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.
Osteochondral injury increases type II collagen degradation products (C2C) in synovial fluid of Thoroughbred racehorses. To investigate the effects of exercise and osteochondral (OC) injury on type II collagen degradation products (collagenase cleavage neoepitope commercially known as C2C) in synovial fluid (SF) from Thoroughbred (TB) racehorses and to compare these results with radiographic and arthroscopic scores of severity of joint injury. Methods: Metacarpophalangeal/metatarsophalangeal (MCP/MTP) and carpal SF was obtained from (1) 20 normal rested horses, (2) the same horses after 5 to 6 months of race training, and (3) 27 horses with OC injury from racing. For group 3, radiographic and arthroscopic scores...
Arthroscopic surgical approach and intra-articular anatomy of the equine suprapatellar pouch. To describe a direct arthroscopic approach to the suprapatellar pouch (SPP), its intra-articular anatomy, and report our clinical experience with SPP arthroscopy. Methods: (1) Experimental study and (2) retrospective clinical study. Methods: (1) Cadaveric equine hind limbs (n=24; 14 horses) and (2) 5 horses. Methods: Four femoropatellar joints (FPJ) were dissected or injected with latex to document surface landmarks and topographic anatomy. (1) Arthroscopic exploration of 20 SPP (10 equine cadavers) was performed and described, followed by dissection. (2) Medical records of horses that had FPJ...
Comparison of radiofrequency treatment and mechanical debridement of fibrillated cartilage in an equine model. To compare a radiofrequency energy (RFE) prototype probe to mechanical debridement (MD) and a commercially available RFE system used for chondroplasty in the treatment of an experimentally created partial thickness cartilage lesion in horses. The study design was experimental, randomized complete block, n=8, using fifteen mature ponies. Methods: Grade 2 to 3 cartilage lesions were prepared in both patellae. After 10 months duration, the injuries were used to study the effects of MD, a commercially available bipolar RFE device (CoVac 50; ArthroCare Corporation) and a prototype monopolar RFE dev...
Joint dependent concentrations of bone alkaline phosphatase in serum and synovial fluids of horses with osteochondral injury: an analytical and clinical validation. Validate use of a commercially available immunoassay for measurement of bone alkaline phosphatase (BAP) in equine serum and synovial fluid (SF), and investigate the effects of osteochondral (OC) injury in horses on BAP concentrations in serum and SF. Methods: SF was collected from 37 joints of 34 Thoroughbred (TB) racehorses undergoing arthroscopic surgery for the removal of OC fragments from either the carpal joints (n=18) or the metacarpo-/metatarsophalangeal (MP) joints (n=19). SF was also obtained from 52 joints of 16 normal TB horses, collected bilaterally from carpal joints of 10 horses ...
Arthroscopic injection of corticosteroids into the fibrous tissue of subchondral cystic lesions of the medial femoral condyle in horses: a retrospective study of 52 cases (2001-2006). There are no published results of subchondral cystic lesions (SCLs) in the medial femoral condyle (MFC) treated with arthroscopic injection of corticosteroids into the lining of the cyst. Objective: 1) To determine the success rate for treatment of SCLs in the MFC with arthroscopic injection of the fibrous tissue of the cyst with corticosteroids. 2) To identify any factors that may predict outcome. Objective: Injection of the fibrous tissue of SCLs of the MFC with corticosteroids utilising arthroscopic guidance yields a similar or higher chance for intended performance than does arthroscopic d...
Comparison of magnetic resonance contrast arthrography and arthroscopic anatomy of the equine palmar lateral outpouching of the middle carpal joint. The objective of this report was to provide an anatomic description of the equine palmar lateral outpouching of the middle carpal joint by comparing its arthroscopic and magnetic resonance (MR) contrast arthrography appearance and to define the structures within the palmar lateral outpouching of the middle carpal joint that can be assessed arthroscopically. MR contrast arthrography was performed on seven cadaveric limbs; images were compared with those obtained during arthroscopic exploration of the palmar lateral outpouching of the middle carpal joint. Gross dissection was performed to confir...
Diagnostic imaging of the equine tarsal region using radiography and ultrasonography. Part 1: the soft tissues. The equine tarsus is the most commonly affected hindlimb region associated with lameness. Diagnostic imaging is routinely applied but because of its complexity, being composed of 10 multifaceted bones and different joints, multiple ligaments, tendons and bursae, imaging this region can be a challenge. This is the first part of a two-part review of the structures and disorders of the equine tarsus. It describes the principal disorders affecting the soft tissues of the tarsal region and addresses some of the technical aspects in taking radiographic, ultrasonographic and scintigraphic images of t...
