A surgical assist to creating the perfect horse

Dr. Larry Bramlage, right, assisted by Dr. Eric Carlson, inserted a screw in the knee of a Thoroughbred yearling during corrective surgery at Rood & Riddle Equine Hospital.
Dr. Larry Bramlage, right, assisted by Dr. Eric Carlson, inserted a screw in the knee of a Thoroughbred yearling during corrective surgery at Rood & Riddle Equine Hospital. Herald-Leader

All eyes on the Keeneland grounds this week will be looking for the same thing.


As the September Yearling Sale approaches, potential buyers are scrutinizing the parade of babies before them, searching for fluid movers, well-developed frames and any other tips that suggest a successful future on the racetrack or in the breeding shed.

Even in a brutal economy for the Thoroughbred marketplace the past four years, one constant has remained — the buyers' desire to obtain the most horse for their dollars.

That constant puts pressure on sellers to deliver the most flawless horses possible.

To get ready for a sale like the one that will take place Monday through Sept. 21 at Keeneland, some yearlings require a boost that Mother Nature and a selective breeding process failed to provide.

For some foals born with conformation deformities such as crooked limbs, that boost comes from corrective surgery.

The most common procedures, transphyseal bridging (screws and wires) and periosteal elevations (stripping), are both done to either slow down or speed up a growth plate, allowing an otherwise crooked limb to straighten out.

Exactly how often it is done, whether its disclosure should be mandatory, and the impact it has had on the well-being of the breed continue to inspire debate even as its practice has been accepted as routine.

Rare is the issue in the Thoroughbred industry on which everyone agrees, and the use of corrective surgery in foals is no different.

Evolving landscape

Few events have had as core-shaking an impact on the Thoroughbred industry as the rise of the commercial marketplace the past few decades. As the business of selling horses evolved into just that — a vast, lucrative trade drawing participants at all levels — the pressure for sellers to deliver perfection reached unprecedented levels.

While the surgeries have become commonplace in babies with obvious problems, some outfits say they have gotten away from their use in recent years because of a shift in both economics and attitudes.

"Since the dip in the market, I think we've seen a lot less corrective surgeries for a lot of different reasons," said Mark Taylor of perennial leading consignor Taylor Made Sales. "Like anything else, when a new technology comes out, everyone wants to try it. But then they learn over the course of time there are downsides to it also. You get a lot of cosmetic blemishes, sometimes you get infections — and plus, it is not inexpensive.

"Ten years ago, probably 35 percent of the foals in Kentucky were getting strips on their ankles before they were 90 days old, and now it's down to very few of them. ...As a result, more screws are getting done, but it's a smaller percent of the population, maybe 10 percent. It's an interesting evolution that is always changing."

If there is a segment of the market where the use of corrective surgery has dropped, it's in lower-end yearlings who may bring only $10,000-$15,000 at auction — making a potential $2,000 surgery not worth the return.

Instead of turning to the knife, some breeders say they are using more corrective shoeing along with organic techniques such as adjusting a foal's nutrition program to get results.

Still, one of the offshoots of the market downturn has been a decline in the number of foals bred each year. If corrective surgeries are fewer, it might relate to the fact that there are simply fewer patients.

"People may have done less of it because there are less horses, but it hasn't been because they're doing less," said surgeon Dr. Michael Spirito of Lexington's Hagyard Equine Medical Institute. "I've probably done as many of those surgeries as I've ever done this year, so I wouldn't say my numbers are down. It's more the foal crop being down."

Why surgery is necessary

Though its effectiveness in amending deformities is not disputed, the use of corrective surgeries for cosmetic purposes contributed to the procedures' rise in popularity.

By creating a more structurally sound foundation through surgery, one theoretically is giving a horse a better chance to avoid injury and reach its potential on the racetrack. But even if a horse never makes the races, commercial breeders need to get some kind of return on their investment to maintain their livelihood.

As stud fees soared well into the six figures — turning the goal of making a profit at public auction all the more challenging — corrective surgeries allowed some neatly bred but otherwise crooked foals the chance to get on a buyer's short list rather than being passed over.

"We have a pretty good idea the conformation that is consistently present in horses that both do well at the track and minimize their chances for injury," said Dr. Larry Bramlage, chief orthopedic surgeon at Lexington's Rood & Riddle Equine Hospital, referring to a horse's structure and symmetry.

He added that horses without perfect conformation can still race well and avoid injury.

"But in the public sale arena, the best prices are brought by the horses with the best conformation, so you can hardly fault the consignors for wanting to go to a sale with the best product that they can," Bramlage said. "The (buyers) that want the perfect conformation are enough in number that they have the ability to significantly affect the product."

'Weakening the gene pool'

Numerous stakes winners have been surgically corrected, but the unofficial poster child for the procedure is the late champion Real Quiet, who underwent transphyseal bridging on his knees as a yearling and fell just inches short of winning the 1998 Triple Crown.

Without corrective surgery, the racing world could be denied the exploits of top performers who might not be able to run through their flaws otherwise. Within the industry, it's not clear whether that ability to alter history is a positive or a negative.

"It definitely changes the genetic future for the breed to do corrective surgeries in that you will have some horses who succeed at the track that may have not succeeded," said Suzi Shoemaker, owner of Lantern Hill Farm outside Midway. She said her operation has stopped doing corrective surgeries. "A stallion retires to stud that might not have held up to racing say in 1965 or 1975 and now you've got these horses going into the gene pool. I think that unquestionably changes the face of the genetics going forward."

The durability of today's racehorse remains subject to heated scrutiny. The number of lifetime races for the average horse is trending downward, and this season's leading runners have faced a rash of injuries and ailments.

The culprits are many in the debate over durability. But the fact unsound horses can be passed off as physical standouts only to have their frailties potentially emerge in their offspring rankles more than a few.

"I think if they're talking about weakening the gene pool with medication, then they're also weakening the gene pool by doing (corrective surgery)," said trainer Charlie Lopresti. "They're taking mares that produce crooked foals, cosmetically fixing them and selling them for a lot of money at the sale. It used to be back in the old days, only the strong survived, and if they were crooked and they could run through it, they were good horses.

"I don't think it's a bad thing, but I think we all need to get on the same page. And if they're going to try and clean up the racing act, they need to clean up their act too."

Even those who acknowledge corrective surgery can make unsound horses fashionable remind those in opposition that it wouldn't be as necessary if more sound judgments were made in mating selections.

"We probably help some stallion's stallion career by saving a number of their offspring from getting injuries or washing out in the racetrack if they were not corrected," Bramlage said. "The trouble is, all horsemen know who those stallions are. They know which ones get crooked foals, but they breed to them anyway because they run."

Full disclosurenot a necessity

Though learned horsemen can often spot signs that a horse has had work done, disclosing whether a foal had corrective surgery is not mandatory according to the conditions of sale.

"I think it would be great if it's automatically disclosed, but if you ask any consignor, they'll tell you," said bloodstock agent and former WinStar Farm president Doug Cauthen. "I don't really have a problem buying a horse that's had a corrective surgery as long as the bone alignment looks pretty good and the quality of the bone looks good. I understand some people's position that they don't want to buy one. But I hope they pass on the one that I get to buy and that it wins a big race."

How a horse performs in the sales ring has become nearly as important as its results on the racetrack. While some say they aren't leaning on corrective surgery as much in the current economic climate, the science — for better or worse — has helped many horses achieve both goals.

"It's probably one of those things that when it first came around it was overused, and there might be some people that still do," Cauthen said. "But I think it's a reasonably small percentage of horses that get corrective surgeries, and I think they serve a healthy purpose as long as they're used wisely."

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