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.
Preliminary investigations of pain and analgesia assessment in horses administered phenylbutazone or placebo after arthroscopic surgery. Twenty-five horses undergoing arthroscopic surgery were studied to develop a scheme for assessing pain in horses while investigating the effects of phenylbutazone (PBZ) analgesia. Fifteen of the 25 horses received PBZ 4 mg/kg intravenously (IV) before surgery and 2 mg/kg (IV) every 12 hours thereafter until 60 hours; the remaining 10 (placebo group) were given a corresponding volume of saline. In both groups, venous blood samples were collected for catecholamine, beta-endorphin, and cortisol assays before premedication and up to 72 hours after surgery. Postoperative pain was evaluated by measu...
Racing performance in standardbred trotters with chronic synovitis after partial arthroscopic synovectomy in the metacarpophalangeal, metatarsophalangeal and intercarpal (midcarpal) joints. Chronic synovitis may cause recurring lameness in competing race horses. Forty-five standardbred horses with recurring lameness secondary to chronic synovitis were studied. Arthroscopic synovectomy was performed in 32 metacarpo-/metatarsophalangeal joints and in 28 intercarpal joints of horses that had previously been treated unsuccessfully with commonly used intraarticular medication The outcome of the synovectomy was evaluated by comparing racing performance before and after surgery. The synovial membrane was microscopically characterized as chronic synovitis of varying severity. Racing perf...
Atypical villonodular synovitis in a horse. A 4-year-old sexually intact male Standardbred trotter was evaluated for left forelimb lameness. A presumptive diagnosis of severe cartilage damage was made because the horse had a history of infectious arthritis involving the left metacarpophalangeal joint. Arthroscopic evaluation revealed what was presumed to be a large villonodular lesion. The mass was surgically removed, and the horse was treated with procaine penicillin G, trimethoprim-sulfamethoxazole, phenylbutazone, and polysulfated glycosaminoglycans and eventually returned to racing. Histologic examination of the mass revealed a bed ...
A retrospective evaluation of the surgical management of equine carpal injury. Records of 220 thoroughbred horses presented to the Randwick Equine Centre or the University of Queensland Veterinary Teaching Hospital for surgical management of carpal injury were reviewed. Details of racing performance were obtained, enabling evaluation of racing success following surgery. Age and sex matched control horses not known to have suffered carpal injury were selected from the Australian Stud Book and the Australian Racehorse Register. Control and treated populations were compared in terms of overall career racing success. Radiographs or xeroradiographs from 198 horses were availa...
Advances in equine arthroscopy. Surgical procedures completed under arthroscopic guidance have become commonplace in many equine practices and have largely replaced surgery using arthrotomy incisions. With a limited amount of equipment, numerous diagnostic and surgical procedures can be completed. Surgeons need to become familiar with regional and intraarticular (intrasynovial) anatomy to ensure that proper surgical approaches are used, access to the lesion will be realized, and potential complications will be minimized. Specialized motorized instruments and surgical lasers are now available and may be useful in the treatmen...
Hyaluronate and large molecular weight proteoglycans in synovial fluid from horses with various arthritides. To investigate the presence of large molecular weight (MW) proteoglycans (PG) and hyaluronate (HA) in synovial fluid (SF) from horses with various arthritides and from control joints. Methods: Horses with acute (< 2 weeks) or chronic (> 4 weeks) lameness were examined by clinical examination, intrasynovial anesthesia, radiography, arthroscopy, and SF analysis. Joints were grouped on the basis of diagnosis: acute traumatic arthritis, chronic traumatic arthritis (with a subgroup of degenerative joint disease), intra-articular fracture, and infectious arthritis. Methods: 31 horses with arthritis ...
Metacarpophalangeal joint synovial pad fibrotic proliferation in 63 horses. Medical records, radiographs, and sonograms of 63 horses with metacarpophalangeal joint synovial pad proliferation were examined retrospectively. All horses had lameness, joint effusion, or both signs associated with one or both metacarpophalangeal joints. Bony remodeling and concavity of the distodorsal aspect of the third metacarpal bone (Mc3) just proximal to the metacarpal condyles was identified by radiography in 71 joints (93%); 24 joints (32%) had radiographic evidence of a chip fracture located at the proximal dorsal aspect of the proximal phalanx. Fifty-four joints (71%) were examined...
Repair and function of synovium after arthroscopic synovectomy of the dorsal compartment of the equine antebrachiocarpal joint. The reparative ability of equine synovium was determined by gross, histological, and ultrastructural examination. The functional potential of the synovium was estimated by examination of synovial cell organelles with transmission electron microscopy. Results from rested and exercised horses were compared to determine the effect of exercise on synovial healing. The response of synovectomized joint to exercise was evaluated with a standardized lameness examination and by gross, histological, and histochemical observations of the articular cartilage. A 7-mm diameter motorized synovial resector wa...
