Topic:Arthroscopy
Arthroscopy in horses is a minimally invasive surgical procedure used to diagnose and treat joint-related conditions. This technique involves the insertion of a small camera, known as an arthroscope, into the joint through a small incision, allowing veterinarians to visualize the interior of the joint in detail. Arthroscopy is employed to identify and address issues such as cartilage damage, joint inflammation, and the presence of loose bodies within the joint. It is a valuable tool for both diagnostic and therapeutic purposes, offering a less invasive alternative to traditional open surgery. This page compiles peer-reviewed research studies and scholarly articles that explore the applications, techniques, and outcomes of arthroscopic procedures in equine medicine.
Effects of intra-articular administration of hyaluronic acid or platelet-rich plasma as a complementary treatment to arthroscopy in horses with osteochondritis dissecans. Although arthroscopy is the treatment of choice for horses with osteochondritis dissecans (OCD), it is not yet known whether intra-articular therapies in the postoperative period can bring any benefit to the recovery of these animals. This study evaluated the effects of the intra-articular application of platelet-rich plasma (PRP), hyaluronic acid (HA) or lactated Ringer's solution (LR) in horses with OCD undergoing arthroscopy. Eighteen male and female Brazilian Sport horses aged between 2 and 6 years were evaluated. All animals presented OCD fragments in the middle crest of the tibia. Ten da...
Arthroscopically guided lag screw fixation of subchondral bone cysts in the medial femoral condyle in Thoroughbred racehorses: description of technique and comparative results. To describe an arthroscopically guided technique for lag screw placement across subchondral bone cyst (SBC) in the medial femoral condyle (MFC) and to compare postoperative racing performance with corticosteroid injection and cyst debridement. Methods: Retrospective cohort study. Methods: One hundred twenty-three horses with 134 MFC SBCs undergoing treatment at a single referral hospital in the UK between January, 2009, and December, 2020. Methods: Sex, age, limb affected, radiographic cyst dimensions, preoperative and postoperative lameness, surgical technique (lag screw placement, cyst debr...
Osteochondral allograft transplantation for treating medial femoral condyle subchondral bone cyst in a 14-year-old standardbred horse: a case report. Allograft arthroplasty is a promising cartilage-resurfacing technique. A 14-year-old horse was diagnosed with a medial femoral condyle subchondral bone cyst. Allografts were harvested from a young donor animal and implanted to fill the cyst cavity. A visual assessment of the surgical site was possible during follow-up arthroscopy. In addition to a desirable gliding surface and a good adaptation of the grafts, fibrillation of the cranial ligament of the medial meniscus was noted and debrided. The recipient horse became sound four months after follow-up surgery with a high level of owner satisfa...
Administration safety of medical-grade honey (MGH) in septic synovial structures in horses: 3 cases. The objective of this study was to investigate the postoperative use of intrasynovial honey as an antimicrobial after treatment for synovial sepsis in horses. One colt and 2 mares were presented with acute lameness, with or without an associated wound. All 3 cases were initially managed with surgical endoscopic or tenoscopic debridement and lavage for treatment of different synovial structures. Collection of synovial fluid was consistent with synovial sepsis and this was diagnosed in each case. All horses subsequently underwent arthroscopic lavage under general anesthetic and intraarticular or...
Evaluation of cartilage injury in horses with osteochondral fragments in the metacarpo-/metatarsophalangeal joint: A study on 823 arthroscopies. Osteochondral fragment removal is commonly performed but there are little scientific data supporting this procedure in the absence of clinical signs. More information is needed to facilitate clinical decision-making regarding fragment removal of the metacarpo-/metatarsophalangeal joint. Objective: To assess prevalence of cartilage injury in the equine metacarpo-/metatarsophalangeal joint and its association to fragment size, location, age and lameness. Methods: Retrospective observational study. Methods: Clinical records, including radiographs of 823 metacarpo-/metatarsophalangeal joints (640 ...
