Unilateral mandibular condylectomy in an adult warmblood gelding

Abstract

EinleitungKiefergelenkserkrankungen werden beim Pferd selten beschrieben. Dies liegt möglicherweise an den diagnostischen Herausforderungen dieser anatomisch anspruchsvollen Region (Schumacher 2006). Septische, meist traumatisch bedingte Erkrankungen und Luxationen bzw. Subluxationen des Gelenkes werden genannt (Devine et al. 2005) und haben in der Regel einen akuten klinischen Verlauf. Aseptische Entzündungen des Kiefergelenkes und Arthrosen verlaufen eher schleichend und können mit Zahnerkrankungen vergesellschaftet sein (May 1996, Baker 2002, Merz et al. 2006. Im Folgenden wird der Fall einer aseptischen Kiefergelenksentzündung mit hochgradiger Arthrose und deren Untersuchung, Therapie und Verlauf geschildert. Nach Kenntnisstand der Autoren ist eine derartige Kiefergelenkserkrankung ohne Beteiligung der Zähne beim adulten Pferd noch nicht beschrieben. Unilateral mandibular condylectomy in an adult warmblood gelding A 17-year-old Trakehner gelding was admitted with poor general condition, profound weight-loss and masticatory problems. The horse was examined clinically, radiographically, ultrasonographically and with computed tomography. An advanced, degenerative arthrosis and aseptic infection of the right temporomandibular joint (TMJ) was diagnosed. Mandibular condylectomy, with the horse anesthetized, was performed successfully. The operation resulted in resolution of the clinical signs within a few days and complete return of masticatory function within two months. The incision healed by first intention. Six months postoperatively the gelding had regained to normal body weight and was being used for riding. In conclusion, mandibular condylectomy can be used for treatment of advanced aseptic arthrosis of the TMJ in horses with excellent longterm results. Kasuistik

Computed Tomographic Appearance of the Temporomandibular Joint in 1018 Asymptomatic Horses: A Multi‐institution Study

“…However, no publications were found describing TMJ findings in CT scans of asymptomatic older horses. Descriptions of TMJ abnormalities using CT have been reported in individual horse case reports . However, these case reports compared their findings to previously published findings in asymptomatic young horses.…”

“…Surgical intervention has been extensively reported ,. Degenerative TMJ disease, in the absence of sepsis, as published in humans and small animals, are limited to two publications in horses, a citation in a surgical text and a case of poor performance that responded to intra‐articular medication . Possible reasons for the lack of publications include behavioral modification of the horse to adapt to joint pain (masking), specific inherent protective mechanisms, and possibly, the capacity for the articular cartilage to regenerate due to the presence of an undifferentiated mesenchymal cell layer present directly under the fibrocartilage as reported in human studies .…”

Equine temporomandibular joint (TMJ) disease: Fact or fiction?

“…However, of these reports, septic arthritis and subsequent degenerative joint disease feature most commonly. Surgical intervention includes arthroscopic lavage (Carmalt and Wilson ), open arthrotomy with meniscectomy and mandibular condylectomy (Nagy and Simhofer ; Bienert‐Zeit and Rotting ) and open arthrotomy with partial condylectomy (Barnett et al . ).…”

“…However, of these reports, septic arthritis and subsequent degenerative joint disease feature most commonly. Surgical intervention includes arthroscopic lavage (Carmalt and Wilson 2005), open arthrotomy with meniscectomy and mandibular condylectomy (Nagy and Simhofer 2006;Bienert-Zeit and Rotting 2011) and open arthrotomy with partial condylectomy (Barnett et al 2014). The latter report describes the investigation of weakness, ataxia and pyrexia of 2 days' duration in a 2-year-old filly and ultimately septic arthritis of the right TMJ was diagnosed.…”

The effect of acute unilateral inflammation of the equine temporomandibular joint on the kinematics of mastication

“…The arthrology of the equine temporomandibular joint (TMJ) has been well described and yet studies of pathology and pathophysiology of this unique joint remain absent [1][2][3][4][5]. Sporadic reports of degenerative joint disease of the TMJ (TMJ-DJD) have been limited to severe cases involving fracture of the mandibular condyle and secondary or primary sepsis, both followed by subsequent degeneration of the joint [6][7][8][9]. Reports detailing idiopathic clinical osteoarthritis due to degenerative change are limited to a single publication and a citation in a surgical text [10,11].…”