Radiographic and arthroscopic findings associated with subchondral lucency of the distal radial carpal bone in 71 horses. Case records and radiographs of 71 horses with subchondral lucency, without radiographic evidence of fracture, located on the distal radial carpal bone were examined retrospectively. All horses had lameness and/or joint effusion referable to the carpus. Distal radial carpal bone subchondral lucency was found as a solitary lesion or as a lesion concurrent and symmetric to a contralateral distal radial carpal bone chip fracture. The lesion appeared radiographically as a lucency or shadow on the distal dorsal margin of the radial carpal bone and was most evident on the flexed lateromedial and dor...
Effects of holmium: YAG laser energy on cartilage metabolism, healing, and biochemical properties of lesional and perilesional tissue in a weight-bearing model. Comparison of perilesional cartilage, lesional repair tissue, and subchondral bone activity 6 months after application of holmium-yttrium-aluminum-garnet (Ho:YAG) laser energy to chronic (10 week) induced 10-mm full-thickness (FT) circular articular cartilage craters followed by 6 months' intermittent active motion (IAM) in a free exercise environment was investigated. The 2.1-microns wavelength was delivered in hand-controlled near-contact mode by arthroscopic surgery in a saline medium. Bilateral arthroscopy was performed on normal antebrachiocarpal, intercarpal, and metacarpophalangeal join...
Comparison of arthroscopy and arthrotomy for the treatment of osteochondritic lesions in the femoropatellar joint of horses. Forty-eight horses with osteochondritic lesions of the femoropatellar joint were treated, 23 of them by an arthrotomy and 25 by arthroscopy. Follow-up information was obtained from either the owner or the referring veterinarian by telephone inquiry. There were no statistical differences between the groups of horses undergoing the two procedures with regard to age, sex, breed, the involvement of one or both limbs, the size of the lesion, and the duration of either the surgery or anaesthesia. However, the horses treated by an arthrotomy spent 14.5 days in hospital after the operation whereas tho...
Removal of chip fractures of the femoral trochlear ridges of three horses by arthroscopy. Clinical and radiographic examinations of three horses with histories of trauma and/or wounds to the stifle revealed chip fractures from the medial trochlear ridge of the femur of one of them and from the lateral ridges of the femurs of the others. The joints were evaluated and the fragments of bone were removed by arthroscopy. The results were good in all three horses.
Assessment of glycosaminoglycan concentration in equine synovial fluid as a marker of joint disease. A modification of a colorimetric assay was used to determine synovial fluid total and individual sulphated-glycosaminoglycan concentration in various clinical presentations of joint disease in horses. Concentrations of synovial fluid and serum sulphated-glycosaminoglycan (GAG) were measured by the 1,9-dimethylmethylene blue (DMMB) dye assay in normal horses (n = 49), horses with acute (n = 26) or chronic (n = 27) joint disease (defined by clinical, radiographic, and clinicopathological parameters), and horses with cartilaginous lesions at diagnostic arthroscopy, but with normal radiographs and...
Arthroscopic findings in the carpal joints of lame horses without radiographically visible abnormalities: 41 cases (1986-1991). Arthroscopy was performed in 1 carpal joint unilaterally in 27 horses and either in 2 carpal joints unilaterally or 1 carpal joint bilaterally in 7 horses. All horses were lame, but the cause of lameness could not be determined from radiographs. Twenty-seven carpi did not have radiographically visible abnormalities; the remaining 14 had only mild to moderate lucency or sclerosis of the radial facet of the third carpal bone. The primary abnormalities identified during arthroscopy included a crush fracture of the third carpal bone (7 carpi), an incomplete fracture of the third carpal bone in the...
Arthroscopic surgery for subchondral cystic lesions of the medial femoral condyle in horses: 41 cases (1988-1991). Clinical signs, radiographic and arthroscopic findings, and outcome for 41 horses with subchondral cystic lesions of the medial femoral condyle treated by arthroscopic surgery were reviewed. There were 17. Quarter Horses, 15 Arabians, 8 Thoroughbreds, and 1 Holsteiner, with 28 (68%) of the horses being 1 to 3 years old. For all horses, the owners' complaint was mild to moderate hind limb lameness or an altered gait. Bilateral radiographic abnormalities of the medial femoral condyle were detected in 27 horses. Nineteen of the 27 horses had lesions identified bilaterally at arthroscopic surgery....