Diagnostic imaging of the equine tarsal region using radiography and ultrasonography. Part 2: bony disorders. This is the second part of a two-part review of the structures and disorders of the equine tarsus. In this part the bones of the tarsal region are considered and the technical aspects of taking radiographic, ultrasonographic and scintigraphic images of the different lesions are addressed. The diagnostic use of arthroscopy, computed tomography and magnetic resonance are discussed. In current clinical practice the most frequently used combination to arrive at a diagnosis is still radiography and ultrasonography.
Interleukin-6 and tumour necrosis factor in synovial fluid from horses with carpal joint pathology. The carpal joints are common sites of traumatic arthritis and osteoarthritis (OA) in athletic horses. The pro-inflammatory cytokines interleukin (IL)-6 and tumour necrosis factor (TNF) may be of great importance in the development of intra-articular lesions. The aim of the present study was to investigate possible associations between synovial fluid levels of bioactive IL-6 and TNF and different types of joint lesions seen in traumatic arthritis and OA. Synovial fluid was collected from horses with carpal lameness immediately before arthroscopic surgery. Articular cartilage, synovial membranes...
Matrix-encapsulation cell-seeding technique to prevent cell detachment during arthroscopic implantation of matrix-induced autologous chondrocytes. The goal of this study is to evaluate the efficiency of obtaining a large number of viable cells within a construct that will not be detached by high fluid flow during arthroscopic implantation. Methods: Arthroscopic osteochondral biopsy specimens were obtained from the medial femoral trochlea of 8 horses. Chondrocytes were isolated by collagenase digestion and expanded in M199 media until confluency. After 10 to 12 days, cultures were trypsinized and cells resuspended in culture media. Then, 5 x 10(6) cells x mL(-1) were seeded on a culture dish and the same amount in a flask. Once extracellu...
Genetic modification of chondrocytes with insulin-like growth factor-1 enhances cartilage healing in an equine model. Gene therapy with insulin-like growth factor-1 (IGF-1) increases matrix production and enhances chondrocyte proliferation and survival in vitro. The purpose of this study was to determine whether arthroscopically-grafted chondrocytes genetically modified by an adenovirus vector encoding equine IGF-1 (AdIGF-1) would have a beneficial effect on cartilage healing in an equine femoropatellar joint model. A total of 16 horses underwent arthroscopic repair of a single 15 mm cartilage defect in each femoropatellar joint. One joint received 2 x 10(7) AdIGF-1 modified chondrocytes and the contralateral...
Outcome of lag-screw treatment of incomplete fractures of the frontal plane of the radial facet of the third carpal bone in horses. To describe outcomes for horses diagnosed with incomplete, non-displaced fractures of the frontal plane of the radial facet (INFR) of the third carpal bone (C3) treated by placement of a lag screw across the fracture under arthroscopic guidance. Methods: Horses (n=13) diagnosed with INFR and treated between December 1999 and January 2005 using a lag screw placed over the fracture were studied. For each case, five horses matched for sire, age and sex which were not known to have INFR were sought for comparison. Racing performance data were collected from a commercial online database. The racing...
Enhanced early chondrogenesis in articular defects following arthroscopic mesenchymal stem cell implantation in an equine model. Mesenchymal stem cells (MSCs) provide an important source of pluripotent cells for musculoskeletal tissue repair. This study examined the impact of MSC implantation on cartilage healing characteristics in a large animal model. Twelve full-thickness 15-mm cartilage lesions in the femoropatellar articulations of six young mature horses were repaired by injection of a self-polymerizing autogenous fibrin vehicle containing mesenchymal stem cells, or autogenous fibrin alone in control joints. Arthroscopic second look and defect biopsy was obtained at 30 days, and all animals were euthanized 8 month...
Racing performance after arthroscopic removal of apical sesamoid fracture fragments in Thoroughbred horses age < 2 years: 151 cases (1989--2002). Studies on arthroscopic removal of apical proximal sesamoid fracture fragments in Thoroughbred (TB) horses age > or = 2 years have reported a high success rate. However, there are no reports documenting the racing prognosis of TB horses that undergo such surgery as weanlings or yearlings. Objective: To describe the incidence of apical proximal sesamoid fractures in immature TB horses, age < 2 years and determine probability and quality of racing performance after arthroscopic removal of such fractures in 151 TB weanlings and yearlings. Methods: The medical records of TB horses age < 2 years th...
Evaluation of the rate of development of septic arthritis after elective arthroscopy in horses: 7 cases (1994-2003). To determine the rate of development of septic arthritis after elective arthroscopy and evaluate associations between various factors and development of this complication in horses. Methods: Retrospective case series. Methods: 682 horses that underwent arthroscopic procedures at the University of Illinois Veterinary Teaching Hospital from 1994 to 2003. Methods: Information pertaining to signalment, joints treated, whether antimicrobials were administered, and development of postoperative septic arthritis was collected from medical records. Horses with a primary problem of septic arthritis or w...
