operative rehabilitation programmes. CONCLUSION: The technique reported provides a safe, appropriate and repeatable means of repairing slab fractures of the third tarsal bone. Surgical repair is a viable alternative to conservative management.

In vitro biomechanical evaluation of four surgical techniques for fusion of equine centrodistal and tarsometatarsal joints.

OBJECTIVE To evaluate the biomechanical properties of 4 methods for fusion of the centrodistal and tarsometatarsal joints in horses and compare them among each other and with control tarsi. SAMPLE 24 sets of paired tarsi without substantial signs of osteoarthritis harvested from equine cadavers. PROCEDURES Test constructs (n = 6/type) were prepared from 1 tarsus from each pair to represent surgical drilling; 2 medially to laterally placed kerf-cut cylinders (MLKCs); a single large, dorsally applied kerf-cut cylinder (DKC); and a dorsomedially applied locking compression plate (DMLCP). Constructs and their contralateral control tarsi were evaluated in 4-point bending in the dorsoplantar, lateromedial, and mediolateral directions; internal and external rotation; and axial compression. Bending, torsional, and axial stiffness values were calculated. RESULTS Mean stiffness values were consistently lower for surgical drilling constructs than for contralateral control tarsi. Over all biomechanical testing, surgical drilling significantly reduced joint stability. The MLKC constructs had superior biomechanical properties to those of control tarsi for 4-point bending but inferior properties for external and internal rotation. The DMLCP and DKC constructs were superior to control tarsi in dorsoplantar, rotational, and axial compression directions only; DMLCP constructs had no superior stiffness in lateromedial or mediolateral directions. Only the DKC constructs had greater stiffness in the mediolateral direction than did control tarsi. Over all biomechanical testing, DMLCP and DKC constructs were superior to the other constructs. CONCLUSIONS AND CLINICAL RELEVANCE These biomechanical results suggested that a surgical drilling approach to joint fusion may reduce tarsal stability in horses without clinical osteoarthritis, compared with stability with no intervention, whereas the DMLCP and DKC approaches may significantly enhance stability.

Augmentation of arthrodesis in dogs using a free autogenous omental graft.

A technique for using free autogenous omental grafting with arthrodesis in dogs is described and radiographic osseous union and complications after surgery are evaluated. This retrospective study matched body weight and procedure type for 8 cases of pancarpal arthrodesis, 4 cases of pantarsal arthrodesis, and 2 cases of partial tarsal arthrodesis in dogs with omental and cancellous bone autograft (OBG group) and with cancellous bone autograft alone (BG group). Radiographs were reviewed 9 to 12 weeks after surgery to compare scores of radiographic osseous union and it was found that the OBG group had higher scores than the BG group. The BG group had significantly more major complications that required re-operation for implant removal or treatment of a deep infection compared to the OBG group. Overall, free autogenous omental grafts may be used to augment arthrodesis in dogs without significant morbidity and further investigation of its use to reduce major complications and speed bone healing are warranted.

Augmentation de l'arthrodèse chez les chiens en utilisant une greffe omentale autogène libre. Cette étude décrit une technique de l'utilisation d'une greffe omentale autogène avec une arthrodèse chez les chiens et elle évalue l'union osseuse radiographique et les complications après la chirurgie. L'étude rétrospective a jumelé le poids corporel et le type d'intervention pour 8 cas d'arthrodèse pancarpienne, 4 cas d'arthrodèse pantarsienne et 2 cas d'arthrodèse partielle du tarse chez des chiens avec une autogreffe de l'os spongieux (groupe OBG) et avec une autogreffe de l'os spongieux seulement (groupe BG). On a évalué les radiographies de 9 à 12 semaines après la chirurgie pour comparer les notes d'union osseuse radiographique et on a constaté que le groupe OBG avait des notes supérieures à celles du groupe BG. Il s'est produit un nombre significativement supérieur de complications majeures dans le groupe BG qui ont exigé une nouvelle opération pour l'enlèvement de l'implant ou le traitement d'une infection profonde comparativement au groupe OBG. En général, les greffes omentales autogènes libres peuvent être utilisées pour augmenter l'arthrodèse chez les chiens sans morbidité significative et de nouvelles études de leur utilisation pour réduire les complications majeures et accélérer la guérison osseuse sont justifiées.(Traduit par Isabelle Vallières).