Local and remote matrix responses to chondrocyte-laden collagen scaffold implantation in extensive articular cartilage defects. Chondrocyte-laden collagen scaffolds were evaluated in extensive cartilage defects in an equine model. Arthroscopic techniques were used to implant a chondrocyte-collagen culture product in 15-mm defects in the lateral trochlear ridge of the femoropatellar joint of 12 horses. Ungrafted control defects were formed in the opposite joint. Groups of six horses were terminated at 4 and 8 months after implantation and the repair sites, adjacent cartilage, and remote cartilage within each femoropatellar joint examined biochemically. Eight months following surgery the relative proportions of type II c...
Quantitative electroencephalographic evaluation to determine the quality of analgesia during anesthesia of horses for arthroscopic surgery. We compared the anesthetic combination of detomidine, ketamine, and halothane in control horses not undergoing apparently painful procedures with that in horses during arthroscopic surgery. The effectiveness of this regimen in suppressing neurologic response to surgery was, thus, evaluated. In this study, significant differences were not observed in electroencephalographic total amplitude, spectral edge, or beta-to-delta frequency ratio between surgically treated and nonsurgically treated (control) horses. On the basis of its attenuation of encephalographic responses, we conclude that detomidi...
Vertical tears of the cranial horn of the meniscus and its cranial ligament in the equine femorotibial joint: 7 cases and their treatment by arthroscopic surgery. Five horses with a vertical tear in the cranial horn and cranial ligament of the medial meniscus and 2 horses with a similar injury in the lateral meniscus were diagnosed from a series of 126 horses which were examined arthroscopically for stifle lameness. All the lesions had similar characteristics. The tear was about 1 cm from the axial border of the meniscus and its ligament and, in all but one case in which it was incomplete, much of the torn tissue was loosely attached in the axial part of the joint from where it was removed. The remaining meniscus, abaxial to the tear, was displaced cran...
Arthroscopic removal of axial osteochondral fragments of the plantar/palmar proximal aspect of the proximal phalanx in horses: 119 cases (1988-1992). Medical records from 119 horses that had undergone arthroscopic surgery for removal of axial osteochondral fragments of the palmar/plantar proximal aspect of the proximal phalanx were reviewed. Standardbred racehorses represented 109 (92%) of those affected. Ninety-three (78%) of the horses were < 3 years old. Gender distribution was consistent with that of the equine hospital population. Fragments most commonly were observed in the hind limbs (155/164; 95%), specifically, on the medial aspect of the left hind limb (72/164; 44%). Bilateral fragmentation occurred in 21 of 119 (18%) horses, a...
Consideration of anatomic and radiographic features of the caudal pouches of the femorotibial joints of horses for the purpose of arthroscopy. Development of an arthroscopic approach to the caudal pouches of the equine stifle has been necessary because cranial approaches do not allow access to articular lesions in the caudal aspect of the joint. Therefore, the anatomy of the caudal region was examined in 52 cadaver limbs by use of gross dissection (29), x-ray-computed tomography (6), fluoroscopy (8), or arthroscopy (9). Additionally, using arthroscopic techniques developed in equine cadaver limbs, 3 stifles from 2 anesthetized horses were arthroscopically explored. Fluoroscopy was used to verify needle placement for joint injection a...
Osteochondral fragmentation of the plantar/palmar proximal aspect of the proximal phalanx in racing horses. The clinical presentation and outcome of treatment is presented for 26 cases of osteochondral fragmentation of the plantar/palmar proximal aspect of the proximal phalanx. Twenty-three were racing Standardbreds and three were racing Thoroughbreds. The most common reason for presentation was an inability to run straight at high speed. Only eight horses presented for lameness, although on examination 19 were lame. A positive flexion test was recorded in 90% of affected fetlock joints and effusion in 48%. Arthroscopic fragment removal was performed on 23 occasions in 21 horses and arthrotomy in on...
Lead foreign body arthropathy in a horse. A diagnosis of degenerative joint disease secondary to an intra-articular metallic foreign body in the right metacarpophalangeal joint was made in a Quarter Horse gelding. Arthroscopy, performed to evaluate the joint and remove the foreign body, revealed yellow discoloration of the articular cartilage and synovium, and blunting and proliferation of the synovium. The foreign body was identified as a lead sphere. Microscopic examination of synovium revealed chronic synovitis, with accumulation of hemosiderin and multifocal, mild mineralization. Another pigment was evident extracellularly in the ...
