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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.
Evaluation of a tenoscopic approach for desmotomy of the accessory ligament of the deep digital flexor tendon in horses. To develop a tenoscopic approach for desmotomy of the accessory ligament of the deep digital flexor tendon (AL-DDFT) in horses. Methods: Experimental. Methods: Cadaveric forelimbs (n=10) and 4 forelimbs from 2 horses anesthetized for terminal teaching procedures, and 12 forelimbs of 6 experimental horses. Methods: Saline distention of the carpal flexor sheath facilitated insertion of an arthroscope into the distal medial aspect of the sheath between the AL-DDFT and deep digital flexor tendon (DDFT). Location of an instrument portal on the lateral aspect of the metacarpus was identified with a ...
Osteochondrosis lesions of the lateral trochlear ridge of the distal femur in four ponies. Lesions of the lateral trochlear ridge (LTR) of the distal femur were investigated in four pony or pony cross horses. The animals were all geldings and were six to 15 months of age. Lesions were bilateral in three ponies and unilateral in one. Femoropatellar joint effusion and lameness were present in two ponies; clinical signs were absent in the others. The proximal LTR was affected in all four animals. The radiographic appearance of the lesions was a subchondral defect containing mineralised bodies. Arthroscopic and postmortem examination findings included an osteochondral flap, a fissured o...
Evaluation of an arthroscopic approach for transection of the equine collateral sesamoidean ligament. To evaluate: (1) an arthroscopic technique for transection of the collateral sesamoidean ligament (CSL); and (2) the healing response using magnetic resonance (MR) and microscopic examination. Methods: Experimental study. Methods: Adult horses (n=6). Methods: Six sound horses with normal front foot radiographic and MR examinations were used. Lameness examination was performed before surgery and monthly for 12 months. Front foot radiography was performed at 180 and 360 days after surgery. Front foot MR was performed before, and at 7, 90, 180, and 360 days after surgery. Arthroscopic CSL desmoto...
Arthroscopic treatment of fractures of the lateral malleolus of the tibia: 26 cases. A minimally invasive arthroscopic technique for removal of fractures of the lateral malleolus of the tibia is considered to be beneficial but data to this effect are required. Objective: Arthroscopic removal of fractures of the lateral malleolus of the tibia is technically feasible, provides a comprehensive evaluation of the tarsocrural joint and enables removal of remote comminuted fragments and disrupted short collateral ligaments. The technique is associated with low patient morbidity, requires only short periods of hospitalisation and affords a good prognosis to affected horses. Methods: T...
The use of small (2.7 mm) screws for arthroscopically guided repair of carpal chip fractures. Removal of large chip fractures of the carpal bones and the osteochondral deficits that result, have been associated with a worse prognosis than removal of small fragments in similar locations. Objective: Reducing the articular defects by repair of large osteochondral fragments may have advantages over removal. Methods: Horses with osteochondral chip fractures that were of sufficient size and infrastructure to be repaired with small (2.7 mm diameter) AO/ASIF cortex screws were identified and repair effected by arthroscopically guided internal fixation. Results: Thirty-three horses underwent su...
Comparison of conventional and alternative arthroscopic approaches to the palmar/plantar pouch of the equine distal interphalangeal joint. The conventional arthroscopic approach to the palmar/plantar aspect of the distal interphalangeal joint (DIPJ) may result in the inadvertent penetration of the digital flexor tendon sheath (DFTS) and the navicular bursa (NB). This iatrogenic communication would be undesirable subsequent to arthroscopic lavage of a septic DIPJ. Objective: A lateral/medial approach to the palmar/plantar aspect of the DIPJ will result in a significantly lower rate of inadvertent penetration of the DFTS and NB, whilst still providing adequate intra-articular evaluation. Methods: The conventional palmar/plantar app...
