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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.
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...
Needle Arthroscopy of the Scapulohumeral Joint and Bicipital BURSA in Horses: An Ex Vivo Study. To evaluate the feasibility of performing needle arthroscopy of the scapulohumeral joint and bicipital bursa in standing horses by using the thoracic limbs of euthanized horses. To that purpose, this experimental study was designed. Ten thoracic limbs, five left and five right from euthanized horses were retained in an upright position to simulate a standing horse. The craniolateral and lateral scapulohumeral arthroscopic portals were used to access the articular structures. A third (caudal) portal was also identified and described. The degree of difficulty in accessing the articular space and...
Intra-articular use of analgesic/antinflammatory drugs in dogs and horses. Joint pain is a major cause of lameness in animals such as horses and dogs, and it may affect their athletic performance and quality of life. The intra-articular administration of analgesic/antinflammatory drugs is a common practice in veterinary medicine, for both lameness diagnosis and joint pain management. It is used either perioperatively, such as in animals undergoing arthroscopy/arthrotomy, and in osteoarthritic animals. However, evidence regarding efficacy and safety of each drug is limited, and controversies persist in these areas. In particular, it is often uncertain whether a define...
Machine learning augmented near-infrared spectroscopy: In vivo follow-up of cartilage defects. To assess the potential of near-infrared spectroscopy (NIRS) for in vivo arthroscopic monitoring of cartilage defects. Sharp and blunt cartilage grooves were induced in the radiocarpal and intercarpal joints of Shetland ponies and monitored at baseline (0 weeks) and at three follow-up timepoints (11, 23, and 39 weeks) by measuring near-infrared spectra in vivo at and around the grooves. The animals were sacrificed after 39 weeks and the joints were harvested. Spectra were reacquired ex vivo to ensure reliability of in vivo measurements and for reference analyses. Additionally, cartilage thickn...
Factors associated with survival and racing performance of 114 Thoroughbred foals with septic arthritis compared with maternal siblings (2009-2015). There is little consensus on factors associated with survival in foals with septic arthritis and limited data on long-term racing performance of Thoroughbred foals treated for septic arthritis. A more thorough understanding of short- and long-term outcome is necessary to help inform owners, and subsequently guide treatment. Objective: To investigate factors associated with survival, and to analyse racing performance of foals with septic arthritis compared with their maternal siblings. Methods: Retrospective cohort and a case-control study. Methods: Veterinary clinical records of Thoroughbred f...
Differential gene expression analysis reveals pathways important in early post-traumatic osteoarthritis in an equine model. Post-traumatic osteoarthritis (PTOA) is a common and significant problem in equine athletes. It is a disease of the entire joint, with the synovium thought to be a key player in disease onset and progression due to its role in inflammation. The development of effective tools for early diagnosis and treatment of PTOA remains an elusive goal. Altered gene expression represents the earliest discernable disease-related change, and can provide valuable information about disease pathogenesis and identify potential therapeutic targets. However, there is limited work examining global gene expression c...
Diagnostic needle arthroscopy of the scapulohumeral joint in standing sedated horses. To describe the technique to perform diagnostic standing scapulohumeral joint needle arthroscopy with a 1.2-mm-diameter arthroscope in horses. Methods: Experimental study. Methods: Eight thoracic limbs in phase 1 and six horses in phase 2. Methods: In phase 1, the feasibility of the technique was evaluated by using a craniolateral arthroscopic approach. An evaluation of the visible structures of the scapulohumeral joint was performed with both a needle arthroscope and a 4-mm-diameter arthroscope. In phase 2, the technique was performed in six healthy sedated horses to validate the technique in...
Arthroscopic removal of a solitary osteochondroma interfering with the podotrochlear apparatus in a foal. To report the diagnostics, surgical treatment, and outcome of a juvenile foal with solitary osteochondroma (SO) interfering with the podotrochlear apparatus. Methods: Case report ANIMAL: One 36-day-old Arabian colt. Methods: Clinical, radiographic, ultrasonographic, computed tomographic, and histopathologic examinations were required to characterize and treat an SO located at the palmar aspect of the diaphysis of the second phalanx of the left forelimb. This SO caused severe distal interphalangeal joint (DIPJ) inflammation, marked interference with the podotrochlear apparatus, and associated l...
Arthroscopic evaluation of the metacarpophalangeal and metatarsophalangeal joints in horses with parasagittal fractures of the proximal phalanx. Fractures of the proximal phalanx are one of the most common long bone fractures of Thoroughbred racehorses. Although the degree of disruption and damage to the articular surface is generally considered a major prognostic determinant, associated arthroscopic findings have not previously been reported. Objective: To describe the metacarpo/metatarsophalangeal (MCP/MTP) joint lesions associated with parasagittal fractures of the proximal phalanx arthroscopically identified at the time of fracture repair and compare radiographic and arthroscopic appearance of complete fractures. Methods: Retrospec...
Comparing racing performance following arthroscopic surgery of metacarpophalangeal/metatarsophalangeal and carpal joints in Thoroughbred racehorses rehabilitated using conventional and underwater treadmill therapies. Rehabilitation of horses using underwater treadmill therapy has been shown to improve joint range of motion, joint mobility, stride length and proprioceptive parameters with experimental studies. However, studies investigating the prognosis and return to function following rehabilitation are lacking. Methods: A retrospective study of Thoroughbred racehorses treated with arthroscopic surgery for osteochondral fragments of the metacarpophalangeal (MCP) or metatarsophalangeal (MTP) joints or carpal joints undergoing conventional rehabilitation or underwater treadmill assisted rehabilitation at th...
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...
