Simini Surgery Review: Equine Edition

Veterinary Surgery Deep Dive: Equine Ortho — February 2026 Edition

In this episode of the Simini Equine Surgery Podcast, we explore the orthopedic research from the February 2026 issue (Issue 2) of Veterinary Surgery, where three studies showcase how refinements in equine tenoscopic surgery are expanding what surgeons can accomplish through minimally invasive techniques. Together, they highlight a common goal: improving surgical access while preserving critical anatomy and optimizing long-term athletic outcomes.  From preserving tendon blood supply during manica flexoria resection, to a new tenoscopic treatment for proximal digital annular ligament desmitis, and the development of a medial portal for carpal flexor tendon sheath surgery, these papers demonstrate how thoughtful surgical innovation continues to improve patient care. In this episode: ✅ Racine et al. presented a refined two-portal tenoscopic technique for resection of torn proximal manica flexoria (MF) while preserving the mesotendons (MTs) of the deep digital flexor tendon. Using a four-step approach—including a novel Kocher-Ochsner clamp twisting technique to detach the remaining areolar tissue—the authors successfully preserved the mesotendons while minimizing iatrogenic trauma. Among 30 horses, 96.4% achieved successful tendon sheath healing, and 75% returned to their previous or higher level of athletic performance. By maintaining the extrinsic vascular supply of the deep digital flexor tendon, this modified approach may improve long-term tendon healing while reducing surgical morbidity.  ✅ Wood et al. described a tenoscopically guided proximal digital annular ligament (PDAL) desmotomy for horses with proximal digital annular ligament desmitis. After validating the technique in 10 cadaver limbs, the procedure was successfully performed in five clinical cases, with four horses returning to their previous level of exercise following surgery. The study also demonstrates that pathologic thickening of the PDAL actually facilitates surgical identification during tenoscopy, while emphasizing the importance of performing a palmar or plantar annular ligament desmotomy first to improve instrument maneuverability and protect the superficial digital flexor tendon.  ✅ Woods et al. investigated the feasibility of creating a medial tenoscopic portal into the equine carpal flexor tendon sheath using contrast-enhanced CT and cadaver specimens. The authors identified a reproducible portal location approximately 5 mm proximal and 32 mm caudal to the distal medial radial physis, providing 120–140° of instrument triangulation when combined with the standard lateral portal. Although superficial flexor carpi radialis tendon impingement occurred during early testing, careful blunt dissection and transillumination from the lateral portal allowed safe placement while preserving major neurovascular structures. The technique offers surgeons improved visualization and access to previously difficult-to-reach lesions within the carpal sheath.  Together, these studies demonstrate that the future of equine tenoscopy lies not in larger incisions, but in smarter portal placement, preservation of normal anatomy, and continual refinement of minimally invasive surgical techniques. 🎓 Journal Articles Discussed * Racine et al. — Four-step tenoscopic technique to resect a torn proximal manica flexoria while sparing the mesotendons of the deep digital flexor tendon in 30 horses * Wood et al. — Tenoscopically guided proximal digital annular ligament desmotomy for the treatment of proximal digital annular ligament desmitis * Woods et al. — Feasibility of a medial tenoscopic portal in the equine carpal flexor tendon sheath in cadavers 📚 From the February 2026 Issue (Issue 2) of Veterinary Surgery 🎁 Want to learn more about Simini Protect Lavage or request a sample? Learn More: www.simini.com [http://www.simini.com] Request a Sample: https://www.simini.com/evaluation-kit [https://www.simini.com/evaluation-kit]