Concentrated bone marrow aspirate improves full-thickness cartilage repair compared with microfracture in the equine model. The purpose of this study was to compare the outcomes of treatment with bone marrow aspirate concentrate, a simple, one-step, autogenous, and arthroscopically applicable method, with the outcomes of microfracture with regard to the repair of full-thickness cartilage defects in an equine model. Methods: Extensive (15-mm-diameter) full-thickness cartilage defects were created on the lateral trochlear ridge of the femur in twelve horses. Bone marrow was aspirated from the sternum and centrifuged to generate the bone marrow concentrate. The defects were treated with bone marrow concentrate and mic...
Arthroscopic removal of fractures of the lateral malleolus of the tibia in the tarsocrural joint: a retrospective study of 13 cases. There is limited information on the treatment of lateral malleolus (LM) fractures in the horse, with no previously published case series for the outcome following arthroscopic removal of such fractures. This report reviews and evaluates findings of a retrospective study of 13 horses admitted to a private equine referral hospital over a 10 year period (1999-2009) that underwent arthroscopic removal of fractures of the LM. Hospital records were reviewed and details including patient history, aetiology of the fracture and limb affected, results of all diagnostic tests and surgical reports were do...
Romifidine as a constant rate infusion in isoflurane anaesthetized horses: a clinical study. To evaluate the effects of a constant rate infusion (CRI) of romifidine on the requirement of isoflurane, cardiovascular performance and recovery in anaesthetized horses undergoing arthroscopic surgery. Methods: Randomized blinded prospective clinical trial. Methods: Thirty horses scheduled for routine arthroscopy. Methods: After premedication (acepromazine 0.02 mg kg(-1), romifidine 80 microg kg(-1), methadone 0.1 mg kg(-1)) and induction (midazolam 0.06 mg kg(-1) ketamine 2.2 mg kg(-1)), anaesthesia was maintained with isoflurane in oxygen. Horses were assigned randomly to receive a CRI of s...
Comparison of cardiovascular function and quality of recovery in isoflurane-anaesthetised horses administered a constant rate infusion of lidocaine or lidocaine and medetomidine during elective surgery. The effects of lidocaine combined with medetomidine or lidocaine alone on cardiovascular function during anaesthesia and their effects on recovery have not been thoroughly investigated in isoflurane-anaesthetised horses. Objective: To determine the effects of an intraoperative i.v. constant rate infusion of lidocaine combined with medetomidine (Group 1) or lidocaine (Group 2) alone on cardiovascular function and on the quality of recovery in 12 isoflurane-anaesthetised horses undergoing arthroscopy. Objective: The combination would depress cardiovascular function but improve the quality of rec...
Navicular bursoscopy in the horse: a comparative study. To compare the proportion of the proximal recess of the navicular bursa that could be examined through a single endoscopic portal and the severity of iatrogenic lesions between conventional and modified approaches. Methods: Descriptive study. Methods: Equine cadaver forelimbs (n=16). Methods: Arthroscopic access to the navicular bursa in 1 limb of each pair was by a conventional approach and in the other limb, by a modified approach using sharp dissection through the distal digital flexor sheath, immediately palmar to the T ligament. The time required to access the bursa and the estimated prop...
Divergent diagnosis from arthroscopic findings and identification of CPII and C2C for detection of cartilage degradation in horses. The objective of this study was to investigate the changes in synovial fluid concentration of collagen type II cleavage site (C2C) and procollagen II C-propeptide (CPII), markers of joint cartilage degeneration and synthesis, respectively, in horses with intraarticular fracture or osteochondrosis dissecans (OCD), and to examine the relationship between arthroscopic findings and these biomarker levels. Synovial fluid was collected from 36 joints in 18 horses (6 fractures and 12 OCDs). Samples from contralateral normal joints, when available, served as controls (n = 12). Concentrations of C2C an...
