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.
Osteochondritis dissecans of the tarsocrural joint: results of treatment with arthroscopic surgery. The technique and results of arthroscopic surgery for the treatment of osteochondritis dissecans in 318 tarsocrural joints in 225 horses are reported. Of the 225 horses, 154 were racehorses or intended for racing. Arthroscopic surgery was an effective technique for treating osteochondritis dissecans of the tarsocrural joint. The overall functional ability and cosmetic appearance of the limbs were excellent. Post surgical follow-up information was obtained for 183 horses, of which 140 (76.5 per cent) raced successfully or performed their intended use following surgery. Of the remaining 43, 11 w...
Pulsed carbon dioxide laser for cartilage vaporization and subchondral bone perforation in horses. Part I: Technique and clinical results. A carbon dioxide laser, used in a rapidly pulsed mode, was evaluated for intra-articular use in horses. Under arthroscopic guidance, a lensed 5 mm laser probe attached directly to a hand-held carbon dioxide laser was inserted into one intercarpal joint of eight horses. In four horses, a cartilage crater 1 cm in diameter was created to the level of the subchondral bone of the articular surface of the third carpal bone. In four horses, the laser was directed perpendicular to the articular surface of the third carpal bone and activated to penetrate the cartilage and subchondral bone. The intercar...
Repair of shoulder luxation in a horse. Shoulder luxation in a 3-year-old Thoroughbred filly was treated by closed reduction, using a calf jack to provide traction on the limb. Arthroscopic examination of the shoulder allowed removal of soft tissue and bony debris. After surgery, the filly was confined to a box stall for 6 months. Eight months after surgery, the filly was doing light work and was not lame. Muscular atrophy present before surgery had resolved. Use of a calf jack may allow reduction of shoulder luxation under field conditions.
Morphologic study of repair of induced osteochondral defects of the distal portion of the radial carpal bone in horses by use of glued periosteal autografts [corrected]. The use of periosteal autografts to resurface osteochondral defects was investigated in 10 horses (2 to 3 years old), and the repair tissue was characterized morphologically. Middle carpal joint arthrotomies were made, and osteochondral defects were induced bilaterally on the distal articular surface of each radial carpal bone. Each defect measured approximately 1 cm2 and extended 3 mm into the subchondral bone plate. Residual subchondral bone plate of control and principal defects was perforated by drilling. A sterile fibrin adhesive was made by mixing a fibrinogen component and a thrombin co...
Closed suction drainage in the treatment of infectious arthritis of the equine tarsocrural joint. Infectious arthritis of the tarsocrural joint was treated in 13 horses with closed suction drainage through a flat, fenestrated, latex (Jackson-Pratt) drain, broad-spectrum antimicrobial agents, nonsteroidal anti-inflammatory drugs, and bandage immobilization. In 11 horses, arthroscopic lavage and debridement were also performed. Ingress drains were placed for lavage in six horses. Ten horses returned to their previous level of competition or were sound. One horse raced but had lameness of the affected tarsocrural joint and dropped in racing class; one horse was euthanatized because of laminit...
[Chronic disease of the two sesamoid bones of the lower foot of the horse]. The aetiology and pathogenesis of navicular bone disease and sesamoidosis are discussed on the basis of findings reported in the literature and research. A marked similarity is found to be present between the clinical presentation, aetiology and pathogenesis of these two diseases. In addition, the intra and juxta-articular signs of degeneration as seen in these diseases are similar to those seen in various forms of arthrosis. Circulatory disturbances resulting from partial or complete arterial occlusion, caused by arteriosclerosis, are likely to play an important role in the cause of degenerat...
Metabolic and hormonal changes associated with arthroscopic surgery in the horse. The effect of general anaesthesia and arthroscopic surgery on blood glucose and lactate, plasma non-esterified fatty acids, insulin, beta-endorphin and cortisol was investigated in seven horses. Animals were premedicated with xylazine and anaesthesia was induced with guaifenesin and sodium thiamylal and maintained with halothane vaporised in oxygen. Blood samples were collected in the pre-, intra- and post operative period. Induction of anaesthesia was associated with a transient hyperglycaemia and a significant rise in plasma insulin levels. Plasma insulin values fell during surgery but showe...
