Ultrasound-guided, minimally invasive, biceps brachii tenotomy in a standing horse.

Objective: To describe the long-term outcome of a horse that underwent a standing, ultrasound-guided, minimally invasive, biceps brachii tenotomy.

Study design: Case report.

Animal: A 17-year-old Tennessee Walking Horse gelding.

Methods: The horse had a chronic, severe, lameness localized to the left shoulder region. Diagnostic imaging revealed fractures of the intermediate and lesser tubercles of the left humerus, biceps brachii (BB) tendinopathy, and bicipital bursitis. Conservative management was attempted, but lack of improvement prompted surgical intervention. An ultrasound-guided, minimally invasive, BB tenotomy was performed under standing sedation and local anesthesia.

Results: Immediately following the procedure, a substantial improvement in lameness was achieved. Further case management consisted of systemic and local pain management, physiotherapy exercises, and periodic local corticosteroid injections. At 21 months following surgery, the horse remained pasture sound.

Conclusion: An ultrasound-guided, minimally invasive, approach for biceps brachii tenotomy was simple to perform and resulted in rapid improvement in lameness. There were no incisional complications and long-term pasture soundness was achieved.