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.
Standing Arthroscopic Treatment of Temporomandibular Joint Sepsis in a Horse. A 15-year-old Thoroughbred gelding was presented for investigation of fever, right temporomandibular region swelling, and progressive pain when opening the mouth. Right temporomandibular joint (TMJ) sepsis was diagnosed based on synovial fluid analysis, sonographic imaging, and standing robotic cone-beam computed tomography. Concurrent otitis media and temporohyoid osteoarthropathy (THO) were also noted. The horse was treated with arthroscopic debridement and lavage during standing sedation followed by local and systemic antimicrobial therapy. There were no complications associated with the su...
Arthroscopic debridement of short frontal plane proximal phalanx fractures preserves racing performance. Outcomes have been reported for a limited number of short frontal plane fractures of the proximal phalanx following nonsurgical treatment and internal fixation. Objective: To describe a new approach, arthroscopic debridement, of short frontal plane fractures of the proximal phalanx in flat-racing Thoroughbreds and post-operative racing outcome. Methods: Retrospective case-control study. Methods: Medical records of 81 Thoroughbred racehorses treated with arthroscopic debridement for frontal plane fractures of the proximal phalanx were reviewed. Diagnostic images and operative reports were used ...
Arthroscopic approach and intra-articular anatomy of the equine discomandibular joint compartment of the temporomandibular joint. To develop an arthroscopic approach to the discomandibular joint (DMJ), the ventral compartment of the temporomandibular joint (TMJ) of the horse. Methods: Experimental study. Methods: Nine cadaveric equine heads and two live horses. Methods: A 2.5-mm 30° arthroscope was used to explore the DMJ after joint distension. The first portal was created caudally, allowing placement of a rostral portal under visual guidance. Nasotracheal intubation of the live horses allowed mandibular manipulation, which is required for complete visualization of the joint. Results: A novel injection technique allowe...
An alternative arthroscopic approach to the caudal pouches of the equine lateral femorotibial joint. Current arthroscopic approaches to the caudal pouches of the lateral femorotibial joint are challenging and risk iatrogenic nerve and cartilage injury. Objective: Describe an alternative arthroscopic approach to the caudal pouches of the lateral femorotibial joint in the horse and report intra-articular abnormalities observed during diagnostic stifle arthroscopy of these pouches. Methods: Descriptive cadaver anatomical and clinical study. Methods: An approach to the caudal pouches of the lateral femorotibial joint was developed during clinical surgery using an arthroscopic portal in the poplit...
Needle arthroscopy of the radiocarpal and middle carpal joints in standing sedated horses. To develop a technique for standing diagnostic needle arthroscopy of the radiocarpal and middle carpal joints in standing sedated horses. Methods: Experimental study. Methods: Six cadaveric forelimbs (phase 1) and six healthy horses (phase 2). Methods: In phase 1, six cadaveric forelimbs were used to assess needle arthroscopic evaluation of both joints. Six healthy horses were subsequently enrolled in phase 2 to validate the procedure in live animals. The joint was maintained in flexion with a custom-made splint and base. Results: In phase 1, needle arthroscopy allowed thorough evaluation of t...
Bilateral Total Knee Arthroplasty for Charcot Arthropathy After Cauda Equine Syndrome: A Case Report. Charcot arthropathy of the knee is a relatively rare and poorly understood condition. Diagnosis requires detailed history of the patient, radiological investigation and exclusion of other causes of arthropathy. Conservative treatment is sufficient only in early stages. In late stages, either arthrodesis or total knee arthroplasty is the treatment of choice. We report a case of a 65-year-old woman who presented with Charcot arthropathy in both knees, after a spinal fracture 35 years ago, which caused cauda equine syndrome with diminished sensation of both legs. She underwent bilateral total kne...
