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.
Outcome of arthroscopic debridement for the treatment of incomplete third carpal bone slab fractures in racehorses. To describe the outcomes of arthroscopic debridement of third carpal bone (C3) incomplete slab fractures (ISF) in racehorses. Methods: Retrospective case study. Methods: Horses undergoing arthroscopic debridement of ISF of C3. Methods: The medical records of horses surgically treated for ISF of C3 were reviewed. Age, sex, breed, limb, fracture configuration, preoperative radiographs, arthroscopic findings, postoperative intraarticular therapies, and exercise recommendations were recorded. Racing performance was obtained from online databases. Univariable analyses were used to determine associa...
Mosaic arthroplasty in equine stifle and fetlock joints: A retrospective study of 31 cases between 1998 and 2023. To evaluate the clinical application of equine mosaic arthroplasty for joint surface repair, including outcomes and complications. Methods: Retrospective clinical study. Methods: A total of 31 horses diagnosed with subchondral bone cysts (SBCs) in the femoral condyle (22/31), distal metacarpus (7/31), or metatarsus (2/31). Methods: Medical records of horses that underwent autologous or allogeneic osteochondral graft transplantation were reviewed. Follow-up lasted at least 12 months. Success was determined in terms of improvements in lameness and post-surgical athletic performance, classified...
PRP and hyaluronic acid reduce synovitis in horses after arthroscopic OCD removal in Andalusian horses. This study was performed to evaluate the efficacy of intra-articular (IA) injections of a combination of platelet rich plasma (PRP) and hyaluronic acid (HA) on joint effusion following arthroscopic removal of OCD in the tarso-crural joint (TCJ) in young Andalusian horses. Methods: Forty Andalusian horses diagnosed with OCD of the distal intermediate ridge of the tibia (DIRT) were included in the study. Horses enrolled in this study had persisting synovial effusion after arthroscopic removal of OCD in the TCJ. A subjective semi-quantitative effusion score was adopted in the study to define the ...
Direct arthroscopic approach to the distal pouch of the palmar/plantar recess of the metacarpophalangeal/metatarsophalangeal joint in horses. To describe a direct arthroscopic approach of the distal pouch of the palmar/plantar recess of the fetlock to facilitate fragment removal, highlighting its advantages over previously described arthroscopic methods for the fetlock. Additionally, to evaluate and present a retrospective case series. Methods: Ex vivo and retrospective clinical study. Methods: A total of 25 fetlocks in 23 horses. Methods: A direct approach to the distal pouch of the palmar/plantar recess of the fetlock was developed on five cadaveric limbs. Arthroscopic anatomy and landmarks were examined. The approach was clinical...
Racing and sales performance in Thoroughbred yearlings after carpal osteochondral fragment removal. While radiographically evident carpal osteochondral fragments (COF) in Thoroughbred yearlings impair sales, their impact on future racing performance has been minimally investigated. Objective: To assess the impact of COF on Thoroughbred yearling sales and racing performance, and whether these are improved by arthroscopic removal. We hypothesised that surgical removal of COF improves Thoroughbred yearling sales and racing performance. Methods: Retrospective observational. Methods: Using clinical records from years 2015-2018, 46 Thoroughbred yearlings with COF were identified and allocated to a...
Racing performance in 75 Thoroughbreds after arthroscopic removal of Osteochondritis dissecans from the lateral femoral trochlear ridge before first race start in Korea (2015-2017). The lateral trochlear ridge of the stifle joint is highly susceptible to developing Osteochondrosis (OC)/Osteochondritis dissecans (OCD) lesions. This retrospective study evaluated the medical and racing outcomes of 75 Thoroughbreds who underwent arthroscopic OCD removal at the Jeju Stud Farm Equine Hospital from 2015 to 2017. The analysis included medical records, radiographic assessments, and race performance data, comparing 75 horses that underwent surgery with 257 control horses selected as siblings from the same dam. The surgical group had comparable racehorse registration rates (89.3 %...
Sublingual microcirculation in isoflurane-anesthetized horses receiving dexmedetomidine and lidocaine constant rate infusion. To assess the sublingual microcirculation in horses anesthetized with isoflurane and undergoing constant rate infusion of dexmedetomidine (DEX) and lidocaine (LID). Unassigned: 16 horses undergoing arthroscopy were included in a blind, randomized study comparing 2 groups: a DEX group (DEX-LID; 1.75 μg·kg-1·h-1 with a LID bolus of 1.3 mg·kg-1 followed by a continuous infusion of 0.05 mg·kg-1·min-1) and a LID-only group (LID; at the same dose). Hemodynamic variables, including mean, systolic, and diastolic blood pressure; heart rate; capnography; blood gas analysis; blood lactate; and orth...