Correlation of Arthroscopic Grading and Optical Coherence Tomography as Markers of Early Repair and Predictors of Later Healing Evident on MRI and Histomorphometric Assessment of Cartilage Defects Implanted with Chondrocytes Overexpressing IGF-I. Injury of articular cartilage is common, and due to the poor intrinsic capabilities of chondrocytes, it can precipitate joint degradation and osteoarthritis (OA). Implantation of autologous chondrocytes into cartilaginous defects has been used to bolster repair. Accurate assessment of the quality of repair tissue remains challenging. This study aimed to investigate the utility of noninvasive imaging modalities, including arthroscopic grading and optical coherence tomography (OCT) for assessment of early cartilage repair (8 weeks), and MRI to determine long-term healing (8 months). Large (15 mm...
T Helper 17-Like Regulatory T Cells in Equine Synovial Fluid Are Associated With Disease Severity of Naturally Occurring Posttraumatic Osteoarthritis. Infiltration of cluster of differentiation (CD) 3 (CD3) T cells into the synovium and synovial fluid occurs in most patients with posttraumatic osteoarthritis. During disease progression, proinflammatory T helper 17 cells and anti-inflammatory regulatory T cells infiltrate the joint in response to inflammation. This study aimed to characterize the dynamics of regulatory T and T helper 17 cell populations in synovial fluid from equine clinical patients with posttraumatic osteoarthritis to determine whether phenotype and function are associated with potential immunotherapeutic targets. An imbala...
Reattachment of Osteochondritis Dissecans Lesions in the Lateral Femoral Trochlear Ridge With Bioabsorbable Screws in 4 Yearling Standardbreds. This case series describes an alternative surgical technique to obtain reattachment of osteochondritis dissecans (OCD) lesions in the lateral trochlear ridge of the femur (LTRF) as well as the clinical and radiological outcome of treated cases. Four Standardbred yearlings (6 lesions in total) underwent surgical fixation of large OCD defects in the LTRF under arthroscopic guidance. Reattachment of the OCD lesions was obtained using 3.0/3.7 mm headless bio-compression and absorbable poly-l-lactic acid (PLLA) screws, inserted perpendicularly to the cartilage surface through the lesion. All horse...
The use of a hyperosmolar irrigation solution is safe in an equine stifle joint model but does not reduce joint swelling. To determine the following: (1) whether an irrigation solution that is hyperosmolar (HYPER) relative to synovial fluid decreases tissue extravasation during an arthroscopic protocol when compared to a relatively hypoosmolar solution, (2) the safety of a HYPER solution based on viability of joint tissues following joint irrigation, and (3) if the use of a HYPER solution decreases water content in stifle joint tissue. Methods: 8 adult horses. Methods: A prospective, blinded, randomized controlled trial was performed to compare lactated Ringer's solution (LRS; 273 mOsm/L) and a HYPER (600 mOsm/L)...
Effects of oral treatment with chondroitin sulfate and glucosamine in an experimental model of metacarpophalangeal osteoarthritis in horses. Combined chondroitin sulfate (CS) and glucosamine (GlcN) has been widely used in oral formulations to prevent and treat osteoarthritis. CS is effective for controlling pain in osteoarthritic patients, whereas GlcN can stimulate glycosaminoglycan synthesis, thus reducing extracellular matrix degradation. Although several studies have been published on this topic, the effectiveness of treatment with oral CS and GlcN remains uncertain. The objective of this study was to analyze the progression of experimentally induced osteoarthritis in horses and verify the effectiveness of an oral compound base...
Comparison of hydromorphone and butorphanol for management of pain in equine patients undergoing elective arthroscopy: a randomized clinical trial. To compare the effects of hydromorphone and butorphanol in horses undergoing arthroscopy and describe the pharmacokinetics of hydromorphone in anesthetized horses. Methods: Randomized controlled clinical trial. Methods: A total of 40 adult horses admitted for elective arthroscopy. Methods: Horses were randomly assigned to be administered intravenous hydromorphone (0.04 mg kg-1; group TxH; n = 19) or butorphanol (0.02 mg kg-1; group TxB; n = 21) prior to surgery as part of a standardized anesthetic protocol. Pain was scored by two observers unaware of group assignment using the Equine Utrecht...
