Arthroscopic removal of dorsoproximal chip fractures of the proximal phalanx in standing horses

OBJECTIVE: To report a technique for, and outcome after, arthroscopic removal of dorsoproximal chip fractures of a proximal phalanx in standing horses. STUDY DESIGN: Retrospective study. ANIMALS OR SAMPLE POPULATION: A total of 104 horses, 1 to 13 years of age, with a dorsoproximal chip fracture of a proximal phalanx. METHODS: Horses were restrained in standing stocks and sedated with intravenous xylazine, detomidine, or a combination of both drugs. Local analgesia was achieved with 2% mepivacaine administered intra-articularly and by subcutaneous infiltration in a crescent-shaped block dorsal to the fetlock. Sterile drapes were placed on the surgical field, and impervious drapes were used on the hoof and floor. Arthroscopic portals were created in the dorsal pouch of the metacarpophalangeal or metatarsophalangeal joints to remove chip fractures. Statistical analysis was performed on race records for all Thoroughbred racehorses and compared with previously published studies. Operative and hospitalization times were compared with those of the general hospital population, and risks associated with general anesthesia were examined. RESULTS: No major operative or postoperative complications occurred. Ninety-one percent of racehorses raced after surgery with 78% returning to race at the same or higher level. CONCLUSION: Standing arthroscopic surgery can be performed successfully to remove dorsoproximal chip fractures of the proximal phalanx. CLINICAL RELEVANCE: Standing arthroscopic surgery is a valid alternative treatment for experienced surgeons to avoid the expense and potential risks associated with general anesthesia.     

Racing performance after arthroscopic removal of apical sesamoid fracture fragments in Thoroughbred horses age < 2 years: 151 cases (1989--2002)

REASONS FOR PERFORMING STUDY: Studies on arthroscopic removal of apical proximal sesamoid fracture fragments in Thoroughbred (TB) horses age > or = 2 years have reported a high success rate. However, there are no reports documenting the racing prognosis of TB horses that undergo such surgery as weanlings or yearlings. OBJECTIVES: To describe the incidence of apical proximal sesamoid fractures in immature TB horses, age < 2 years and determine probability and quality of racing performance after arthroscopic removal of such fractures in 151 TB weanlings and yearlings. METHODS: The medical records of TB horses age < 2 years that underwent arthroscopic surgery for removal of apical proximal sesamoid fracture fragments were reviewed. Follow-up information was obtained from race records. Student's t tests were used to compare performance variables of operated racehorses to that of their maternal siblings. RESULTS: Ninety-two percent (139/151) of fractures occurred in the hindlimbs and 8% (11/151) in the forelimbs (fracture of both fore- and hindlimb, n = 1). Horses with forelimb fractures had a greatly reduced probability of racing (55%) compared to those with hindlimb fractures (86%). Overall, 84% of the horses raced post operatively and had performance records similar to that of their maternal siblings, 78% (787/1006) of which raced. CONCLUSIONS: Arthroscopic removal of apical proximal sesamoid fracture fragments in TB weanlings and yearlings carries an excellent prognosis for racing in horses with hindlimb fractures and a reduced prognosis in those with forelimb fractures. Medial fractures of the forelimb carry the worst prognosis. POTENTIAL RELEVANCE: The determination of prognosis increases knowledge on apical sesamoid bone fractures and potential for arthroscopic restoration of the ability to race; and enables the value of yearlings for subsequent sale to be established.     

Racing performance after arthroscopic removal of apical sesamoid fracture fragments in Thoroughbred horses age > or = 2 years: 84 cases (1989-2002)