Debridement of cartilage lesions before autologous chondrocyte implantation by open or transarthroscopic techniques: a comparative study using post-mortem materials. We compared the quality of debridement of chondral lesions performed by four arthroscopic (SH, shaver; CU, curette; SHCU, shaver and curette; BP, bipolar electrodes) and one open technique (OPEN, scalpel and curette) which are used prior to autologous chondrocyte implantation (ACI). The ex vivo simulation of all five techniques was carried out on six juvenile equine stifle joints. The OPEN, SH and SHCU techniques were tested on knees harvested from six adult human cadavers. The most vertical walls with the least adjacent damage to cartilage were obtained with the OPEN technique. The CU and SHC...
Analgesic efficacy of intra-articular morphine in experimentally induced radiocarpal synovitis in horses. To compare the analgesic effect of intra-articular (IA) and intravenous (IV) morphine in horses with experimentally induced synovitis. Methods: Eight adult horses. Methods: Randomized, observer blinded, double dummy trial with sequential crossover design. Methods: Radiocarpal synovitis was induced by IA injection of lipopolysaccharide on two occasions separated by a 3-week washout period. In one study period horses received treatment IA; morphine IA (0.05 mg kg(-1)) plus saline IV and in the other study period they received treatment IV; saline IA plus morphine IV (0.05 mg kg(-1)). Lameness an...
Effects of adding butorphanol to a balanced anaesthesia protocol during arthroscopic surgery in horses. Three groups of horses scheduled for arthroscopic surgery were premedicated with 0.025 mg/kg acepromazine, 88 microg/kg romifidine and 25 mg/kg guaifenesin, and anaesthesia was induced with 2.2 mg/kg ketamine. In group 1 (14 horses), anaesthesia was maintained by halothane vaporised in oxygen, with supplementary doses of 20 microg/kg romifidine and 0.5 mg/kg ketamine every 20 minutes. The 17 horses in group 2 were maintained as for group 1; however, an additional dose of 0.05 mg/kg butorphanol was administered before the first incision. The 14 horses in group 3 were maintained as for group 2, ...
Post-anesthetic pulmonary edema in two horses. CASE 1: A two-year old, 462 kg Standard bred horse was anesthetized for arthroscopy and castration. During anesthesia, hyperemia of the mucosal membranes and urticaria were noticed. During 5 hours of anesthesia subcutaneous edema of the eyelids and neck region developed. In the recovery box, the orotracheal (OT) tube was left in situ and secured in place with tape. Following initial attempts to stand, the horse became highly agitated and signs consistent with pulmonary edema developed subsequently. Arterial hypoxemia (PaO(2): 3.7 kPa [28 mmHg]) and hypocapnia (PaCO(2): 3.1 kPa [23 mmHg]) were ...
Long-term outcome after arthroscopic debridement of distal phalanx extensor process fragmentation in 13 horses. To report long-term outcome after arthroscopic removal of fragmentation of the extensor process of the distal phalanx in horses. Methods: Case series. Methods: Adult horses (n=13). Methods: Medical records (2003-2004) of horses that had arthroscopic debridement of fragmentation of the extensor process of the distal phalanx were reviewed. Inclusion criteria included: lameness localized to the foot, fragmentation of the extensor process of the distal phalanx debrided arthroscopically, and a follow-up period of > or = 4 years. Results: Of the 13 horses, lameness was resolved in 11 (85%) initia...
Modified tenoscopic method for carpal flexor retinaculum release in a horse. To report the use of a proximolateral endoscopic portal with a distolateral instrument portal for carpal retinaculum release in a horse clinically affected with carpal canal syndrome. Methods: Clinical report. Methods: A 4-year-old Thoroughbred female. Methods: Carpal canal syndrome secondary to traumatic suppurative tenosynovitis was treated by accessory carpal bone debridement and carpal retinaculum release using a tenoscopic approach to the carpal flexor synovial sheath through a proximolateral endoscope portal and a distolateral instrument portal. Results: Resolution of carpal sheath effus...