Synovial fluid parameters following acute articular fracture in the horse. The objective was to investigate synovial sample appearance, total nucleated cell count (TNCC), total protein concentration (TP), and neutrophil percentage in horses with acute articular fractures to aid decision making in acutely lame horses. Methods: Retrospective case series. Methods: Synovial fluid samples (n = 55). Methods: Synovial fluid records were analyzed over an 11 year period from horses undergoing lag screw fixation or arthroscopic fragment removal of intra-articular fractures within 48 h of occurrence. Horses were excluded when presented with wounds close to the joint or ...
Comparison of a dorsolateral approach and a dorsomedial approach to access the medial malleolus of the distal tibia in horses. To determine the utility of a dorsolateral arthroscopic approach to the tarsocrural joint (TCJ) to examine and surgically access the medial malleolus (MM) and compare this to the standard dorsomedial approach to the MM. Methods: Experimental cadaver study. Methods: Six pelvic limbs from four adult horses. Methods: Arthroscopic examination of the dorsal aspect of the TCJ was performed followed by the dorsomedial and dorsolateral surgical approaches to the MM, in randomized order on cadaver limbs (n = 6). The dorsomedial approach involved placing the arthroscope and instrument in the dorsome...
Severity, distribution and postoperative therapy are not predictors of return to work in western performance horses with stifle chondromalacia. (1) To evaluate the ability of western performance horses diagnosed with chondromalacia to return to performance; Specifically, the relationship between the grade of chondromalacia and the horses' ability to resume work; (2) To determine the impact of postoperative therapy on clinical outcomes. Methods: Retrospective case series. Methods: Horses (n = 34). Methods: Records of western performance horses with lameness localized to the stifle that underwent subsequent arthroscopy with chondromalacia as the most significant diagnosis were reviewed. Chondromalacia was surgeon-graded as slight, m...
Tenoscopic-guided resection of the manica flexoria utilizing radiofrequency energy. A proof of concept study. To develop and optimize a tenoscopic technique for resection of the manica flexoria utilizing a radiofrequency probe. Methods: Experimental study. Methods: Eighteen cadaver limbs and two experimental horses. Methods: Tenoscopic-guided resection of the manica flexoria using radiofrequency energy proceeded sequentially by transection of the medial, lateral and proximal borders. The technique was performed in ex vivo limbs and then in vivo to replicate clinical scenarios. Time to complete resection of the manica flexoria (mean ± SD) and complications was recorded. Limbs were dissected and sc...
Arthroscopic Removal of Traumatic Fractures of the Proximal Medial Trochlear Ridge of the Talus: A Retrospective Analysis of 18 Horses. The objectives of this study were (1) to evaluate the need for flexed radiographs of the proximal medial trochlear ridge (PMTR) after trauma involving medial tarsus; (2) to evaluate outcome following arthroscopic removal of traumatic osteochondral fragments (TOCF) resulting from direct injury to PMTR. Methods: Records of patients with wounds to the medial tarsus were searched and those with TOCF of the PMTR included. Patient history, fracture etiology, preoperative diagnostics, and intraoperative findings were documented. Postoperative performance data were collected using Thoroughbred R...
Effects of anesthetic protocol, procedure, and recovery stall and interval on the quality of recovery in repeatedly anesthetized horses. The objective of this prospective study was to investigate whether repeated consecutive general anesthesia in horses undergoing 2 different anesthetic protocols could lead to improved recovery scores. Six healthy female Standardbred horses (453 ± 57 kg; 6.5 ± 4.2 y old) underwent 4 anesthetic protocols over 12 to 13 wk. Procedures 1 and 4 were arthroscopic surgeries [induction: xylazine, diazepam, and ketamine; and maintenance: Fe'Isoflurane (1.1%), lidocaine (2 mg/kg body weight [BW], 50 to 100 μg/min per kg BW), dexmedetomidine (2.5 μg/h per kg BW)]. Procedures 2 and 3 were preparation f...
Severe auricular skin necrosis as potential postanaesthetic complication in a horse undergoing general anaesthesia for orthopaedic surgeries. A Trotter mare (aged 5 years 8 months) presented with severe thoracic limb lameness 2 years after screw fixation of a third carpal bone fracture. Septic arthritis of the intermediate carpal joint necessitated three anaesthetics: two arthroscopic lavages in dorsal recumbency, followed by a computed tomography-guided screw explantation with curettage of an infected, sclerotic third carpal bone in right lateral recumbency. For each anaesthetic, maintenance was with isoflurane carried in oxygen and air, and a medetomidine constant rate infusion. Twelve days after the third anaesthetic, the horse h...
