Study suggests pantarsal arthrodesis may lower revision risk in dogs

A multicenter retrospective study in Veterinary Surgery reviewed 89 surgeries performed in 80 dogs with common calcaneal tendon pathology across five referral hospitals from January 2011 through December 2021. The authors found that pantarsal arthrodesis delivered short-term outcomes comparable to tendon repair, but with a significantly lower risk of catastrophic complications requiring revision surgery. Tendon repair with tarsocrural immobilization was the most common approach, used in 46 of 89 limbs, while pantarsal arthrodesis was used in 32 of 89 limbs. Overall complication rates did not differ significantly between tendon repair and arthrodesis, but catastrophic complications were higher after tendon repair with immobilization, at 26.1%, versus 0% for pantarsal arthrodesis. Client-reported long-term outcome data were limited, with only 23 Liverpool Osteoarthritis in Dogs questionnaires returned, and those did not show a difference in the proportion of mildly affected dogs among groups. (pubmed.ncbi.nlm.nih.gov)

Why it matters: For veterinary professionals, the study adds weight to a long-running surgical decision point in Achilles injury management: whether to prioritize tendon preservation or choose a more definitive salvage procedure. The findings suggest pantarsal arthrodesis may deserve stronger consideration in selected dogs, especially where revision risk, client finances, compliance with immobilization, or chronic tissue compromise are concerns. That aligns with prior case-based literature suggesting arthrodesis can be used not only after failed repair, but sometimes as a first-line option when tendon quality is poor or failure risk is high. Related feline data also point in the same direction on stabilization strategy: in a multicenter study of 39 cats undergoing common calcaneal tendon repair, temporary internal fixation was associated with lower complication rates than external immobilization, 13% versus 54.2%, with catastrophic complications seen only in the external immobilization group. (pubmed.ncbi.nlm.nih.gov)

What to watch: Longer-term functional data, prospective comparisons, and more detail on case selection will be important in determining when arthrodesis should move from salvage option to earlier recommendation. It will also be worth watching how future studies compare immobilization methods, since both canine and feline reports suggest postoperative stabilization may strongly influence failure risk. (pubmed.ncbi.nlm.nih.gov)