Chronic proliferative synovitis of the equine metacarpophalangeal joint. Chronic proliferative synovitis of 27 metacarpophalangeal joints in 16 horses is described. The diagnosis was based on a history of lameness and, or, poor performance, pain on flexion of the metacarpophalangeal joint, the response to intra-articular anaesthesia, and plain and contrast radiography. Radiographic findings included concavity of the distal dorsal metacarpus proximal to the sagittal ridge, and an increase in size of the synovial tissue adjacent to the proximal, dorsal attachment of the joint capsule. Mineralisation of the synovial tissue was present in some joints, and chip fracture...
Endoscopy of the digital flexor tendon sheath in horses. An arthroscopic procedure for examination of the digital flexor tendons and tendon sheath was developed in 16 equine limbs and 12 horses. Distension of the tendon sheath and insertion of the arthroscope was accomplished through a cul-de-sac on the palmar or plantar surface of the tendon sheath 1 to 2 cm palmar or plantar to the digital neurovascular structures and between the annular ligament and proximal digital annular ligament. A single arthroscope entry point allowed examination of all regions of the tendon sheath cavity and most surfaces of the digital flexor tendons within the sheath. Di...
Osteochondral fragmentation of the distal aspect of the patella in horses. A condition characterised by osteochondral fragmentation of the distal aspect of the patella in 15 horses is described. The problem was unilateral in six horses and bilateral in nine. There were eight Quarterhorses, three Thoroughbreds, two American Saddlebreds, one American Paint and one Warmblood-Thoroughbred cross. A previous medial patellar desmotomy had been performed on 12 of the 15 horses. The condition manifested as hindlimb lameness and stiffness ranging from mild to severe. There was fibrous thickening in the stifle area in the 12 cases with a previous medial patellar desmotomy, and ...
Correlation between radiographic and arthroscopic findings in the equine carpus. The radiographic and arthroscopic findings in 150 carpal joints in 114 lame horses were compared. Chip, slab, or sagittal fractures were identified in 130 (87%) joints. In 101 (78%) of these there was good agreement between radiographic and arthroscopic findings on the number and position of fractures. In 23 (18%) joints, chip fractures additional to those seen radiographically were found arthroscopically. In one joint a large chip fracture from the craniolateral aspect of the distal radius was identified only by arthroscopy, while in 6 joints fractures were identified only by radiography. Obs...
Arthrography of the equine shoulder joint. Techniques and normal radiographic anatomy for positive and double contrast shoulder arthrography in horses were evaluated. General anaesthesia was used for most radiographic projections of the shoulder. The mediolateral projection provided the most information during arthrography, although the supinated mediolateral view occasionally allowed better definition of the cartilage surfaces on the medial aspects of the humeral head. The craniocaudal mediolateral oblique and caudocranial projections provided limited additional information. Water soluble non-ionic contrast agents, such as metrizamide...
Arthroscopic approaches and intraarticular anatomy of the equine elbow. Periarticular anatomy and techniques for arthroscopic access to the equine elbow were studied in six joints from cadavers. Caudomedial and craniolateral approaches were evaluated subsequently in 11 anesthetized horses. The caudomedial approach was made between the flexor carpi radialis and flexor carpi ulnaris muscle bellies. Most of the caudal articular surfaces of the humeral condyles, the caudal perimeter of the radius, and the trochlear notch and portions of the anconeal process of the ulna could be identified. The voluminous caudal joint capsule cul-de-sac proximal to the anconeal process...
Biochemical changes in articular cartilage opposing full- and partial-thickness cartilage lesions in horses. Using arthroscopic technique, identical diameter defects were created in the proximal articular surface of both intermediate carpal bones of 6 horses. One of each pair of defects was deepened to penetrate the subchondral plate. Removed cartilage was assayed for [35S] sulfate incorporation, total hexosamine content, and DNA content. Six weeks later, cartilage was harvested and similarly analyzed from the distolateral portion of the radius directly opposite the created lesions and the distomedial portion of the radius distant from the lesion. The repair tissue filling the full-thickness defect a...