Evaluation of the caudal cervical articular process joints by using a needle arthroscope in standing horses. To determine the safety and efficacy of caudal cervical articular process joint arthroscopy by using needle arthroscopy in standing sedated horses. Methods: Prospective experimental case series. Methods: Six adult horses. Methods: Three horses underwent exploration of bilateral C5-6 vertebral articular process joints and three bilateral C6-7 articular process joints by using a 1.2 × 65-mm needle arthroscope under standing sedation. The 16-gauge arthroscopic trocar and canula assembly was inserted in the desired articular process joint under ultrasonographic guidance without distention of ...
Diagnostic tenoscopy of the carpal sheath with a needle arthroscope in standing sedated horses. To investigate the use of a needle arthroscope for diagnostic tenoscopy of the carpal sheath in standing horses. Methods: Experimental study. Methods: Six forelimbs for the cadaveric part of the study and six horses for the in vivo part of the study. Methods: Six cadaveric limbs were used to perform carpal sheath tenoscopy with a 1.2-mm-diameter needle arthroscope (65 and 100 mm long), followed by tenoscopy with a 4-mm arthroscope through a standard proximolateral approach. Then, unilateral standing carpal sheath tenoscopy was performed in six healthy sedated horses with a 65-mm-long needle ...
Retrospective assessment of perioperative antimicrobial use for elective arthroscopy in horses. To describe perioperative antimicrobial use in horses undergoing elective arthroscopy. Methods: Retrospective study. Methods: Horses that underwent elective arthroscopy at one institution between July 2016 and May 2018, excluding those with a suspected infectious orthopedic disease or with a comorbidity that may have impacted prophylactic antimicrobial use decisions. Methods: Medical records were reviewed to evaluate preoperative, intraoperative, and postoperative antimicrobial drug selection, dose, and timing. Associations between body weight and underdosing were evaluated by using analysis o...
Diagnostic needle arthroscopy of the tarsocrural joint in standing sedated horses. To develop and assess a needle arthroscopic technique to diagnose conditions of the tarsocrural joint (TCj) in standing sedated horses. Methods: Experimental study. Methods: Six cadaveric hind limbs (phase 1) and six healthy horses (Phase 2). Methods: In phase 1, each TCj was examined with a 1.2-mm-needle arthroscope. Suitability of the needle arthroscope and degree of joint visualization with traditional arthroscopic approaches were assessed. In phase 2, the feasibility of the procedure was assessed in six standing healthy horses. A custom-made splint and base were developed to maintain joint...
Chondromalacia of the cranial medial femoral condyle; its occurrence and association with clinical outcome in a population of adult horses with stifle lameness. Chondromalacia of the cranial medial femoral condyle (CMFC) is a potential cause of stifle lameness in adult horses. However, there is scant published evidence of either its occurrence or its clinical significance. Objective: To document the occurrence of CMFC seen during diagnostic arthroscopy in adult horses with stifle lameness and to investigate its prognostic significance. Methods: Retrospective cohort study. Methods: The records were reviewed of all horses with unilateral or bilateral lameness localised to the stifle that underwent diagnostic arthroscopy of the cranial medial femorotibia...
Nonsurgical and surgical management of metacarpo/metatarsophalangeal joint dorsal chip fracture in the Thoroughbred racehorse. Arthroscopy is considered the treatment of choice for dorsal osteochondral chip fractures of the metacarpo/metatarsophalangeal (MCP/MTP) joints in the racehorse; however, there is no published research on non-surgical management of this injury. Objective: To compare clinical features, intra-articular medication use and return to racing in Thoroughbred racehorses with non-surgically (non-SX) or surgically (SX) managed MCP/MTP dorsal chip fracture. Methods: Retrospective observational study conducted between 2006 and 2014. Methods: Radiographs of Thoroughbred racehorses were reviewed to identify...