REASONS FOR PERFORMING STUDY: Studies have shown that surgical removal of apical fracture fragments in Standardbred racehorses carries the best prognosis for return to racing performance, but there are no reports involving mature Thoroughbred (TB) racehorses. OBJECTIVES: To describe the incidence of apical proximal sesamoid fractures in TB racehorses and determine probability and quality of racing performance after arthroscopic removal of such fractures in TB racehorses age > or = 2 years. METHODS: Medical records and pre- and post operative race records of TB racehorses age > or = 2 years that underwent arthroscopic surgery for removal of apical proximal sesamoid fracture fragments were reviewed. RESULTS: Sixty-four percent of fractures occurred in the hindlimbs and 36% in the forelimbs. Horses with forelimb fractures had a reduced probability of return to racing (67%) compared to those with hindlimb fractures (83%), but the majority (77%) of treated horses recovered to return to race post operatively. Horses with medial forelimb fractures raced at only a 47% rate; those with suspensory desmitis at 63%. Unlike Standardbreds, there was no difference in probability of racing post operatively between horses that had, and had not, raced preoperatively. CONCLUSIONS: Data show that arthroscopic removal of apical proximal sesamoid fracture fragments is successful at restoring ability to race in skeletally mature TB horses without evidence of severe suspensory ligament damage. Prognosis for return to racing is excellent (83%) in horses with hindlimb fractures and good (67%) in those with forelimb fractures. Medial fractures of the forelimb have the worst prognosis. POTENTIAL RELEVANCE: The determination of prognosis for differing sites in TB racehorses should increase knowledge of apical proximal sesamoid bone fractures and improve communication from veterinarian to owner, and trainer, on the potential for arthroscopic restoration of the ability to race.     

Arthroscopic removal of fractures of the lateral malleolus of the tibia in the tarsocrural joint: A retrospective study of 13 cases

There is limited information on the treatment of lateral malleolus (LM) fractures in the horse, with no previously published case series for the outcome following arthroscopic removal of such fractures. This report reviews and evaluates findings of a retrospective study of 13 horses admitted to a private equine referral hospital over a 10 year period (1999–2009) that underwent arthroscopic removal of fractures of the LM. Hospital records were reviewed and details including patient history, aetiology of the fracture and limb affected, results of all diagnostic tests and surgical reports were documented. Performance information concerning Thoroughbred horses that went onto race post operatively was collected using an online database. Owners and trainers were contacted regarding the return to performance for non‐Thoroughbred cases or those that did not go onto race post operatively. Of the 13 horses presented, 12 were Thoroughbreds, 9 of which were National Hunt racehorses and 3 were Flat racehorses. The other horse in the study was used for general purpose riding. All cases presented with an acute unilateral fracture. Eleven of the 13 had >6 months post operative follow‐up and all were nonlame. Of the 12 Thoroughbreds, 10 have raced again, a total of 104 times (median 5 times). The median time from surgery to return to racing was 241 days (180–366 days). It is concluded that horses with fractures of the LM have an excellent prognosis for return to full athletic performance following arthroscopic debridement; and that arthroscopic fragment removal is an appropriate treatment method for fractures of the LM.     

Survey of arthroscopic surgery for carpal chip fractures in thoroughbred racehorses in Japan

Medical and racing records of 155 Thoroughbred racehorses that underwent arthroscopic surgery for carpal chip fractures were investigated. Articular damage for 98.4% of the fractures was classified as G1 or G2 using McIlwraith's criteria. The rate of return to racing after surgery was 82.6%. Evaluation of racing performance after surgery was attempted using a placing index (PI) based on race finish position. There was no significant difference in the PI distribution between horses that underwent surgery and other healthy horses.     

Incomplete Oblique Sagittal Fractures of the Dorsal Cortex of the Third Metacarpal Bone in Six Horses

Objective —To describe incomplete oblique sagittal dorsal cortical fractures of the equine third metacarpal bone, their surgical repair, and subsequent performance of the horses.
Study Design —Retrospective examination of medical records and racing performance.
Animal Population —Six Thoroughbred race horses, 2 to 4 years of age.
Methods —Radiographic confirmation of all fractures preceded general anesthesia and surgical correction. Three fractures were treated by intracortical compression using screws placed in lag fashion, and five fractures were treated by osteostixis. Race records were reviewed for each horse to determine performance after surgery.
Results —Fractures were best observed on palmarodorsal radiographic projections. Three horses treated by intracortical compression returned to racing, but fracture recurred in one horse and was treated by osteostixis. This horse and the other three horses treated by osteostixis raced after surgery.
Conclusions —Horses with incomplete oblique sagittal fractures of the dorsal cortex of the third metacarpal bone can race after surgical management of the fracture by screws placed in lag fashion or osteostixis. The authors' preferred surgical procedure for managing this fracture is osteostixis.
Clinical Relevance —Palmarodorsal radiographic projections of the third metacarpal bone are recommended in young Thoroughbred race horses suspected of having dorsal metacarpal stress fractures.     