Effect of betamethasone and exercise on equine carpal joints with osteochondral fragments. Osteochondral fragments were created arthroscopically on the distal aspect of both radial carpal bones in 12 horses. On day 14 after surgery, one middle carpal joint of each horse was injected with 2.5 mL Betavet Soluspan (3.9 mg betamethasone sodium phosphate and 12 mg betamethasone acetate per milliliter) and the contralateral joint was injected with 2.5 mL saline as a control. Intra-articular treatments were repeated on day 35. On day 17, six horses began exercising 5 days per week on a high-speed treadmill. The other six horses were kept in box stalls throughout the study as nonexercised c...
The anatomic features of the normal tarsus of the live horse as perceived by the sense of sight. A description is given of 75 features present in the normal tarsus of the standing horse which are apparent due to visible skin contours overlying them. Depending on whether or not the pelvic limb is supporting full weight or resting, some contours alter their configuration. Therefore the contour of each underlying feature is described separately for each stance of the limb. It is considered that visual inspection and identification of the apparent superficial features of the normal equine tarsus form the basis of orientation and clinical inspection. Furthermore, these features provide referen...
Proximodorsal first phalanx osteochondral chip fragmentation in 336 horses. The results of arthroscopic surgery in the treatment of osteochondral fragmentation of the proximodorsal aspect of the first phalanx and the influence of other fetlock joint lesions on prognosis were evaluated in 336 horses. Horses were classified as: 1) returning to previous use at the same or higher class of performance; 2) returning to previous use (regardless of class of performance); or 3) failing to return to previous use. Ninety-six horses (29%) had fragmentation alone; 140 horses (42%) had fragmentation and additional fetlock lesions, and 100 horses (29%) underwent concurrent carpal ar...
Diagnostic and operative arthroscopy of the coxofemoral joint in horses. Arthroscopic examination of the hip joint was performed in mature and juvenile horses, using a lateral approach and standard or long instruments depending on body weight. Nine hip joints were examined in three cadavers and four anesthetized horses. The lateral, cranial, and caudal regions of the femoral head and acetabulum were accessible, and, after distraction of the limb, the ligament of the head of the femur and the acetabular notch were also visible. In small horses, the medial regions of the hip joint were visible but were inaccessible in larger horses. Iatrogenic injury to the sciatic n...
Long-term fate and effects of exercise on sternal cartilage autografts used for repair of large osteochondral defects in horses. Bilateral osteochondral defects (10 mm2 x 3 mm deep) were created on the distal articular surface of the radial carpal bone of ten, 2- to 3-year-old horses. One defect of each horse was repaired, using a sternal cartilage autograft (treated), and the other was left untreated (control). The horses were exercised on a high-speed treadmill at incrementally increased speed and duration over the course of 12 months. Horses were evaluated arthroscopically at 6 to 7 weeks, and clinical examinations were conducted weekly at exercise. Twelve months after surgery, carpuses of each horse were radiographe...
Arthroscopic removal of osteochondral fragments from the proximal interphalangeal joint of the pelvic limbs in three horses. Osteochondral fragments detected in the proximal interphalangeal joint in the pelvic limbs of 3 horses (2 Standardbreds and 1 Thoroughbred) caused joint enlargement and lameness. Fragments were removed by use of arthroscopy. Accurate placement of the arthroscope into the dorsal joint space was necessary to obtain an adequate view of the fragments. After surgery, 2 of the horses resumed racing without joint problems, and the third was in training to race. High-detail radiographs are necessary to detect osteochondral fragments in horses with joint enlargement or lameness localized to the proxima...
Morphological effects of arthroscopic partial synovectomy in horses. Gross and microscopic effects of arthroscopic partial synovectomy on synovium and articular cartilage of middle carpal joints were studied in 15 horses. A 7-mm diameter motorized synovial resector was inserted into each middle carpal joint and arthroscopic partial synovectomy and lavage or arthroscopic lavage alone was performed. Study periods were 0 (three horses), 16 (three horses), and 30 days (six horses). No gross evidence of degenerative joint disease was observed at day 16 or 30. At 30 days, resected areas lacked villi and there was deposition of fibrin on the synovial surface with vary...
Arthroscopic removal of a fragment from an intercondylar eminence fracture of the tibia in a two-year-old horse. A 2-year-old Standardbred colt was admitted because of lameness of the left hind limb. Physical examination revealed marked effusion of the left femoropatellar and femorotibial joints and grade IV/V lameness of the left hind limb. Radiography of the left stifle revealed a complete fracture of the medial tubercle of the intercondylar eminence of the tibia. Arthroscopy was used to provide diagnostic, therapeutic, and prognostic information. A cranial approach to the medial compartment of the femorotibial joint was performed. Manipulation of the medial tubercle revealed it to be unstable, but a d...