Further investigations into the potentiation of infection by intra-articular injection of polysulfated glycosaminoglycan and the effect of filtration and intra-articular injection of amikacin. Polysulfated glycosaminoglycan (PSGAG) recently have been reported to potentiate the infectivity of Staphylococcus aureus in horses with experimentally induced septic arthritis. Four groups of 8 horses each had 1 midcarpal joint injected with approximately 33 viable colony-forming units (CFU) of S aureus plus either 1 ml of saline solution (group 1), 250 mg of PSGAG (group 2), 250 mg of PSGAG passed through a 0.6-microns filter (group 3), or 250 mg of PSGAG plus 125 mg of amikacin (group 4). Horses that developed clinical signs consistent with sepsis were euthanatized, and samples were collect...
Production of patellar lesions by medial patellar desmotomy in normal horses. Medial patellar desmotomy was performed on one (treated) hindlimb, and a sham operation on the other (control) hindlimb, of 12 normal horses. The horses were examined for lameness before medial patellar desmotomy and at months 1, 2, and 3. The femoropatellar joints were examined radiographically and arthroscopically at month 3. All horses were lame on the treated limb at months 1, 2, or 3. Radiographic changes, including fragment formation at the distal aspect of the patella and bone production at the attachment of the middle patellar ligament on the patella, were present in 11 horses at month...
Neochondrogenesis in free intra-articular, periosteal, and perichondrial autografts in horses. Periosteal autografts were obtained from the medial aspect of the proximal portion of the tibia, and perichondrial autografts were obtained from the sternum. Using arthroscopic visualization, each autograft was placed as a loose body into 1 tarsocrural joint in 6 young horses (2 to 4 years old). Horses were hand-walked daily, starting the day after surgery, for a total of 6 h/wk for 8 weeks. Eight weeks after autograft implantation, radiographs were taken of each tarsocrural joint and were interpreted with regard to mineralization in the transplanted autografts. Autografts were then surgically...
Subchondral lucency of the third carpal bone in Standardbred racehorses: 13 cases (1982-1988). Thirteen Standardbreds had subchondral lucency of the third carpal bone (C3), described as single or multiple central areas of C3 bone loss in the radial fossa. Sclerosis of the radial fossa was also detected. The mean age of 9 stallions, 3 mares, and 1 gelding was 4.1 years (range, 3 to 7 years). All horses had an acute moderate to severe lameness referable to the middle carpal joint. A dorsoproximal dorsodistal (skyline) radiographic projection was most useful and identified mild (3 horses), moderate (6 horses), and severe (4 horses) subchondral lucency and sclerosis of the radial fossa. The...
Arthroscopic removal of apical and abaxial sesamoid fracture fragments in five horses. Five horses with apical and abaxial fractures of the proximal sesamoid bones were treated arthroscopically. Ipsilateral and contralateral triangulation were used to remove abaxial fragments; apical fragments were removed by ipsilateral triangulation. Excellent visibility of the fracture fragments was obtained with each method. Dissection and removal of fragments was accomplished with standard arthroscopic instruments, tendon-splitting knives, and curved scissors. Excellent functional and cosmetic results were achieved in all cases.
Injuries to the cranial cruciate ligament and associated structures: summary of clinical, radiographic, arthroscopic and pathological findings from 10 horses. The clinical, radiographic, arthroscopic and pathological findings of 10 horses with injury to the cranial cruciate ligament are presented. The most consistent clinical signs included moderate to severe distension of the femoropatellar joint and a Grade III to a Grade V out of V lameness. Craniocaudal instability could be elicited in five horses under general anaesthesia and in one conscious horse. Radiographic evaluation of the stifles revealed that avulsion fracture of the medial intercondylar eminence was the most common finding in six out of 10 horses. Arthroscopic examination of the affec...
The effect of exercise on the healing of articular cartilage defects in the equine carpus. Arthroscopic surgery was performed on 12 horses (2-4 years of age) to create a 7 x 14 mm full-thickness cartilage defect in one radial carpal bone and in the contralateral third carpal bone. Six horses remained confined to a small paddock and six horses underwent a program of increasing exercise consisting of walking, trotting, and cantering for 13 weeks. All lesions showed evidence of healing at week 6 that progressed to more complete healing at week 13. There was no difference in the amount of repair tissue covering the defect. Histologically, the lesions healed with a combination of fibrous...