Effect of third carpal slab fracture and repair on racing performance in Thoroughbred horses: 31 cases (1977-1984)

Between 1977 and 1984, 31 Thoroughbred horses (mean age, 2.8 years) were surgically treated for slab fractures of the third carpal bone. All fractures involved the articular surfaces of the intercarpal and the carpometacarpal joints in a frontal plane and had a cuboidal or slab shape. In 20 of the horses, the bone was fractured during racing and in 8 of the horses, the bone was fractured during race training. The right limb was affected more frequently than was the left limb (24 vs 7, P less than 0.05). Twenty-one (67.6%) horses raced at least once after recovery from the surgery. Data were available from 11 claiming horses that had raced at least twice before their injuries and 4 times after recovery. A claiming horse is one that competes where any horse entered is subject to being purchased for the designated amount of the claiming race; therefore, each race tends to automatically attract entrants of similar ability. In this group of 11 horses, claiming value decreased from a mean of $13,900 to a mean of $6,500 (P less than 0.05), and the mean finish position was 5.8 +/- 3.16 before injury and 5.8 +/- 3.30 after recovery. The mean claiming value for horses that had not raced before injury, but had raced after recovery (n = 5) was $8,150.     

Racing performance of Thoroughbred horses after arthroscopic surgery of the carpus

The case record, and subsequent racing performance, of 110 horses that had undergone arthroscopic surgery of the carpus, were reviewed. Of these, 87% resumed racing, with 43% able to win at least one race, after surgery. Horses with chip fractures from the distal radius had the best prognosis, while horses with sagittal fractures of the third carpal bone had the poorest. The performance of horses with bilateral lesions was similar to those with unilateral lesions. It was concluded that arthroscopic surgery was a suitable technique for the diagnosis and treatment of carpal lesions in the horse.     

Osteochondral fragmentation of the plantar/palmar proximal aspect of the proximal phalanx in racing horses

SUMMARY The clinical presentation and outcome of treatment is presented for 26 cases of osteochondral fragmentation of the plantar/palmar proximal aspect of the proximal phalanx. Twenty-three were racing Standardbreds and three were racing Thoroughbreds. The most common reason for presentation was an inability to run straight at high speed. Only eight horses presented for lameness, although on examination 19 were lame. A positive flexion test was recorded in 90% of affected fetlock joints and effusion in 48%. Arthroscopic fragment removal was performed on 23 occasions in 21 horses and arthrotomy in one horse. Of the 16 horses that had returned to racing, 12 had improved their performance, while three showed no improvement, and one was retired for other reasons. In three horses refragmentation occurred after surgery, two of which had improved after initial arthroscopic removal. Degenerative changes within the fetlock joint were detected at surgery in eight horses. Of the four horses treated conservatively, one returned to its previous level of performance temporarily after intra-articular medication, one showed no improvement and two were still resting. Plantar/palmar osteochondral fragmentation of the proximal aspect of the first phalanx is a common cause of low-grade lameness in racing horses, and arthroscopic removal results in improvement in race performance in a high percentage of cases.     

Apical fracture of the proximal sesamoid bone in standardbred horses: 43 cases (1990-1996).