Multiple tarsal luxations in 2 Holstein heifers.

Two Holstein heifers were referred for non-weight bearing lameness. The physical examination and radiographic findings were diagnostic of tarsal luxation. Treatment and outcome are reported. A closed reduction was successfully performed in 1 heifer. The second animal was euthanized after attempts to reduce and stabilize the joint.

Luxations multiples du tarse chez 2 taures Holstein. Deux taures Holstein ont été référées pour boiterie de non-appuie. L'examen physique et les radiographies étaient diagnostiques d'une luxation du tarse. Les traitements et pronostic sont décrits. Une réduction fermée a été possible sur une taure et l'autre a été euthanasiée après l'échec de la réduction.(Traduit par les auteurs).

Surgical correction of a bilateral congenital tarsal hyperextension deformity in a cat.

CASE DESCRIPTION: An approximately three-month-old, 0.45 kg female Domestic Shorthaired kitten with stiff hyperextended hindlimbs distal to the talo-central joint is reported. Attempts at repositioning of the joints by flexion failed while increased manipulative forces caused signs of pain and vocalization. Orthogonal radiographic views revealed a significant malarticulation of the tarsus. Goniometric measurments revealed a 145° extensor and 95° internal torsional deformity. TREATMENT AND OUTCOME: Pantarsal arthrodesis with a transarticular external fixation system was performed for both limbs in two separate stages. Pre-assembled frames were composed of two 40 mm diameter half rings (on the medial side) and two 40 mm diameter full rings connected with two pre-contoured (125° flexion) rods from proximal to distal. Following transection of the superficial and deep digital flexor tendons, cartilage was removed from the articular surfaces, autologous cancellous bone graft was inserted, and joints were fixed in 125° flexion with pre-contured external frames. The cat commenced weight-bearing bilaterally immediately postoperatively. Frames were removed 32 and 27 days after application. Two months after frame removal, joint fusion was confirmed and full weight-bearing at the walk and run was achieved. CLINICAL RELEVANCE: To our knowledge, this is the first report of surgical correction of a bilateral congenital tarsal hyperextension deformity by pantarsal arthrodesis using a transarticular external fixation system.

Short- and long-term racing performance of Standardbred pacers and trotters after early surgical intervention for tarsal osteochondrosis.

REASONS FOR PERFORMING STUDY: Osteochondrosis (OC) is commonly diagnosed in young Standardbred racehorses but its effect on performance when surgically treated at a young age is still incompletely understood. This is especially true for Standardbred pacers, which are underrepresented in the existing literature. OBJECTIVE: To characterise the short- (2-year-old) and long-term (through 5-year-old) racing performance in Standardbred pacers and trotters after early surgical intervention (<17 months of age) for tarsal OC. STUDY DESIGN: Retrospective clinical study. METHODS: The study population consisted of related, age-matched Standardbred racehorses (n = 278; 151 pacers, 127 trotters) with (n = 133) or without (n = 145) one or more tarsal OC lesions. All OC-affected horses were treated surgically prior to being sold as yearlings. Data obtained from publicly available race records for each horse included starts, wins, finishes in the top 3 (win, place or show), earnings and fastest time. Comparisons between OC-affected and unaffected horses were made for the entire population and within gaits. A smaller related population (n = 94) had these performance measures evaluated for their 2-5-year-old racing seasons. RESULTS: Osteochondrosis status was associated with few performance measures. Trotters were at higher risk for lesions of the medial malleolus but lower risk for lesions of the distal intermediate ridge of the tibia than were pacers. Horses with bilateral OC lesions and lateral trochlear ridge (LTR) lesions started fewer races at 2 years of age than those with unilateral lesions or without LTR lesions. CONCLUSIONS: Osteochondrosis seemed to have minimal effect on racing performance in this cohort, although horses with bilateral and LTR lesions started fewer races at 2 years. There was evidence for different distribution of OC lesions among pacers and trotters, which should be explored further. Standardbreds undergoing early removal of tarsal OC lesions can be expected to perform equivalently to their unaffected counterparts.

Computed tomography assisted determination of optimal insertion points and bone corridors for transverse implant placement in the feline tarsus and metatarsus.