The influence of tenoscopic approaches on radiocarpal joint perforation during carpal sheath tenoscopy in horses. To report the frequency of radiocarpal joint (RCJ) perforation during two proximolateral carpal sheath (CS) approaches and to investigate whether the presence or absence of a natural communication between the RCJ and CS. Methods: Experimental, randomized, controlled study. Methods: Twelve adult horses and 12 cadaver front limbs. Methods: Proximolateral CS tenoscopy was performed on both carpi of 12 horses under general anaesthesia. Limbs were randomly assigned into two groups. In group 1, the instrument portal was centered at the level of the distal radial physeal remnant (PR). In group 2, the...
Osteochondral fragments of the pastern joint at the origin of the collateral ligament of the distal sesamoid bone: performance after arthroscopic removal (2000-2015). To describe the presence of fragments in the dorsal proximal interphalangeal (PIP) joint and to report flat racing performance after surgical treatment. Methods: Retrospective study. Methods: Thirty-nine affected thoroughbred flat racehorses and 169 age- and sex-matched maternal siblings. Methods: Medical records from 2000 to 2015 were reviewed for thoroughbred horses that underwent arthroscopic removal of osteochondral fragments in the dorsal aspect of the PIP joint. The horses' 2-year-old year, 3-year-old year, and career athletic performances were compared with their matched siblings. Resul...
Radiographic and arthroscopic features of third carpal bone slab fractures and their impact on racing performance following arthroscopic repair in a population of racing Thoroughbreds in the UK. Slab fractures of the third carpal bone (C3) are a common injury of Thoroughbred racehorses. Results of arthroscopically guided repair have not been reported since the initial description of the technique in 1986. Additionally, fracture details and racing outcomes in a population of Thoroughbreds racing under UK jurisdiction have not previously been described. Objective: To report the frequency distribution of C3 slab fractures and to determine the impact on racing performance following arthroscopically guided repair in a population of Thoroughbred racehorses. Methods: Retrospective case serie...
Anatomical variations of the equine popliteal tendon. The function of the popliteal muscle and tendon in horses remains undescribed. In humans, it is considered a stabilizer of the posterior-lateral region of the knee; its function is closely related to that of the lateral collateral ligament (LCL) and meniscus. The popliteal tendon (PopT) constitutes the main proximal attachment of the popliteus muscle to the femur, and in humans, insertional variations have been described. Knowledge of anatomical variations is needed for the correct interpretation of diagnostic images and arthroscopic findings. To elucidate further the anatomy of the equine Pop...
A 10-year study of arthroscopic surgery in racing Thoroughbreds and Quarter Horses with osteochondral fragmentation of the carpus. Osteochondral fragmentation of the carpus is a common cause of lameness in racehorses. Prognosis following arthroscopic removal of the fragments was reported in 1987, but little is known of recent success rates. Objective: To identify associations between the severity and location of osteochondral fragments in the carpus, and to describe the racing performance of horses pre- and post-surgery in Thoroughbreds and Quarter Horses. To identify factors associated with a horse racing post-surgery. Methods: Retrospective study of clinical records (2006-2016). Methods: Surgical and racing records for ...
Outcome of arthroscopic debridement of cartilage injury in the equine distal interphalangeal joint. The purpose of this study was to report long-term outcome following arthroscopic debridement of articular cartilage lesions of the distal interphalangeal joint, diagnosed with high-field magnetic resonance imaging. Diagnosis was based on the results of diagnostic anesthesia, magnetic resonance imaging (MRI), and arthroscopy. Ten horses underwent arthroscopic evaluation for cartilage injury and received various intra-articular therapies after surgery. Three of ten horses had lesions that were surgically inaccessible. Four horses became sound and returned to their preoperative level of athletici...
A retrospective comparison of induction with thiopental/guaifenesin and propofol/ketamine in Thoroughbred racehorses anesthetized with sevoflurane and medetomidine during arthroscopic surgery. This study compares clinical characteristics between induction with thiopental/guaifenesin and propofol/ketamine in Thoroughbred racehorses anesthetized with sevoflurane and medetomidine. Clinical records of 214 horses that underwent arthroscopic surgery between 2015 and 2016 were retrospectively retrieved. Horses were premedicated with medetomidine and midazolam to sedate at the adequate level for smooth induction, and then induced with either thiopental (4.0 mg/kg) and guaifenesin (100 mg/kg) in Group TG (n=91) or propofol (1.0 mg/kg) and ketamine (1.0 mg/kg) in Group PK (n=123). Anesthesia ...