Arthroscopic removal of osteochondral fragments located within the condylar fossa of the third metacarpus/metatarsus in Thoroughbred yearlings. To describe an arthroscopic technique for the removal of osteochondral fragments located within the condylar fossa of the third metacarpal/tarsal bone. Methods: Retrospective study. Methods: Thoroughbred yearlings (n = 11). Methods: Osteochondral fragments located within the condylar fossa of the third metacarpal/tarsal bone identified during presale radiographic examination were removed via arthroscopy, assisted with ultrasonography in select cases. Complete fragment removal was confirmed by intraoperative radiography. Results: Fragments were successfully removed using rongeurs following di...
The Equine Temporomandibular Joint: Comparisons Between Standard and Needle Arthroscopic Examination of Cadaver Specimens and Standing Horses. Definitive diagnosis of equine temporomandibular joint osteoarthritis (TMJ-OA) may require advanced diagnostic imaging. Arthroscopy is a modern, minimally invasive, diagnostic, and treatment modality. Standing arthroscopic treatment of joint disease is a relatively recent advance in equine surgery, despite which there are few published comparisons between the available arthroscopic systems. Unassigned: To compare and contrast two arthroscopic systems for assessing the equine temporomandibular joint compartments in cadavers and standing horses. Unassigned: Experimental study. Unassigned: Phase ...
Arthroscopic removal of palmar intermediate carpal bone fracture fragments in four horses using a transthecal approach through the carpal flexor tendon sheath. To describe the removal of palmar intermediate carpal bone (ICB) fracture fragments using a transthecal approach through the carpal flexor tendon sheath. Methods: Case series. Methods: Four horses with fractures of the palmar aspect of the ICB. Methods: Two horses were injured when falling and two during recovery from general anesthesia. Three horses underwent MRI to supplement conventional imaging. Three horses had concurrent fractures of the radial and/or accessory carpal bones. Conventional proximolateral carpal sheath arthroscope and instrument portals were used, supplemented with a medial...
A systematic review evaluating the use of ultrasound in the identification of osteochondrosis in horses. Osteochondrosis is commonly encountered in young horses, with welfare, performance, and economic effects. Consequently, pre-purchase radiographic screening for osteochondrosis is routinely performed. Ultrasonographic examination of articular cartilage and osteochondrosis lesions are described in the literature with many case series or single case reports published. This systematic review was undertaken to examine the evidence for using ultrasonography in comparison to traditional radiography, arthroscopy or necropsy findings in the detection of osteochondrosis. The systematic review identified...
Plantar osteochondral fragments in young Standardbreds are associated with minimal joint inflammation at the time of surgical removal. Plantar osteochondral fragments (POF) are common but their effect on joint health of young Standardbreds in race training is largely unknown. Objective: Evaluate the inflammatory effects of POF in metatarsophalangeal joints of young Standardbreds as a step towards developing evidence-based recommendations for surgical removal. Methods: Cohort study. Methods: Forty-nine Standardbred horses (age 11-33 months) presented for surgical removal of POF from 56 metatarsophalangeal joints. Synovial tissue collected at arthroscopy was subjected to histopathology. IL-1β, TNF-α, and PGE-2 were measured ...
Ex vivo comparison of 3 Tesla magnetic resonance imaging and multidetector computed tomography arthrography to identify artificial soft tissue lesions in equine stifles. To determine the diagnostic performance of computed tomographic arthrography (CTA) and 3 Tesla magnetic resonance imaging (MRI) for detecting artificial meniscal, meniscotibial ligament (MTL) lesions and cruciate ligament (CL) lesions in horses. Methods: Ex vivo controlled laboratory study. Methods: Nineteen stifles from adult horses. Methods: Stablike defects (n = 84) (16 mm long, 10 mm deep) were created in the menisci (n = 35), CLs (n = 24), and MTLs (n = 25) via arthroscopy prior to MRI and CTA (80 mL contrast at 85 mg/mL per joint). Two radiologists, unaware of the lesions...