OBJECTIVE: Describe optimal corridors for mediolateral or lateromedial implant placement in the feline tarsus and base of the metatarsus. METHODS: Computed tomographic images of 20 cadaveric tarsi were used to define optimal talocalcaneal, centroquartal, distal tarsal, and metatarsal corridors characterized by medial and lateral insertion points (IP), mean height, width, length and optimal dorsomedial-plantarolateral implantation angle (OIA). RESULTS: Talocalcaneal level: The IP were at the head of the talus and plantar to the peroneal tubercle of the calcaneus and OIA was 22.7° ± 0.3. Centroquartal level: The IP were at the centre of the medial surface of the central tarsal bone and dorsoproximal to the tuberosity of the fourth tarsal bone and OIA was 5.9° ± 0.06. Distal tarsal level: The IP were at the centre of the medial surface of the tarsal bone II and dorsodistal to the tuberosity of the fourth tarsal bone and OIA was 5.4° ± 0.14. Metatarsal level: The IP were at the dorsomedial surface of the proximal end of the metatarsal bone II and at the dorsolateral surface of metatarsal bone V and OIA was 0.5° ± 0.06. Significant positive correlation was found between body weight and the length of each corridor. CLINICAL SIGNIFICANCE: Most of the corridors obtained in this study had a diameter between 1.5 mm and 2 mm with a length of 15 mm to 18 mm, which stresses the importance of their accurate placement.

Plate fixation for management of plantar instability of the distal tarsus/proximal metatarsus in 5 horses.

OBJECTIVE: To report plate fixation for management of traumatic injuries resulting in plantar instability of the proximal intertarsal (PIT) and tarsometatarsal (TMT) joints. STUDY DESIGN: Case series. MATERIALS AND METHODS: Medical records (October 1988 to August 2007) of horses that had internal fixation of the distal aspect of the tarsus were reviewed. Horses that had a broad dynamic compression plate (DCP) or broad locking compression plate (LCP) applied on the plantar-lateral aspect of the tarsus extending from the proximal calcaneus to the proximal one third of the metatarsus were included. Signalment, clinical signs, radiographic findings, time to surgery, implant type, postoperative management and complications were recorded. Long-term (>1 year) outcome was obtained for 4 horses. RESULTS: Five horses were treated, 4 had DCP fixation and 1 had LCP fixation. Subluxation of the proximal intertarsal joint was treated in 3 horses and 2 horses had fractures of the distal tarsal bones or proximal aspect of the metatarsus. Perioperative complications included peroneus tertius rupture (2 horses) and postoperative infection.(1) Four horses were discharged and 1 year after surgery were considered sound at pasture; 3 horses were sound enough for limited riding. CONCLUSIONS: Plate fixation provides adequate strength and stability for successful management of injuries that result in plantar instability of the tarsus and proximal metatarsus.

Surgical treatment of distal tarsal joint luxations in three horses.

The clinical signs, radiographic findings, surgical treatment, and outcome of three horses with luxation of the distal tarsal joints are reported. Two patients showed luxations of the tarsometatarsal joint whereas luxation of the proximal intertarsal joint was found in one case. Open reduction, followed by internal fixation was performed in two horses and closed reduction with a transfixation pin cast was performed in the third. The treatment in all three cases resulted in a satisfactory clinical outcome.

Feline pantarsal arthrodesis using pre-contoured dorsal plates applied according to the principles of percutaneous plate arthrodesis.

OBJECTIVE: To describe the surgical technique for pantarsal arthrodesis (PTA) in cats according to the principles of percutaneous plate arthrodesis with application of a pre-contoured dorsal plate, without external coaptation and to report the long-term clinical outcome. MATERIALS AND METHODS: Retrospective review was performed of all cats treated by percutaneous plate application using a new pre-contoured dorsal plate for PTA between 2008 and 2011. Inclusion criteria were clinical and radiographic records plus clinical follow-up to at least six weeks. Data recorded included signalment, indication for surgery, postoperative care, and complications encountered. Radiographs were assessed for arthrodesis progression and complications. Outcome was assessed using an owner questionnaire. RESULTS: Eleven cats were treated for tarsal injuries and met the inclusion criteria. Mean age was 86 ± 45 months, weight 4.50 ± 0.92 kg. The only major short-term complication encountered was wound dehiscence requiring sedation and re-suturing. In the medium-term (23.3 months ± 11.6 months) eight out of nine cats returned to normal activity and one cat showed intermittent lameness. Long-term (34.3 months ±17.5 months) radiographic evaluation was performed in seven out of nine cats; six manifested complete arthrodesis and one sustained plate breakage. Based on owner questionnaire, all nine cats returned to normal activity in the long-term, even the case with plate breakage. CONCLUSION: Based on our results, PTA using a custom pre-contoured dorsal plate is a suitable salvage surgery for treatment of severe tarsal injuries in cats.