Prevalence of various presale radiographic findings and association of findings with sales price in Thoroughbred yearlings sold in Kentucky. To estimate prevalences of various presale radiographic findings and of presale arthroscopy in horses offered for sale at the 2006 Keeneland September yearling sale and to compare sales prices between yearlings with and without various presale radiographic findings or a history of arthroscopy. Methods: 397 Thoroughbred yearlings. Methods: Cross-sectional study. Methods: Presale radiographs and health records were examined to estimate prevalences of various radiographic findings and presale arthroscopy. Sales price records were used to compare sales prices between yearlings with and without var...
Concurrent or sequential development of medial meniscal and subchondral cystic lesions within the medial femorotibial joint in horses (1996-2006). Summary Reasons for performing study: Medial meniscal injuries and subchondral cystic lesions (SCL) are known to occur independently within the medial femorotibial (MFT) joint in horses. However, there are no reports of a potential clinical relationship between these 2 types of lesions. Objective: To: 1) document the concurrent presence or sequential development of medial meniscal and SCL of the medial femoral condyle within the MFT joint; and 2) determine the prognosis with both types of lesions. Methods: Retrospective case series of horses with both a medial meniscal and SCL of the medial fe...
Effect of exercise and osteochondral injury on synovial fluid and serum concentrations of carboxy-terminal telopeptide fragments of type II collagen in racehorses. To investigate the effects of exercise and osteochondral injury on concentrations of carboxy-terminal telopeptide fragments of type II collagen (CTX-II) in synovial fluid (SF) and serum of Thoroughbred racehorses and to compare findings with radiographic and arthroscopic scores of joint injury severity. Methods: 78 Thoroughbreds with (n = 38) and without (40) osteochondral injury. Methods: Serum and metacarpophalangeal or carpal joint SF samples were collected from noninjured horses before and at the end of 5 to 6 months of race training (pre- and postexercise samples, respectively) and from h...
Association between clinical signs and histopathologic changes in the synovium of the tarsocrural joint of horses with osteochondritis dissecans of the tibia. To develop a scoring system for histopathologic changes in the synovium of tarsocrural joints (TCJs) of horses with osteochondritis dissecans (OCD) and to test for association between histopathologic changes and joint effusion or lameness. Methods: 93 horses with OCD of the intermediate ridge of the tibia of 1 or both TCJs (134 joints) and 38 control horses without disease of TCJs (38 joints). Methods: For OCD-affected horses, pretreatment lameness, TCJ effusion, and results of pelvic limb flexion test were scored. Synovial biopsy specimens were obtained from TCJs of OCD-affected horses during...
Lameness and effusion of the tarsocrural joints after arthroscopy of osteochondritis dissecans in horses. The presence and degree of tarsocrural joint effusion and lameness, and the result of a hindlimb flexion test were scored subjectively in 79 horses before, and six weeks to 20 months after, arthroscopic surgery to remove osteochondritis dissecans fragments. The scores of all three variables improved significantly after surgery. The score reductions for the right and left hindlimbs, respectively, were 82 per cent and 95 per cent for lameness, 48 per cent and 41 per cent for joint effusion, and 89 per cent and 84 per cent for reaction to flexion (P < or = 0.01). The oldest horses reacted more...
Comparison of radiography and ultrasonography for the diagnosis of osteochondritis dissecans in the equine femoropatellar joint. Osteochondritis dissecans (OCD) lesions of the femoropatellar (FP) joint are diagnosed routinely by radiography, but lesions located in the trochlear groove or without accompanying subchondral bone changes can be difficult to visualise. Ultrasonography allows evaluation of articular cartilage and subchondral bone in the FPjoint. Objective: To document the radiographic and ultrasonographic appearance of OCD lesions in the equine FP joint, grade ultrasonographic lesions and compare their accuracy in the diagnosis of these lesions. Methods: The medical records of all horses diagnosed with FP OCD ...