Incidence of carpal fractures and risk factors for recurrent fractures after arthroscopic removal of carpal chip fracture fragments in Thoroughbred racehorses. We aimed to investigate the recent incidence of carpal fractures and the risk factors for recurrent ipsilateral fractures after arthroscopic removal of clinically active unilateral carpal chip fracture fragments in Thoroughbred racehorses. The findings for horses managed under the Japan Racing Association that developed carpal bone fractures between 2014 and 2018 were retrospectively reviewed. The proportion of cases that developed a recurrent carpal fracture in the originally affected joint was calculated, and the risk factors for recurrent fractures were analysed. In total, 2858 carpal fract...
Arthroscopic findings and long-term outcomes in 76 sport horses with meniscal injuries (2008-2018). To report the findings and long-term outcome of 76 sport horses with meniscal injury. Methods: Retrospective case series. Methods: Seventy-six horses with 93 meniscal injuries in 85 stifles. Methods: Medical records of sport horses diagnosed with meniscal injury during arthroscopy were reviewed. Owner follow up was obtained via telephone interview ≥1.5 years postoperatively. Preoperative and intraoperative findings, and postoperative treatments, were analyzed for potential association with return to athletic performance. Results: The medial meniscus was involved in 82.8% of cases, with gra...
Comparative results of 3 treatments for medial femoral condyle subchondral cystic lesions in Thoroughbred racehorses. To compare 3 different methods for treatment of medial femoral condyle (MFC) subchondral cystic lesions in Thoroughbred horses <24 months old based on the criterion of ability to race post-treatment. Methods: Retrospective cohort study. Methods: Thoroughbreds (n = 107, age < 24 months) diagnosed with MFC subchondral cystic lesions. Methods: Medical records between January 2004 and December 2017 were reviewed. Three treatment methods were used in these horses during that time frame: arthroscopic debridement, intralesional autologous mesenchymal stem cell (MSC) injection, and int...
Fragment size is associated with post-operative complications following elective arthroscopy of the tibiotarsal joint of horses. The objective of this retrospective study was to determine the occurrence of joint-related complications after elective arthroscopy of the tibiotarsal joint (TTJ) in 329 horses, and the association with specific clinical parameters. Data were collected from medical records of horses undergoing elective tibiotarsal joint arthroscopy for fragment removal. Exact conditional univariate regression was used to determine significant risk factors for joint-related post-operative complications. Of 485 joints, 2 (0.4%) developed surgical site infection, 4 (0.8%) developed septic arthritis, 1 (0.2%) deve...
Arthroscopic guided repair of a slab fracture of the fourth carpal bone in an 8-month-old thoroughbred horse. An 8-month-old thoroughbred colt presented with sudden onset right forelimb lameness. A radiographic series of the right carpus was performed, and it revealed a slab fracture of the fourth carpal bone and fracture of the proximal part of the third metacarpal bone. Arthroscopically guided repair of the slab fracture of the fourth carpal bone with a 3.5 mm cortex screw and lag screw fixation of the fracture of the proximal part of the third metacarpal bone were performed. The horse started to race at 32 months old and started in 65 races over three years without any trouble associated with the r...
Usefulness of Selected Acute-Phase Proteins in the Postsurgical Monitoring of Arthroscopy and Splint Bone Removal in Horses. Arthroscopy and splint bone removal are the common orthopedic procedures in horses. Estimation of the dynamics of acute phase proteins in postoperative monitoring seems to be interesting diagnostic approach. The aim of the study was to investigate changes in the concentrations of plasma inflammatory markers-fibrinogen, haptoglobin, and protease inhibitors-following orthopedic surgery in horses. The study involved 114 horses, divided into two study groups undergoing: arthroscopy (41 horses) and splint bone removal (13 horses). The control group consisted of 60 healthy horses. The blood was coll...
Arthroscopic evaluation of the synovial membrane and its relationship with histological changes and biomarkers in equine joint disease. The synovial membrane (SM) presents itself with distinctive characteristics during arthroscopic procedures in cases of osteoarthritis (OA) as well as osteochondritis dissecans (OCD) in horses. Most of the arthroscopic findings of the SM are limited to a description of a nonspecific inflammation state. In the present study, the macroscopic and histological aspects of the SM in OA and OCD horses were compared to those of healthy horses. The expression of interleukin (IL) in SM was also investigated. Besides, the concentrations of ILs and keratan sulfate (KS) in the synovial fluid (SF), and the m...