Veterinary Surgery Deep Dive: Equine Soft Tissue — January 2026 Edition

In this episode of the Simini Equine Surgery Podcast, we explore the soft tissue research from the January 2026 issue (Issue 1) of Veterinary Surgery, where two innovative studies focus on making equine upper airway surgery less invasive, mechanically stronger, and more effective over the long term.  One study introduces a standing, minimally invasive technique for prolonged treatment of guttural pouch disease, while the second evaluates new prosthetic laryngoplasty implant designs aimed at reducing the long-term failure that continues to challenge treatment of recurrent laryngeal neuropathy. In this episode: ✅ Lepage et al. described a novel technique for endoscopically assisted transcutaneous guttural pouch catheterization (TGPC) using a 20 French balloon catheter placed into the medial guttural pouch compartment of standing horses. Across 15 procedures, the authors achieved a 100% technical success rate without major arterial or nerve injury. The catheter remained in place for 4 to 17 days, allowing repeated lavage and prolonged local treatment of guttural pouch mycosis and empyema while avoiding the morbidity associated with open surgical approaches and general anesthesia. Minor complications were limited to superficial venous bleeding and temporary skin abrasions, with all catheter tracts healing rapidly following removal. The study demonstrates that prolonged standing access to the guttural pouch is both practical and safe, opening new possibilities for managing these anatomically challenging diseases.  ✅ Ysebaert et al. compared three prosthetic laryngoplasty constructs in an ex vivo biomechanical study of equine larynges. Traditional suture fixation was evaluated alongside a suture anchor and a novel tie bolt implant. While the suture anchor achieved equivalent arytenoid abduction using significantly less tension, the tie bolt demonstrated the greatest construct stiffness, the least cyclic elongation, and the highest ultimate failure load. Rather than failing through progressive suture cut-through of the arytenoid cartilage, the tie bolt distributed forces so effectively that failure occurred only after fracture of the cartilage itself. These findings suggest that optimizing implant mechanics may substantially improve long-term stability following prosthetic laryngoplasty for recurrent laryngeal neuropathy.  Together, these studies illustrate how innovation in equine soft tissue surgery increasingly centers on minimizing surgical morbidity while maximizing mechanical reliability and long-term patient outcomes. 🎓 Journal Articles Discussed * Lepage et al. — Endoscopically assisted transcutaneous placement of a balloon catheter in the medial guttural pouch compartment of the horse: A surgical approach to local treatment * Ysebaert et al. — Biomechanical testing of three constructs for prosthetic laryngoplasty in horses demonstrates advantages of differing metallic implants in the arytenoid cartilage 📚 From the January 2026 Issue (Issue 1) of Veterinary Surgery 🎁 Want to learn more about Simini Protect Lavage or request a sample? Learn More: www.simini.com [http://www.simini.com] Request a Sample: https://www.simini.com/evaluation-kit [https://www.simini.com/evaluation-kit]