Differences in need for hemodynamic support in horses anesthetized with sevoflurane as compared to isoflurane. To study whether hemodynamic function in horses, particularly mean arterial blood pressure (MAP), is better maintained with sevoflurane than isoflurane, thus requiring less pharmacological support. Methods: Prospective randomized clinical investigation. Animals Thirty-nine racehorses undergoing arthroscopy in lateral recumbency. Methods: Horses were assigned to receive either isoflurane (n = 20) or sevoflurane (n = 19) at 0.9-1.0 minimum alveolar concentration (MAC) for maintenance of anesthesia. Besides routine clinical monitoring, cardiac output (CO) was measured by lithium dilution. Hemodyn...
Cartilage T2 assessment: differentiation of normal hyaline cartilage and reparative tissue after arthroscopic cartilage repair in equine subjects. To prospectively assess T2 mapping characteristics of normal articular cartilage and of cartilage at sites of arthroscopic repair, including comparison with histologic results and collagen organization assessed at polarized light microscopy (PLM). Methods: Study protocol was compliant with the Canadian Council on Animal Care Guidelines and approved by the institutional animal care committee. Arthroscopic osteochondral autograft transplantation (OAT) and microfracture arthroplasty (MFx) were performed in knees of 10 equine subjects (seven female, three male; age range, 3-5 years). A site of art...
Racing performance after arthroscopic removal of apical sesamoid fracture fragments in Thoroughbred horses age > or = 2 years: 84 cases (1989-2002). Studies have shown that surgical removal of apical fracture fragments in Standardbred racehorses carries the best prognosis for return to racing performance, but there are no reports involving mature Thoroughbred (TB) racehorses. Objective: To describe the incidence of apical proximal sesamoid fractures in TB racehorses and determine probability and quality of racing performance after arthroscopic removal of such fractures in TB racehorses age > or = 2 years. Methods: Medical records and pre- and post operative race records of TB racehorses age > or = 2 years that underwent arthroscopic surger...
Oral hyaluronan gel reduces post operative tarsocrural effusion in the yearling Thoroughbred. Hyaluronan (HA) has been used to treat joint disease via intra-articular, i.v. and oral administration. The efficacy of intra-articular and i.v. use has been evaluated but the oral route has yet to be examined. Objective: To determine the effect of oral hyaluronan gel on joint effusion following arthroscopic surgery for osteochondritis dissecans (OCD) of the tarsocrural joint of yearling Thoroughbreds. Methods: Forty-eight yearlings diagnosed with unilateral or bilateral osteochondritis dessicans (OCD) of the tarsus were arbitrarily chosen prior to arthroscopic surgery. The yearlings were incl...
Effects of calcified cartilage on healing of chondral defects treated with microfracture in horses. Microfracture of full-thickness articular defects has been shown to significantly enhance the amount of repair tissue. However, there is a suggestion that leaving calcified cartilage inhibits this repair response. Objective: Removal of the calcified cartilage with retention of subchondral bone enhances the amount of attachment of the repair tissue compared with retention of the calcified cartilage layer. Methods: Controlled laboratory study. Methods: There were 1-cm(2) articular cartilage defects made in 12 skeletally mature horses on the axial weightbearing portion of both medial femoral cond...
Palmar carpal osteochondral fragments in racehorses: 31 cases (1994-2004). To evaluate records of racehorses with palmar carpal osteochondral fragments and determine whether the fragments were indicators of the severity of pathologic joint changes or prognosis. Methods: Retrospective case series. Methods: 31 racehorses. Methods: Medical records, radiographs, and videos of arthroscopic procedures were reviewed. Information gathered included signalment; location, number, and size of the primary lesion; number and size of palmar carpal fragments; and details pertaining to surgical procedures. Outcome variables were obtained from race records. Results: 31 horses met the ...
In situ and ex vivo evaluation of an arthroscopic indentation instrument to estimate the health status of articular cartilage in the equine metacarpophalangeal joint. To evaluate an arthroscopic indentation instrument (Artscan 200) for assessment of the health status of equine articular cartilage. Methods: In vitro experiment using equine isolated proximal phalanx (P1) specimens. Methods: P1 specimens from 39 horses (aged 1.5-22 years). Methods: Reproducibility was tested by determination of the coefficient of variation (CV). Dynamic modulus and cartilage degeneration index (CDI) values were measured at 2 predefined sites (site 1, joint margin; site 2, joint center) to assess the accuracy and to evaluate the relation with surface integrity. Results: CV was ...