Comparison of ultrasonography and radiography with arthroscopy for diagnosis of dorsoproximal osteochondral fragmentation of the proximal phalanx in 56 Thoroughbred racehorses. Osteochondral fragmentation of the proximal phalanx (DPP1 fragment) is a common finding in the racehorse. Whilst radiographic assessment has been reported to lack diagnostic sensitivity, ultrasonographic examination has been documented to be extremely sensitive for identification of bone fragments in the metacarpophalangeal joint. Objective: To determine the sensitivity and specificity of ultrasonography as an imaging modality for diagnosis of DPP1 fragmentation and to compare it with radiography in the Thoroughbred racehorse. Methods: Retrospective cohort study. Methods: Medical records (radi...
Fungal osteitis of the axial aspect of the mid body of the medial proximal sesamoid bone in a horse. The satisfactory outcome of fungal osteitis in an 8-year-old American Quarter Horse is described. The horse was admitted with a grade 4 out of 5 lameness and exhibited metacarpophalangeal synovial effusion, indicative of a mild suppurative inflammation. Results of initial radiographic and ultrasonographic examination were unremarkable. Intra-articular anesthesia of the metacarpophalangeal joint allowed localization of the insult. It was not until day 6 of hospitalization when lytic changes on the axial aspect were observed on radiographic examination. Arthroscopic examination permitted identif...
Arthroscopic removal of osteochondral fragments of the cervical articular process joints in three horses. To report arthroscopic osteochondral fragment removal from the equine cervical spine articular process joints (APJs) including long-term follow-up. Methods: Case series. Methods: Three Warmblood horses with forelimb lameness and/or reduced range of motion of the cervical spine with osteochondral fragments between the cervical vertebrae C5 /C6 or C6 /C7 . Methods: Arthroscopy of the APJs of C5 /C6 and C6 /C7 was performed under general anesthesia. Following endoscopic evaluation of the joints, osteochondral fragments were removed using a rongeur. Results: All horses recovered from anesthesia wi...
Slab fractures of the third carpal bone involving both radial and intermediate facets and outcomes after surgical repair in racing Quarter Horses. Characteristics and outcomes after surgical repair of third carpal bone (C3) slab fractures involving both radial and intermediate facets in racing Quarter Horses are unknown. Objective: To describe the pre- and intraoperative characteristics of C3 slab fractures of both radial and intermediate facets in Quarter Horses and to report on the long-term outcomes after internal fixation. Methods: Retrospective case series. Methods: Case records were collected from racehorses with C3 slab fractures between 2008 and 2020. Inclusion criteria required arthroscopic-guided repair of C3 slab fractures inv...
Recombinant fibroblast growth factor-18 (sprifermin) enhances microfracture-induced cartilage healing. Posttraumatic osteoarthritis is a disabling condition impacting the mostly young and active population. In the present study, we investigated the impact of intra-articular sprifermin, a recombinant truncated fibroblast growth factor 18, on the outcome of microfracture treatment, a widely used surgical technique to enhance cartilage healing at the site of injury. For this study, we created a cartilage defect and performed microfracture treatment in fetlock joints of 18 horses, treated joints with one of three doses of sprifermin (10, 30, or 100 μg) or with saline, hyaluronan, and evaluated a...
Use of Clinical Audits to Evaluate Timing of Preoperative Antimicrobials in Equine Surgery at a Veterinary Teaching Hospital. Based on human surgical guidelines, intravenous antimicrobials are recommended to be administered within 60 min of surgical incision. Achieving this target in horses is reportedly challenging and influenced by hospital policies. The objectives of this study were to evaluate and improve: (1) the timing of antimicrobial administration to surgical incision (tAB-INC), (2) contributions of anesthesia pre-induction (tPRI) and surgical preparation (tPREP) periods to tAB-INC, and the (3) completeness of antimicrobial recording. Two clinical audits were conducted before and after the policy changes (pa...