OBJECTIVE: To determine whether fracture fragment dimensions, suspensory ligament damage, and racing status at the time of injury were associated with outcome in Standardbred horses with apical fracture of the proximal sesamoid bone. DESIGN: Retrospective study. ANIMALS: 43 Standardbred racehorses. PROCEDURE: Medical records, racing records, and radiographs were reviewed, and ultrasonographic findings were scored. Measurements of the fractured portion of the proximal sesamoid bone were made. RESULTS: Seventy-four percent (32/43) of horses were pacers, and 26% (11/43) were trotters. Statistical differences between trotters and pacers regarding ability to start, number of starts, or amount of money earned after injury were not detected. Females earned significantly more money per start after injury than males. Eighty-six percent (37/43) of fractures involved hind limbs and 14% (6/43) involved forelimbs. Horses with forelimb injuries earned less money per start. Severity of suspensory ligament damage did not affect postinjury racing performance. A higher proportion of horses that had raced before injury returned to racing after surgery than horses that had not raced before injury, although a significant difference between these groups was not detected. Eighty-eight percent of horses that raced before injury raced after injury. Fifty-six percent of horses that did not race before injury raced after injury. Fracture fragment dimensions did not affect outcome. CLINICAL IMPLICATIONS: Dimensions of the apical fracture fragment of the proximal sesamoid bone in Standardbred horses and degree of suspensory ligament damage did not affect outcome. Prognosis for return to racing soundness is good in horses that had raced before injury and fair in horses that had not raced before injury.     

Sternothyroideus myotomy, staphylectomy, and oral caudal soft palate photothermoplasty for treatment of dorsal displacement of the soft palate in 102 thoroughbred racehorses

Objective— To compare racing performance before and after sternothyroideus myotomy, staphylectomy, and oral caudal soft palate photothermoplasty in Thoroughbred racehorses with intermittent dorsal displacement of the soft palate (DDSP).
Study Design— Retrospective study.
Animals— Thoroughbred racehorses (n=102) with DDSP.
Methods— Retrieved data included signalment, primary complaint, and upper respiratory tract endoscopic finding. Lifetime race records were compared for earnings per start before and after surgery, days to 1st start, and races won postoperatively.
Results— Comparing mean earnings per start for 3 races before ($2792) and after ($3806) surgery, racing performance improved significantly after surgery in 63% (46/73) of horses that competed in at least 1 race before and after surgery ( P =.02). Mean and median days to 1st start after surgery were 109 and 69 days, respectively. Of horses that raced postoperatively 65% (60/92) won at least 1 race, and 77% (71/92) raced in >5 races after surgery.
Conclusions— Sternothyroideus myotomy, staphylectomy, and oral caudal soft palate photothermoplasty significantly improved racing performance in experienced Thoroughbred racehorses with performance limiting DDSP, and overall had a similar outcome to other reported surgical techniques for treatment of DDSP.
Clinical Relevance— Sternothyroideus myotomy, staphylectomy, and oral caudal soft palate photothermoplasty should be considered as a surgical approach to correction of DDSP in Thoroughbred racehorses; however, it is possible that staphylectomy may not be necessary to achieve a desirable outcome.     

Palmar/Plantar Process Fractures of the Proximal Phalanx In 15 Horses

Fifteen fractures of the palmar or plantar process of the proximal phalanx in 15 horses are described. Ten were articular and five were nonarticular. Two modes of therapy were used depending on the location of the fracture. Nonarticular fractures were treated with stall rest or reduction in exercise, and articular fractures were treated with either surgical removal or internal fixation of the fragment. All horses that were operated on were sound within 6 months after surgery. Follow-up information was obtained on all horses through client questionnaire and race records in the racing breeds (Standardbred and Thoroughbred) and client questionnaire alone is the nonracing breeds (Quarterhorse and Arabian). Fourteen horses returned to an equal or better level of performance than before injury; one horse returned to a lower level of performance.     