Comparison of arthroscopic approaches and accessible anatomic structures during arthroscopy of the caudal pouches of equine femorotibial joints. To (1) describe a caudal approach to equine medial and lateral femorotibial (FT) joints and (2) illustrate the complex anatomic detail of the caudal compartments of the lateral FT joint. Methods: Prospective experimental study. Methods: Cadaveric equine hindlimbs (n = 36; 26 horses) and 6 horses (11 hind limbs). Methods: Stifles (n = 8) were dissected and 10 FT joints were injected with silicone. Arthroscopic exploration (n = 29) was performed, followed by dissection to determine sites and structures penetrated during entry. Results: A more caudal approach to the caudal pouch of the medial FT ...
Arthroscopic approaches to the palmar aspect of the equine carpus. To identify sites for arthroscopic access to the palmar aspects of the antebrachiocarpal (AC) and middle carpal (MC) joints, and describe visible carpal bone surfaces for each approach. Methods: Prospective experimental study. Methods: Equine carpi: 16 cadavers, 8 live horses. Methods: A latex model was used to identify possible sites for arthroscopic access to the palmar aspects of the AC and MC joints. Carpi (n = 24) were examined arthroscopically and arthroscopic access sites and visible carpal bone surfaces were described. Results: Arthroscopic approaches and instrument portals were develo...
Arthroscopically assisted arthrodesis of the distal interphalangeal joint with transarticular screws inserted through a dorsal hoof wall approach in a horse. A 16-year-old Thoroughbred gelding was examined because of chronic right forelimb lameness. Results: On radiographs of the right front foot, the distal interphalangeal (DIP) joint space was narrow, and osteophytes and periarticular bony proliferation indicative of severe osteoarthritis were seen. Arthrodesis of the right DIP joint was recommended to improve the horse's comfort on the limb. Results: The horse was anesthetized, and palmar and dorsal arthroscopic approaches were used to remove as much of the articular cartilage as was accessible. Holes were then drilled through the dorsal aspect ...
In vivo study on the short-term effect of radiofrequency energy on chondromalacic patellar cartilage and its correlation with calcified cartilage pathology in an equine model. Chondromalacia can cause joint pain and synovial effusion with the potential for developing into osteoarthritis. Thermal chondroplasty using radiofrequency energy (RFE) has been reported to be superior to mechanical debridement for treating chondromalacia. We compared short-term changes in biomechanical properties of articular cartilage after treatment with monopolar (mRFE) or bipolar RFE (bRFE) or mechanical debridement (MD) on experimentally created grade II chondromalacia patellae. Chondromalacia patellae was created arthroscopically in both patellae of 15 ponies. Ten months after surgery, ...
Comparison of hemodynamic, clinicopathologic, and gastrointestinal motility effects and recovery characteristics of anesthesia with isoflurane and halothane in horses undergoing arthroscopic surgery. To compare hemodynamic, clinicopathologic, and gastrointestinal motility effects and recovery characteristics of halothane and isoflurane in horses undergoing arthroscopic surgery. Methods: 8 healthy adult horses. Methods: Anesthesia was maintained with isoflurane or halothane (crossover study). At 6 intervals during anesthesia and surgery, cardiopulmonary variables and related derived values were recorded. Recovery from anesthesia was assessed; gastrointestinal tract motility was subjectively monitored for 72 hours after anesthesia. Horses were administered chromium, and fecal chromium concen...
Arthroscopic diagnosis and treatment of intra-articular insertional injuries of the suspensory ligament branches in 18 horses. Clinical association between the branches of insertion of the suspensory ligament (SL) and metacarpophalangeal (MCP) and metatarsophalangeal (MTP) joints has been reported. However, there has been no assessment of the lengths of the SL branches which are subsynovial with respect to the joints or reports of involvement of the MCP/MTP joints in injuries of the SL branches. Objective: To establish proportions of SL branches subsynovial with respect to the MCP/MTP joints and report clinical and arthroscopic findings in horses with desmitis of SL branches identified as having an articular component...
New surgical treatments for osteochondritis dissecans and subchondral bone cysts. Osteochondritis dissecans (OCD) and subchondral bone cysts (SBCs) occur commonly and at many different locations in equine limbs and can lead to secondary osteoarthritis when left untreated. Depending on the location and extent of the lesion, arthroscopic surgical debridement may be an effective treatment for returning a horse to athletic soundness. In many cases, however, additional techniques to improve the healing response in bone and cartilage are needed so as to preserve articular function. Methods for improving cartilage repair (ie, restoration of damaged cartilage)or regeneration (ie, r...