Veterinary Surgery Deep Dive: Equine Ortho & Soft Tissue — January 2026 Edition

In this episode of the Simini Equine Surgery Podcast, we explore the orthopedic and soft tissue research from the January 2026 issue (Issue 1) of Veterinary Surgery, where three innovative studies challenge long-standing approaches to some of the most difficult conditions in equine surgery. Together, they ask an important question: Can smarter surgical techniques improve outcomes while reducing patient risk?  From salvaging severe chronic laminitis, to performing subtotal nasal septum excision under standing sedation, and investigating a novel treatment for dorsal nasopharyngeal collapse, these studies highlight how careful biomechanical thinking and minimally invasive approaches continue to reshape equine surgery. In this episode: ✅ Hargitaiova et al. evaluated a modified high metacarpal deep digital flexor tenotomy combined with Steward Clog shoeing for horses with chronic, refractory laminitis. By transecting the deep digital flexor tendon proximal to the accessory ligament, the technique unloads the distal phalanx while preserving passive restraint of the distal interphalangeal joint. Among 15 horses and ponies (26 limbs), only one limb developed distal interphalangeal joint subluxation (4%), while long-term survival reached 43% in horses and 50% in ponies despite the severity of disease. The study demonstrates that preserving the accessory ligament, together with immediate orthotic support, can successfully realign the distal phalanx while minimizing joint instability in cases where traditional options have failed.  ✅ Brink et al. described a standing technique for subtotal nasal septum excision using sedation, regional anesthesia, and obstetrical wire transection. Among 12 horses, 11 returned to their intended athletic use, including racehorses, while surgeons reported less intraoperative hemorrhage than is typically encountered under general anesthesia. The paper emphasizes two key technical principles: meticulous ethmoidal nerve blockade to ensure patient comfort, and creating the caudal septal cut at an angle of 60 degrees or greater to prevent postoperative airway obstruction as the septal stump heals. The findings suggest that many complex sinonasal procedures may be safely performed standing, reducing anesthetic risk while maintaining excellent long-term outcomes.  ✅ Jeong et al. investigated transendoscopic laser fenestration of the dorsal pharyngeal recess as a treatment for dorsal nasopharyngeal collapse (NPC). Using an experimental model of bilateral glossopharyngeal neurectomy, the authors found that creating a permanent communication with the guttural pouches failed to improve respiratory performance. In fact, airflow diversion into the guttural pouches appeared to worsen inspiratory airflow in experimentally induced disease. Interestingly, a single horse with naturally occurring NPC demonstrated improved exercise performance following surgery, suggesting that although the technique is ineffective for severe neurogenic collapse, it may still warrant investigation in naturally occurring, less severe cases.  Together, these studies demonstrate that innovation in equine surgery is not simply about developing new procedures—it is about understanding biomechanics, respecting anatomy, and carefully validating new techniques before they become standard practice. 🎓 Journal Articles Discussed * Hargitaiova et al. — High-metacarpal deep digital flexor tenotomy and Steward clog shoeing for managing chronic refractory laminitis: A retrospective clinical study * Brink et al. — Standing excision of the nasal septum of 12 horses * Jeong et al. — Laser fenestration of the dorsal pharyngeal recess does not correct experimentally induced dorsal nasopharyngeal collapse in horses 📚 From the January 2026 Issue (Issue 1) of Veterinary Surgery 🎁 Want to learn more about Simini Protect Lavage or request a sample? Learn More: www.simini.com [http://www.simini.com] Request a Sample: https://www.simini.com/evaluation-kit [https://www.simini.com/evaluation-kit]

Veterinary Surgery Deep Dive: Equine Ortho — November 2025 Edition

In this episode of the Simini Equine Surgery Podcast, we explore the orthopedic research from the November 2025 issue (Issue 8) of Veterinary Surgery, where two studies focus on a shared objective: identifying orthopedic injuries earlier and treating them more effectively to maximize athletic performance and long-term soundness.  One study demonstrates how early arthroscopic intervention can prevent incomplete third carpal bone slab fractures from progressing into career-ending injuries, while the second presents the largest multicenter case series to date evaluating plate fixation for proximal splint bone fractures in horses. In this episode: ✅ Garcia-Collao et al. evaluated arthroscopic debridement of incomplete third carpal bone slab fractures (ISFs) in Thoroughbred and Standardbred racehorses. Reviewing 33 horses, the authors reported that 66.7% successfully returned to racing following early surgical intervention, with a median rehabilitation period of 247 days. The study emphasizes the importance of recognizing these lesions before progression to complete slab fractures or advanced osteoarthritis. During arthroscopy, surgeons observed medial palmar intercarpal ligament (MPIL) injury in every horse, raising important questions about whether ligament pathology may contribute to the development of these fractures rather than simply occurring as a consequence of them. The findings strongly support early diagnosis using skyline radiographs followed by aggressive arthroscopic debridement to preserve athletic careers.  ✅ Melly et al. presented the largest published series evaluating plate fixation of proximal small metacarpal and metatarsal (splint bone) fractures in horses. Among 27 cases, 76% returned to their previous level of work or higher, while more than 90% of racehorses returned to racing following surgery. The study provides valuable technical guidance on implant selection, emphasizing the importance of maximizing screw purchase in relatively soft splint bone while avoiding penetration into the cortex of the third metacarpal or metatarsal, where stress risers may lead to catastrophic fractures during anesthetic recovery. The authors also discuss intraoperative screw stripping, postoperative complications, and practical considerations that can significantly influence surgical success.  Together, these studies reinforce a central principle of equine orthopedic surgery: successful outcomes often depend on recognizing injuries before they become catastrophic and executing meticulous surgical technique that respects both anatomy and biomechanics. 🎓 Journal Articles Discussed * Garcia-Collao et al. — Outcome of arthroscopic debridement for the treatment of incomplete third carpal bone slab fractures in racehorses * Melly et al. — Plate fixation of small metacarpal and metatarsal bone fractures in 27 horses 📚 From the November 2025 Issue (Issue 8) of Veterinary Surgery 🎁 Want to learn more about Simini Protect Lavage or request a sample? Learn More: www.simini.com [http://www.simini.com] Request a Sample: https://www.simini.com/evaluation-kit [https://www.simini.com/evaluation-kit]