Arthroscopic visualisation of the third metacarpal and metatarsal condyles in the horse. Arthroscopy of the fetlock joints is a routine surgical procedure in the horse. It is unclear how much of the articular surface of the condyles of the metacarpal (MCIII)/metatarsal (MTIII) bone can be visualised using either the dorsal or palmar/plantar arthroscopic approach. Objective: To investigate which part of the articular surface of the MCIII/MTIII condyles of the fetlock joints can be evaluated arthroscopically using: 1) dorsal approach in combination with flexion; 2) standard palmar/plantar approach; or 3) additional portal at the base of the sesamoid bone with joint extension. Method...
High-mobility group box chromosomal protein 1 as a potential inflammatory biomarker of joint injury in Thoroughbreds. To investigate effects of osteochondral injury on high-mobility group box chromosomal protein 1 (HMGB-1) concentrations in synovial fluid (SF) from Thoroughbreds and to compare these results with radiographic and arthroscopic scores of severity of joint injury. Methods: 40 clinically normal rested Thoroughbreds (group 1) and 45 Thoroughbreds with osteochondral injury as a result of racing. Methods: SF was obtained from the metacarpophalangeal (MCP) joints, metatarsophalangeal (MTP) joints, middle carpal joints, and radiocarpal joints. For group 2, radiographic and arthroscopic scores were dete...
Arthroscopic removal of metallic foreign body from the talocrural joint using a magnetic retriever in a horse. To report use of a magnetic retriever for arthroscopic removal of a metallic foreign body from the equine talocrural joint. Methods: Clinical report. Methods: A 2-year-old Warmblood stallion. Methods: A metallic foreign body was removed from a talocrural joint using a 10-mm magnetic retriever under arthroscopic guidance. Preoperative radiographs were used to locate the intra-articular position of the foreign body. Results: Six months after surgery, the horse was no longer lame. Conclusions: A magnetic retriever can be used for arthroscopic removal of metallic foreign bodies from the equine tal...
Comparison of ultrasonography versus radiography for the diagnosis of dorsal fragmentation of the metacarpophalangeal or metatarsophalangeal joint in horses. To compare clinical usefulness of ultrasonography versus radiography for detection of fragmentation of the dorsal aspect of the metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints in horses. Methods: Cross-sectional study. Methods: 36 horses with fragmentation of the MCP (n = 19) and MTP (29) joints. Methods: In all joints, radiography (4 standard projections) and ultrasonography were performed prior to arthroscopic examination and fragment removal. Number and location of fragments identified radiographically and ultrasonographically were compared with arthroscopic findings. Results...
Long-term outcome in 44 horses with stifle lameness after arthroscopic exploration and debridement. To (1) examine the outcome in horses with osteoarthritis or intra-articular soft tissue injuries of the stifle after arthroscopic exploration and debridement and (2) to determine any imaging or surgical findings that may influence prognosis. Methods: Case series. Methods: Horses (n=44) with lameness referable to the stifle, diagnosed with osteoarthritis, meniscal tears, or other intra-articular soft tissue injuries based on arthroscopic examination. Methods: Medical records of horses with stifle lameness that had arthroscopic exploration were reviewed. Horses with osteochondrosis lesions, intr...
Evaluation of anesthesia recovery quality after low-dose racemic or S-ketamine infusions during anesthesia with isoflurane in horses. To compare anesthesia recovery quality after racemic (R-/S-) or S-ketamine infusions during isoflurane anesthesia in horses. Methods: 10 horses undergoing arthroscopy. Methods: After administration of xylazine for sedation, horses (n = 5/group) received R-/S-ketamine (2.2 mg/kg) or S-ketamine (1.1 mg/kg), IV, for anesthesia induction. Anesthesia was maintained with isoflurane in oxygen and R-/S-ketamine (1 mg/kg/h) or S-ketamine (0.5 mg/kg/h). Heart rate, invasive mean arterial pressure, and end-tidal isoflurane concentration were recorded before and during surgical stimulation. Arterial blood...