Metacarpophalangeal Joint Synovial Pad Fibrotic Proliferation in 63 Horses

Medical records, radiographs, and sonograms of 63 horses with metacarpophalangeal joint synovial pad proliferation were examined retrospectively. All horses had lameness, joint effusion, or both signs associated with one or both metacarpophalangeal joints. Bony remodeling and concavity of the distodorsal aspect of the third metacarpal bone (Mc3) just proximal to the metacarpal condyles was identified by radiography in 71 joints (93%); 24 joints (32%) had radiographic evidence of a chip fracture located at the proximal dorsal aspect of the proximal phalanx. Fifty-four joints (71%) were examined by ultrasound. The mean ± SD sagittal thickness of the synovial pad was 11.3 ± 2.8 mm. Seventy-nine percent of the horses had single joint involvement with equal distribution between the right and left forelimbs. Sixty-eight joints in 55 horses were treated by arthroscopic surgery. Sixty joints (88%) had debridement of chondral or osteochondral fragmentation from the dorsal surface of Mc3 beneath the synovial pad and 30 joints (44%) had a bone chip fracture removed from the medial or lateral proximal dorsal eminence of the proximal phalanx. Complete or partial excision of both medial and lateral synovial pads was completed in 42 joints. Only the medial synovial pad was excised or trimmed in 21 joints, and 5 joints had only the lateral pad removed. Eight joints in eight horses were treated by stall rest, administration of intra-articular medication and systemic nonsteroidal anti-inflammatory drugs. Follow-up information was obtained for 50 horses treated surgically and for eight horses treated medically. Forty-three (86%) that had surgery returned to racing; 34 (68%) raced at an equivalent or better level than before surgery. Three (38%) of the medically treated horses returned to racing; only one horse raced better than the preinjury level. Horses that returned to racing at a similar or equal level of performance were significantly younger in age than horses returning at a lower level or not racing (P≤.05). Overall, horses with synovial pad proliferation treated by arthroscopic surgery had a good prognosis for return to racing at a level equal or better than before injury.     

Performance after partial arytenoidectomy without mucosal closure in 27 Thoroughbred racehorses

OBJECTIVE: To examine the effect of partial arytenoidectomy without mucosal closure on postoperative racing performance and long-term complications in Thoroughbred racehorses treated for laryngeal hemiplegia, arytenoid chondropathy, or failed laryngoplasty. STUDY DESIGN: Retrospective study. ANIMALS: Twenty-seven Thoroughbred racehorses. METHODS: Medical records of Thoroughbred racehorses that had partial arytenoidectomy without mucosal closure between 1992 and 2002 were reviewed. Horses were divided into groups: horses that had not raced (Group 1) and those that had raced (Group 2) before surgery. Lifetime race records were compared between groups. A standard starts index (SSI) and performance index (PI) were used for Groups 1 and 2, respectively, to objectively evaluate each horse's postoperative performance. Telephone interviews of owners and trainers were used for subjective performance evaluation and to determine prevalence of long-term complications. RESULTS: Eleven (61%) Group 1 and 7 (78%) Group 2 horses raced and earned money after surgery. All Group 1 horses that raced performed at a level lower than the national average. Only 1 Group 2 horse had an improved PI score postoperatively. CONCLUSIONS: Thoroughbred racehorses have a fair prognosis for racing successfully after partial arytenoidectomy without mucosal closure. CLINICAL RELEVANCE: This technique may be a practical alternative to primary mucosal closure, would decrease surgical time, and avoid some problems reported with primary mucosal closure.     

Surgical and nonsurgical management of sagittal slab fractures of the third carpal bone in racehorses: 32 cases (1991-2001)

OBJECTIVE: To compare results (ie, return to racing and earnings per race start) of surgical versus nonsurgical management of sagittal slab fractures of the third carpal bone in racehorses. DESIGN: Retrospective study. ANIMALS: 32 racehorses (19 Thoroughbreds, 11 Standardbreds, and 2 Arabians). PROCEDURE: Medical records and radiographs were reviewed to obtain information regarding signalment and treatment. Follow-up information was obtained from race records. Robust regression analysis was performed to evaluate earnings per start in horses that raced at least once before and after injury. RESULTS: 22 (69%) horses raced at least once after treatment of the fracture. All 7 horses treated by means of interfragmentary compression raced after treatment, and horses that underwent interfragmentary compression had significantly higher earnings per start after the injury than did horses treated without surgery. Eight of 9 horses treated by means of arthroscopic debridement of the damaged cartilage and bone raced after treatment, but only 7 of 16 horses treated without surgery (ie, stall rest) were able to return to racing after treatment. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that racehorses with sagittal slab fractures of the third carpal bone have a favorable prognosis for return to racing after treatment. Horses treated surgically were more likely to race after treatment than were horses treated without surgery.     