Successful wound healing over exposed metal implants using vacuum-assisted wound closure in a dog.

An eight-month-old Labrador retriever was presented with a grade IIIb open shearing injury of the left tarsus. Acute severe surgical site infection developed 2 days after pan-tarsal arthrodesis, resulting in wound dehiscence. Vacuum-assisted wound therapy was carried out for 12 days to treat an extensive full-thickness soft tissue defect with exposure of metal implants. New granulation tissue formation covering most of the defect was achieved by day 10 of this therapy. Epithelialization was achieved by second intention healing with open wound management. To the authors' knowledge, this is the first veterinary clinical case report documenting complete healing over exposed metal implants without any requirement for surgical revision.

Arthroscopically accessible anatomy of the tarsal collateral ligaments in the horse.

OBJECTIVE: To describe the arthroscopically accessible anatomy of the tarsal collateral ligaments in the horse. STUDY DESIGN: Descriptive study. ANIMALS: Cadaveric equine hind limbs (n = 24) obtained from horses without tarsal disease. METHODS: Two pairs of tarsal joints were used to obtain silicone models of the tarsocrural joint and dissect the tarsal collateral ligaments (CLs). Ten pairs of tarsocrural joints had arthroscopic exploration and the accessible parts of the tarsal CLs were marked with an arthroscopic hook knife. Subsequently, the limbs were dissected and the marked positions were allocated to the specific parts of the CLs. RESULTS: Ipsilateral arthroscope and instrument portals were used in each pouch of the tarsocrural joint. Via the plantaromedial pouch, the superficial (2/20 limbs), middle (7), deep (6) or both middle and deep (3) short medial CL and the long medial CL (14) were reached. Access via the plantarolateral pouch allowed manipulation of the deep short lateral CL (20/20 limbs) and the long lateral CL (20). Dorsally, arthroscopy via the dorsomedial pouch gave access to the deep short medial CL (20/20 limbs), while the superficial (9) or middle (10) or both superficial and middle (1) short lateral CL could be reached via the dorsolateral joint recess. CONCLUSIONS: Limited parts of the tarsal CLs can be observed or manipulated arthroscopically in normal equine tarsocrural joints.

Soft tissue injuries of the tarsocrural joint: a retrospective analysis of 30 cases evaluated arthroscopically.

REASONS FOR PERFORMING THE STUDY: Intra-articular soft tissue injuries of the equine tarsocrural joint have been poorly defined. METHODS: All horses that underwent arthroscopic surgery of a tarsocrural joint over a 10 year period were identified. Those with primary intra-articular soft tissue injuries were selected for inclusion and the cases evaluated retrospectively. RESULTS: Two hundred and eighty-one horses underwent tarsocrural joint arthroscopy during the study period, 30 of which met the inclusion criteria (30 joints). A combination of soft tissue lesions was more common than injury to a single structure. Injuries involved the joint capsule (n = 25), collateral ligaments (n = 20), dorsal plica (n = 8) and open communication between the tarsocrural joint and extensor bundle (n = 7). Following arthroscopic surgery and rehabilitation, 81% of horses were able to return to their previous function. CONCLUSION: Intra-articular soft tissue injuries of the tarsocrural joint may be associated with localising clinical signs of inflammation. This series represented 11% of the total number of arthroscopic procedures undertaken on that joint in a single referral hospital. Arthroscopic surgery allows accurate definition of the injuries and facilitates lesion management. Case outcome following arthroscopic debridement and a subsequent period of rehabilitation is favourable. POTENTIAL RELEVANCE: In lame horses with clinical signs localised to the tarsocrural joint, disrupted intra-articular soft tissues should be considered in the list of differential diagnoses. Attending clinicians should consider arthroscopic evaluation in cases where primary intra-articular soft tissue injuries are suspected to be causative.