Effects of blood-derived products and sodium hyaluronate on equine synovial fluid cells and on synovial fluid from osteochondrotic joints of horses after arthroscopy and administration of treatment. To compare effects of platelet-rich plasma (PRP), interleukin-1 receptor antagonist protein (IRAP), autologous processed plasma (APP), and sodium hyaluronate treatments on synovial fluid cells in vitro and on synovial fluid obtained from osteochondrotic joints of horses. Methods: Synovial fluid cells from 8 healthy equine tibiotarsal joints (in vitro experiment) and synovial fluid samples from 40 tibiotarsal joints of 25 horses with osteochondrosis dissecans (in vivo experiment). Methods: Effects of various treatments on concentrations of prostaglandin (PG) E2, interleukin (IL)-1β, tumor necr...
Effects of positive end-expiratory pressure alone or an open-lung approach on recruited lung volumes and respiratory mechanics of mechanically ventilated horses. To evaluate the effects of positive end-expiratory pressure (PEEP) alone and PEEP preceded by lung recruitment manoeuvre (LRM) on lung volumes and respiratory system mechanics in healthy horses undergoing general anaesthesia. Methods: Controlled, prospective clinical study. Methods: A group of 15 horses undergoing arthroscopy. Methods: Following anaesthetic induction, initial ventilatory settings were: tidal volume 15 mL kg, inspiratory:expiratory ratio 1:2, respiratory rate to maintain end-tidal CO between 5.3-6.6 kPa (40-50 mmHg). The following settings were implemented sequentially: zero PE...
Long-term outcome after stifle arthroscopy in 82 Western performance horses (2003-2010). To report the outcome of horses engaged in Western performance disciplines after stifle arthroscopy and identify prognostic factors for return to performance. Methods: Retrospective case series. Methods: Eighty-two Western performance horses undergoing stifle arthroscopy. Methods: Medical records were reviewed for horses involved in athletic performance/training for various Western performance disciplines and undergoing arthroscopy for lameness localized to the stifle. Follow-up was obtained ≥2 years postoperatively by telephone interviews with the owners. Preoperative and intraoperative f...
Effects of pulsed inhaled nitric oxide on arterial oxygenation during mechanical ventilation in anaesthetised horses undergoing elective arthroscopy or emergency colic surgery. Administration of pulsed inhaled nitric oxide (PiNO) improves arterial oxygenation in spontaneously breathing anaesthetised healthy horses and in horses undergoing colic surgery. However, because hypoventilation commonly occurs, horses are often mechanically ventilated to prevent hypercarbia. Objective: To evaluate the effects of PiNO on arterial oxygenation during anaesthesia in mechanically ventilated healthy horses and horses undergoing colic surgery. Methods: Prospective nonblinded clinical trial. Methods: Fifty horses undergoing elective arthroscopy (Group A) and 30 horses undergoing coli...
Evaluation of the effect of experimentally induced cartilage defect and intra-articular hyaluronan on synovial fluid biomarkers in intercarpal joints of horses. Inflammatory and degenerative activity inside the joint can be studied in vivo by analysis of synovial fluid biomarkers. In addition to pro-inflammatory mediators, several anabolic and anti-inflammatory substances are produced during the disease process. They counteract the catabolic effects of the pro-inflammatory cytokines and thus diminish the cartilage damage. The response of synovial fluid biomarkers after intra-articular hyaluronan injection, alone or in combination with other substances, has been examined only in a few equine studies. The effects of hyaluronan on some pro-inflammatory m...