Synovial hernia as a possible complication of arthroscopic surgery in a horse. A 3-year-old Standardbred gelding was referred for evaluation of a fluctuant swelling that developed over the dorsum of the carpus subsequent to arthroscopic surgery on that carpus. A synovial hernia was diagnosed and surgically repaired. Although complications secondary to arthroscopy are rare, synovial herniation can develop after arthroscopic surgery. The condition must be differentiated from the more common true bursitis or false bursitis that is commonly referred to as a hygroma.
Effects of intramuscular polysulfated glycosaminoglycan on chemical and physical defects in equine articular cartilage. The effect of intramuscular polysulfated glycosaminoglycan (PSG) on repair of cartilage injury was evaluated in eight horses. In each horse, one middle carpal joint had both a partial-thickness and a full-thickness articular cartilage defect created. In the contralateral middle carpal joint, chemical articular cartilage injury was created by intra-articular injection of 50 mg sodium monoiodoacetate (MIA). Horses were divided into two groups for treatment. Group 1 horses (control) received an intramuscular injection of normal saline every four days for a total of seven injections starting seven...
Osteochondral fragments within the dorsal pouch or dorsal joint capsule of the proximal intertarsal joint of the horse. The anatomy of the dorsal pouch of the proximal intertarsal joint (PIJ) and its communication with the tarsocrural joint (TCJ) was studied in 15 pairs of hocks from young and mature horses. The mediolateral length of the TCJ-PIJ fenestration was 14 to 29 mm. The potential volume of the dorsal pouch of the PIJ was 3 to 5 ml, and a recess extended 10 to 28 mm medial to the medial commissure of the TCJ-PIJ fenestration. In a correlated clinical study, osteochondral fragments were identified radiographically within the dorsal pouch (category 1) or dorsal joint capsule (category 2) of the PIJ in 17...
Tourniquet-induced hypertension in a horse. Arterial hypertension developed in a horse anesthetized for arthroscopy and lavage of an inflamed right carpal joint. Anesthesia was induced with xylazine HCl, butorphanol, guaifenesin, and thiamylal Na and was maintained with halothane in oxygen. Arterial hypertension and tachycardia developed within 15 minutes after a pneumatic tourniquet was placed 8 to 10 cm proximal to the right carpus and inflated to 800 mm of Hg. The surgical procedure was expedited, halothane was discontinued and anesthesia was maintained with guaifenesin to facilitate bandaging. Heart rate decreased from 72 to 42 beat...
Severe Synovitis in Two Horses due to the Use of Irrigating Solutions Containing Methanol and Formaldehyde. Two horses were examined because of chronic lameness, which followed arthroscopy in one case, and tendon sheath lavage in a second case. Clinical investigations linked both cases to the use of irrigating fluids containing preservatives. The clinical signs were reproduced in a Shetland pony by injection and lavage of the carpal joints with the same fluid. Lameness was slow in onset and accompanied by profound periarticular fibrosis. Postmortem examination confirmed the presence of a severe, erosive, noninfectious arthritis that may have an immune-mediated component. Clinicians should read produ...
Arthroscopic examination of the femorotibial joints of horses. A technique for satisfactory arthroscopic examination of the lateral and medial femorotibial joints of the horse is described. The entry portal is made between the middle and medial patellar ligaments with the horse on its back and the stifle flexed. This position allows easy access to view the intercondylar eminence of the tibia. From this reference point, examination of all but the most caudal and medial structures of the joints are possible by manipulating the sleeve and telescope and maintaining joint distention. In a series of 20 examinations, iatrogenic trauma was recognized only once.
Arthroscopic surgery for the treatment of osteochondral chip fractures in the equine carpus. The technique and results of arthroscopic surgery for the removal of osteochondral fragments from 1,000 carpal joints in 591 horses are reported. Of the 591 horses, 580 were racehorses (including 349 Quarter Horses and 220 Thoroughbreds). The distal aspect of the radial carpal bone was the most commonly affected site, followed by the proximal aspect of the intermediate carpal bone and distolateral aspect of the radius. More than one carpal joint was simultaneously operated on in 58.9% of the Quarter Horses and in 37.4% of the Thoroughbreds. Marked differences in the amount of damage were noted...