Department of Veterinary Clinical Sciences, University of Copenhagen, Copenhagen, Denmark.
Hørsholm Equine Hospital, Hørsholm, Denmark.
Equine Vet J. 2022 May;54(3):495-501. doi: 10.1111/evj.13472. Epub 2021 Jun 29.
Outcome after desmotomy of the accessory ligament of the deep digital flexor tendon (AL-DDFT) to treat flexural deformity of the distal interphalangeal joint has been reported to be excellent. However, no studies have compared long-term athletic performance of sport horses exposed to desmotomy of the AL-DDFT to that of matched controls.
The objective of this study is to compare long-term athletic performance in sports horses subjected to desmotomy of the AL-DDFT with the performance of matched controls.
This is an observational multicentre retrospective matched cohort study.
Records from horses undergoing desmotomy of the AL-DDFT between 2004 and 2015 were reviewed. Various databases were used to identify age-matched siblings as unexposed controls and data on the horses' athletic careers.
Seventy-four exposed and 194 matched unexposed horses were included. Although not significantly different, the proportion of exposed horses entering competition (28%, 95% CI 16%-38%) had a substantial risk difference compared with the proportion of unexposed horses entering competition (38%, 95% CI 26%-44%) (P = .2). Career longevity was significantly better for unexposed (15.6 competitions [95% CI 10.7-22.5] over a median of 570 days [IQR 210-1340]) than for exposed horses (9.7 competitions [95% CI 6.4-14.6] over a median of 219 days [IQR 2-1159] for horses operated in one limb and 6.1 competitions [95% CI 3.6-9.9] over a median of 446 days [IQR 23-603 days] for horses operated in two limbs, P < .001). Age at surgery and whether the condition was unilateral or bilateral did not affect chance of competing.
Small sample size, varying quality of medical records, stage of contraction not noted in many records and missing information on reasons for not entering into competition.
Desmotomy of the AL-DDFT is associated with decreased long-term athletic performance in sport horses compared with matched unexposed horses.
已经报道过，通过切断指深屈肌腱的副侧副韧带（AL-DDFT）来治疗远侧指间关节的弯曲畸形，其结果是出色的。然而，没有研究比较过接受 AL-DDFT 切断术的运动马与匹配对照的长期运动表现。
本研究的目的是比较接受 AL-DDFT 切断术的运动马与匹配对照的长期运动表现。
这是一项观察性的多中心回顾性匹配队列研究。
回顾了 2004 年至 2015 年间接受 AL-DDFT 切断术的马匹的记录。使用各种数据库来确定年龄匹配的兄弟姐妹作为未暴露的对照组，并获取有关马匹运动生涯的数据。
共纳入 74 只暴露组和 194 只匹配的未暴露组马匹。尽管没有显著差异，但暴露组进入比赛的比例（28%，95%CI 16%-38%）与未暴露组进入比赛的比例（38%，95%CI 26%-44%）相比，风险差异具有实质性差异（P=0.2）。未暴露组的职业寿命明显更长（15.6 场比赛[95%CI 10.7-22.5]，中位数为 570 天[IQR 210-1340]），而暴露组的职业寿命更短（9.7 场比赛[95%CI 6.4-14.6]，中位数为 219 天[IQR 2-1159]，单侧手术组和 6.1 场比赛[95%CI 3.6-9.9]，中位数为 446 天[IQR 23-603 天]，双侧手术组，P<0.001）。手术时的年龄以及该疾病是单侧还是双侧并不影响比赛的机会。
样本量小、医疗记录质量参差不齐、许多记录中未记录收缩阶段以及缺少未参赛的原因信息。
与匹配的未暴露组马匹相比，AL-DDFT 的切断术与运动马的长期运动表现下降有关。