Standing Needle Arthroscopy of the Metacarpophalangeal and Metatarsophalangeal Joint for Removal of Dorsal Osteochondral Fragmentation in 21 Horses. The aim of this study was to report the technique, experience and outcome of standing arthroscopic removal of dorsal osteochondral fragmentation of the metacarpophalangeal and metatarsophalangeal joint using a 1.2-mm needle arthroscope. Methods: This was a prospective clinical study. Methods: All horses referred for standing arthroscopic removal of dorsoproximal first phalanx fragments or fragments embedded in the distal aspect of the synovial plica were included. Relevant information from the cases was recorded. Follow-up was obtained by a telephone questionnaire. Results: Twenty-...
Synovial sepsis of unknown origin in the adult Thoroughbred racehorse. Synovial sepsis of unknown origin is a rare cause of lameness in the adult horse, and a haematogenous pathogenesis has been proposed in previous cases. Objective: To describe the features and outcome of synovial sepsis of unknown origin in adult Thoroughbred racehorses. Methods: Retrospective case series. Methods: Hospital records for admissions between 2005 and 2015 were reviewed to identify adult horses diagnosed with synovial sepsis of unknown origin. Presentation, clinicopathological, microbiological and diagnostic imaging findings were recorded. Treatment methods, surgical findings, compl...
Temporal changes in synovial fluid composition and elastoviscous lubrication in the equine carpal fracture model. The objective of this study was to examine temporal variations in synovial fluid composition and lubrication following articular fracture. Post-traumatic osteoarthritis (PTOA) was induced by creating an osteochondral fracture in the middle carpal joint of four horses while the contralateral limb served as a sham-operated control. Horses were exercised on a high-speed treadmill, and synovial fluid was collected pre-operatively and at serial timepoints until 75 days post-operatively. Lubricin and hyaluronic acid (HA) concentrations were measured using sandwich ELISAs, and the molecular weight di...
Evaluation of alginate hydrogel encapsulated mesenchymal stem cell migration in horses. Osteoarthritis is an incapacitating disease characterized by pain and a progressive decrease in joint mobility. The implantation of mesenchymal stem cells (MSCs) has shown promising results for its treatment. The challenge remains to keep the cells longer at the site of action, increasing their therapeutic potential. The aim of this study was to evaluate the effectiveness of the Qtracker® 655 nanocrystal marking on allogeneic synovial membrane (SM) MSCs, encapsulated in alginate hydrogel, evaluating the migration of these cells. The 10 radiocarpal joints were submitted to arthroscopic surgery...
Efficacy, chondrotoxicity and plasma concentrations of tramadol following intra-articular administration in horses undergoing arthroscopy: preliminary findings. Intra-articular administration of analgesics is performed to ensure good perioperative pain management avoiding undesirable systemic effects. To evaluate the effect of intra-articular injection of tramadol on postoperative pain after arthroscopy in horses and to determine whether tramadol had a local effect. Before the in vivo study, an in vitro test was performed aiming to evaluate the viability of equine chondrocytes after exposure to various concentrations of tramadol. The concentration identified as most appropriate was used to treat the horses' joints. Twelve horses affected by osteochond...
Usefulness of caudomedial-craniolateral oblique radiographic views for the diagnosis of injury to the origin of the cranial cruciate ligament in two horses. CASE DESCRIPTION A 12-year-old mixed-breed mare (horse 1) and 6-year-old Friesian gelding (horse 2) were examined for chronic lameness associated with the stifle joint. CLINICAL FINDINGS Lameness examination revealed effusion of the right (horse 1) or left (horse 2) femoropatellar and medial femorotibial joints and grade 3/5 (horse 1) or 4/5 (horse 2) lameness. A diagnosis of cranial cruciate ligament (CCL) injury with associated mineralization and avulsion (horse 1) or mineralization alone (horse 2) was facilitated in both horses with a caudomedial-craniolateral oblique radiographic view obta...