Highlights of recent clinically relevant papers

Abstract

colleagues in the USA have recently published their retrospective study evaluating the short-and long-term outcomes of 50 horses that underwent palmar or plantar digital neurectomy due to chronic foot pain, and related this outcome to preoperative factors including magnetic resonance imaging (MRI) findings.Magnetic resonance imaging and radiographic analyses were conducted retrospectively by a single operator for each imaging modality. Variables such as age, breed, sex, athletic activity, lameness duration and response to local anaesthesia were analysed to assess if they were associated with likelihood of post operative lameness; logistic regression was then performed to assess the relationship between the variables, long-term survival was also assessed. The included horses competed at a low-level in a range of disciplines. Those horses that had persistent lameness following local anaesthesia were found to have an increased likelihood of post operative lameness compared to those whose lameness completely resolved following this diagnostic procedure. Time to follow-up varied but overall 92% of horses became sound following surgery, with 80% and 70% remaining sound at 15 months and 30 months, respectively. Neuroma formation was a complication in 2 cases. The median time to reoccurrence of lameness was 20 months. Those horses that were found to have a core or linear lesion of the deep digital flexor tendon (DDFT) on MRI were significantly more likely to have lameness recurrence following surgery.This study provides useful data to inform clients of the potential long-term outcome of a palmar or plantar digital neurectomy, when MRI findings are available. Horses with a core or linear DDFT lesion are less likely to respond to this surgical procedure than those without. Racehorse injuries after corticosteroid injectionIn this retrospective cohort study, R. Whitton and colleagues in Australia and the UK compared the rates of musculoskeletal injury (MSI) in horses receiving local corticosteroid injection (LCI) with those that were untreated and those prior to treatment.Of the 1911 horses in this study, 392 were treated with an injection of corticosteroid into or adjacent to a synovial structure, muscle or tendon/ligament. Limb injuries following which the horse did not race for at least 6 months, or was retired were classified as MSIs. Hazard of injury following injection was compared to that in untreated horses and those prior to treatment to calculate the hazard ratio (HR). All 392 horses were administered at least one LCI, with most LCIs performed bilaterally and intra-articularly into the carpal or fore fetlock joints. Carpal injuries, fore fetlock and forelimb tendon injuries were the most common of the 219 MSIs that ocurred. Following LCI the hazard of MSI was greater (HR 4.83) than the incidence rate of MSI in untreated horses and those prior to injection (1.22 injuries/100 horse-months). The hazard ratio returned to pretreatment levels after 49 days. The hazard for MSI in horses following second and subsequent LCI...