Alcohol-based antisepsis without the use of chlorhexidine for arthroscopy in horses. Alcohol-based antisepsis has shown experimentally to be as effective as 4% chlorhexidine gluconate (CHG) at reducing bacterial counts (colony forming units; CFU) on equine skin. Our objectives were to determine the immediate and post-surgical reduction in CFU/mL on equine skin prepared with CHG-based or 70% isopropyl alcohol (IPA)-based (without CHG) protocols in a clinical setting with arthroscopic surgery. Our hypotheses were that the logCFU/mL reduction would not significantly differ between protocols immediately after preparation or at the end of surgery. Six horses underwent a 40 min bila...
A hybrid repair strategy for full-thickness cartilage defects: Long-term experimental study in eight horses. The objective of this study was to evaluate a non-resorbable implant for the focal repair of chondral defects in eight adult horses with 12-month follow-up. The bi-layered construct composed of a polycarbonate-urethane-urea biomaterial which was printed in 3D fashion onto a bone anchor was implanted into surgically created osteochondral defects into the femoropatellar joints of eight horses. The analysis of post-mortem outcomes were compared to defects treated with microfracture in the same animal on the contralateral femoropatellar jointfemoropatellar joint. The overall macroscopic scoring af...
Determinants of joint effusion in tarsocrural osteochondrosis of yearling Standardbred horses. Tarsocrural osteochondrosis (OCD) is a developmental orthopedic disease commonly affecting young Standardbreds, with different fragment localization and size. Clinically, it is characterized by variable synovial effusion in the absence of lameness, whose determinants are ill-defined. We hypothesized that localization and physical characteristics of the osteochondral fragments like dimensions, multifragmentation, and instability influence joint effusion and correlate with synovial markers of cartilage degradation and inflammation. Clinical data, synovial fluid and intact osteochondral fragments...
Athletic prognosis following arthroscopic removal of osteochondral fragments of the proximal dorsal sagittal ridge of the fetlock in Thoroughbreds intended for flat racing. To establish racing prognosis in Thoroughbred yearlings with proximal sagittal ridge osteochondral lesions and compare them to dorsoproximal and palmar/plantar first phalanx osteochondral lesions. Methods: A total of 47 horses had proximal sagittal ridge lesions, 34 had palmar/plantar first phalanx lesions, and 115 had dorsoproximal first phalanx lesions. Methods: Retrospective case series. Methods: Medical records of Thoroughbred yearling racing prospects treated arthroscopically for fetlock osteochondral lesions were reviewed. Data were collected from a public database, including the ability...
Outcome of tenoscopically guided palmar/plantar annular ligament desmotomy for the treatment of palmar/plantar annular ligament constriction without concurrent intrathecal soft-tissue injury in a UK horse population. To determine the outcome of tenoscopically guided palmar/plantar annular ligament (PAL) desmotomy to treat PAL constriction without concurrent intrathecal soft-tissue injury, notably of the digital flexor tendons and manica flexoria. Methods: Retrospective multicenter cohort study. Methods: Sixty-five horses. Methods: Horses from four UK equine hospitals, with digital flexor tendon sheath (DFTS) tenosynovitis, which underwent tenoscopically guided PAL desmotomy for treatment of PAL constriction between 2017 and 2022 were included. All horses had lameness isolated to the DFTS/PAL, and PAL const...
Vascularity evaluation of the equine tarsocrural and proximal intertarsal joint septum, and comparative analysis of two arthroscopic transection techniques. To evaluate vascularity of the synovial membrane covered septum (SMS) separating the tarsocrural (TC) and proximal intertarsal (PIT) joints (Part 1) and compare two methods of transection, electrosurgical or Ferris Smith rongeur (FS rongeur) (Part 2). Methods: Experimental study. Methods: Part 1, 10 SMS (n = 5 horses). Part 2, six horses (n = 12 tarsi). Methods: In part 1, SMS harvested postmortem were each divided into eight regions of interest (ROIs), processed for histology, and immunostained with anti-α-actin antibody for blood vessel identification. Vascular density was calculate...
Case report: Equine metacarpophalangeal joint partial and full thickness defects treated with allogenic equine synovial membrane mesenchymal stem/stromal cell combined with umbilical cord mesenchymal stem/stromal cell conditioned medium. Here, we describe a case of a 5-year-old show-jumping stallion presented with severe lameness, swelling, and pain on palpation of the left metacarpophalangeal joint (MCj). Diagnostic imaging revealed full and partial-thickness articular defects over the lateral condyle of the third metacarpus (MC3) and the dorsolateral aspect of the first phalanx (P1). After the lesion's arthroscopic curettage, the patient was subjected to an innovative regenerative treatment consisting of two intra-articular injections of equine synovial membrane mesenchymal stem/stromal cells (eSM-MSCs) combined with umbilic...
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)...