Veterinary Surgery Deep Dive: Equine Ortho — October 2025 Edition

In this episode of the Simini Equine Surgery Podcast, we explore the orthopedic research from the October 2025 issue (Issue 7) of Veterinary Surgery, where two complementary studies examine the future of equine cervical vertebral fusion. Together, they answer two fundamental questions: Which implant performs best mechanically? And how do horses actually perform after surgery?  This episode follows the evolution of cervical fusion—from decades of clinical experience using the kerf cut cylinder (KCC) to emerging 3D-printed titanium plate-and-spacer technology designed to improve construct stability and long-term outcomes. In this episode:  ✅ Cormier et al. — Evaluated intra-articular injection of decellularized porcine amnion/chorion suspension in horses. Both low- and high-dose groups developed inflammatory responses, but the high-dose group had more clinically evident inflammation, including increased lameness, elevated synovial and systemic SAA, and persistent signs requiring lavage and flunixin in some horses. The study concluded that dPACLS at the tested doses is not recommended for intra-articular injection because of the inflammatory response.  ✅ Janicek et al. present the largest multicenter evaluation of C7–T1 ventral interbody fusion using the kerf cut cylinder implant. Reviewing 38 horses treated over a 20-year period, the authors reported an 89% hospital discharge rate, with 79% achieving successful long-term outcomes. Half of the horses returned to athletic work—including dressage, show jumping, barrel racing, hunters, and western pleasure—while many others regained comfortable pasture soundness. The study also provides valuable surgical pearls for one of the most anatomically challenging regions of the equine cervical spine and highlights laryngeal spasm as the most significant perioperative complication requiring careful airway management.  ✅ Zedler et al. evaluated a 3D-printed titanium plate and spacer construct against the traditional 4.5-mm locking compression plate (LCP) in an ex vivo biomechanical model of C4–C5 fusion. Although both constructs demonstrated similar stiffness and failure loads, the 3D implant was significantly less likely to fail through displaced vertebral fracture or screw pullout during extension loading. The findings suggest that modern patient-specific implant design may improve mechanical reliability while providing a scaffold for future osseous integration.  Together, these studies illustrate how clinical experience and engineering innovation are converging to improve treatment options for horses with cervical vertebral stenotic myelopathy (CVSM). Long-term outcomes demonstrate that cervical fusion is no longer simply a salvage procedure—it is increasingly becoming a realistic path back to athletic performance for appropriately selected horses.  🎓 Journal Articles Discussed * Cormier et al. — Inflammatory Response Following Intra-Articular Injection of Decellularized Porcine Amnion/Chorion in Horses Janicek et al. — Multicenter Results for C7–T1 Ventral Interbody Fusion in Horses Using the Kerf Cut Cylinder Zedler et al. — Ex Vivo Biomechanical Testing of a Three-Dimensional Printed Titanium Plate and Spacer Construct and 4.5 mm Locking Compression Plate for Ventral Cervical Fusion of C4–C5 in the Horse 📚 From the October 2025 Issue (Issue 7) of Veterinary Surgery 🎁 Want to learn more about Simini Protect Lavage or request a sample? Learn More:  www.simini.com [http://www.simini.com] Request a Sample:  https://www.simini.com/evaluation-kit [https://www.simini.com/evaluation-kit]