Fractures of the carpus in racing thoroughbreds of the Japan Racing Association: Prevalence, location, and current modes of surgical therapy

From 1985 through 1994 approximately 39,800 Thoroughbred horses competed in over 3,400 races each year conducted by the Japan Racing Association (JRA). During this time the prevalence of fractures incurred during racing was 1.99, and 0.09% during training. Of these, 0.32% of the horses during racing died or were humanely destroyed as a direct result of their injuries. During 1994, 1,837 fractures occurred. The cuboidal bones of the carpus and the distal end of the radius accounted for 33.5% of all recorded fractures, with 47.4% of these occurring during racing and 24.2% occurring during training. The most common sites of fracture within the carpus were the distal end of the radius, the third carpal bone, and the radial carpal bone accounting for 35.3, 35.2, and 29.5% of fractures, respectively. Of these, 86/7% of osteochondral fractures occurred on the dorsal aspect of the cuboidal bones. At racing speed, characteristic fractures of the carpus are relatively common in race horses.Since 1991 in Japan, arthroscopic surgery has been the treatment of choice for the removal of carpal joint osteochondral fragments. Of all horses having arthroscopic surgery (n=155), 68.4% of these horses returned to race 9 months after surgery. Of all horses having osteochondral fractures of the distal end of the radius, radial carpal, and third carpal bones treated with arthroscopic surgery in 1993 (n=97) 52.6%, 60.0%, and 55.6% respectively, returned to race and competed at the same level of competition or higher compared with pre-operative racing performance. Arthroscopic surgery, as adapted by the JRA, is a useful technique for the treatment of carpal bone fractures in race horses; however, following surgery some horses had chronic arthritic changes associated with the surgical site. This suggests that the surgical methods and post-operative training program have to be re-evaluated.The objectives of this paper are to describe the prevalence, location, post-operative complication and racing performance for horses having cuboidal carpal bone fractures in racing Throughbreds of JRA.     

Surgical treatment of dorsal cortical fractures of the third metacarpal bone in thoroughbred racehorses: 53 cases (1985-1989).

Between January 1985 and May 1989, 53 Thoroughbred horses (mean age 3.2 years) were surgically treated for dorsal cortical fractures of the third metacarpal bone (MC III). All horses were treated with cortical drilling through the fracture line (osteostixis). Diagnosis of the fractures was confirmed by xeroradiography. Lifetime racing records were obtained for all horses. Forty-seven horses returned to racing after surgery (89%). The mean time between surgery and the first race was 6.8 months. Horses had a mean of 10.9 starts before surgery and 16.1 starts after surgery. The mean earnings per start before surgery was $6,459 and after surgery was $5,685. Of the 47 horses that raced after surgery, 70% raced at the same class or improved. Complications related to surgery were seen in 10 horses. Two horses had a second fracture of MC III at the same site, and were again treated by osteostixis, after which both horses returned to competition. Fractured drill bits were left in the MC III of 4 horses. One of these horses had catastrophic failure of MC III. Two horses developed subcutaneous infections and 2 horses had catastrophic failure of MC III in the surgically treated limb. Osteostixis appears to be an effective treatment for returning horses affected with dorsal cortical fractures to racing.     

Nonsurgical management of type II fractures of the distal phalanx in 48 Standardbred horses

OBJECTIVE: To evaluate nonsurgical management of type II fractures of the distal phalanx in Standardbred horses. DESIGN: Retrospective study of 48 affected horses. RESULTS: Most fractures occurred on the lateral palmar process of the left forelimb or the medial palmar process of the right forelimb; 81% of horses were considered sound enough to return to training and 63% raced. Of those returning to racing, 41% competed in > 10 races, 37% in 2 to 10 races and 22% in only 1 race. There was no difference in performance before and after fracture. Twenty-four of 25 horses had a bar shoe fitted for > 50% of the treatment phase. Of those horses returning to training without a bar shoe, 89% refractured at the same site. Sixty percent of horses returning to training with a bar shoe raced successfully. The total convalescent time, the time rested in a box and the time spelled in a paddock were similar for horses returning to racing and those that did not. The age of the horse had no effect on the ability to return to racing. CONCLUSION: The prognosis for type II fractures of the distal phalanx is guarded. It is advisable to fit a bar shoe on the horse during convalescence. Horses returning to training and racing with a bar shoe appear less likely to refracture the distal phalanx. Those horses that return to racing can perform at a level similar to that prior to fracture.     

Racing Performance in 72 Racehorses Treated with Prosthetic Laryngoplasty for Laryngeal Hemiplegia

The purpose of this study was to compare racing performance before and after prosthetic laryngoplasty for treatment of laryngeal hemiplegia in inexperienced (horses without at least one start before surgery) and experienced (horses with at least one start before surgery) Thoroughbred and Quarter Horse racehorses. Medical records of 54 Thoroughbred and 18 Quarter Horse racehorses or horses intended for racing treated with prosthetic laryngoplasty and unilateral ventriculectomy for laryngeal hemiplegia were reviewed. Signalment, age at the time of surgery, resting endoscopic grade of laryngeal function, surgical procedure, and type of suture were recorded. Median performance index (PI), earnings, distance, and Beyer speed figure (BSF) per start for three races before and after surgery were compared, and factors associated with improved postsurgical performance were evaluated. Seventy-three percent of horses that had not raced before surgery and 84% of horses that competed in at least one race before surgery were able to return to racing after surgery. Fifty-nine percent and 27% of Thoroughbreds and Quarter Horses, respectively, were able to improve their PI after surgery. Sixty-two percent and 20% of Thoroughbreds and Quarter Horses, respectively, significantly increased their distance after surgery. Additionally, 61% and 66% of racehorses were able to increase their earnings and BSF after surgery, respectively. Horses treated with laryngoplasty and unilateral ventriculectomy have a good prognosis for return to racing. Inexperienced racehorses have a better prognosis for improvement after surgery than do experienced racehorses. Thoroughbred racehorses have a better success rate than Quarter Horse racehorses.     

Long-term study of partial arytenoidectomy with primary mucosal closure in 76 Thoroughbred racehorses (1992-2006)

REASON FOR PERFORMING STUDY: The effectiveness and best method to perform a partial arytenoidectomy in racehorses is unclear. This study was performed to evaluate the success of and complications that can occur after a unilateral partial arytenoidectomy with primary mucosal closure in Thoroughbred racehorses. HYPOTHESIS: Partial arytenoidectomy is an effective surgical procedure to return Thoroughbred racehorses, afflicted by arytenoid chondropathy or a failed laryngoplasty, to preoperative levels of performance. METHODS: Seventy-six Thoroughbred racehorses admitted to the New Bolton Centre between 1992 and 2006 were assessed. Information was obtained from the medical records about the horse, laryngeal abnormalities, surgery and other findings during hospitalisation. Racing information was evaluated relative to those independent variables by an analysis of variance with a level of significance of P<0.05. RESULTS: Arytenoid chondropathy was the presenting complaint in 54 horses and failed laryngoplasty in 22 horses. Thirteen horses (17%) underwent a second surgery for laser excision of intralaryngeal granulation tissue at the arytenoidectomy site. Seventy-three horses were discharged from the hospital and racing outcome was evaluated. Sixty horses (82%) raced after surgery and 46 horses (63%) raced 5 or more times after surgery. The median time from surgery to the first start was 6 months. The average earnings/start was not significantly different before and after surgery. There was no association between earnings after surgery and age, gender, location of lesion, type of lesion, duration of tracheal intubation or undergoing a second surgery. CONCLUSIONS AND POTENTIAL RELEVANCE: A Thoroughbred racehorse is likely to race after a unilateral partial arytenoidectomy with primary mucosal closure and return to a preoperative level of performance.