An Alternative, Direct Approach for Arthroscopic Removal of Osteochondral Fragments in the Dorsal Pouch of the Proximal Intertarsal Joint of Horses.
Abstract: To describe an alternative technique and resulting outcomes for arthroscopic removal of osteochondral (OC) fragments from the proximal intertarsal joint (PIJ) using a direct approach without resection of the membrane between the tarsocrural joint (TCJ) and the PIJ. Methods: Retrospective case series. Methods: Client owned horses (n = 11) with Category 1 OC fragments in the PIJ. Methods: Arthroscopic examination of the dorsal pouch of the TCJ was performed with horses positioned in dorsal recumbency using routine portals. A hook probe placed through one of the standard portals was used to lift the edge of the communication between TCJ and PIJ to help pass the arthroscope into the PIJ from the opposite standard portal. A third direct portal into the PIJ was created under arthroscopic visualization, and loose OC fragments (Category 1) were removed using the direct portal. Medical records, race records, and owner surveys were reviewed for case details and outcome. Results: The described technique allowed removal of all fragments in all 11 cases. No complications associated with the procedure were observed. Of the 9 horses with long term follow-up available, 7 were used as intended (4/4 riding horses, 3/5 racehorses). Two horses did not enter an athletic career because of reasons unrelated to fragment removal. Conclusions: A direct approach for arthroscopic removal of OC fragments of the PIJ using a third portal into this joint, without resection of the membrane between the TCJ and PIJ is a good alternative for removal of fragments at this site.
© Copyright 2016 by The American College of Veterinary Surgeons.
Publication Date: 2016-01-08 PubMed ID: 26749057DOI: 10.1111/vsu.12431Google Scholar: Lookup
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- Journal Article
Summary
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This study outlines an alternative technique for the arthroscopic removal of osteochondral fragments from the proximal intertarsal joint of horses, via a direct approach, without cutting the membrane between the tarsocrural joint and proximal intertarsal joint. The technique was successful in all tested cases, and presented no associated complications.
Methods
- The retrospective study was conducted on 11 client-owned horses with Category 1 osteochondral fragments lodged in their Proximal Intertarsal Joints (PIJs).
- The arthroscopic examination was done with horses laid down in a dorsal position, using regular portals.
- To facilitate the entrance of the arthroscope into the PIJ, a hook probe was used via one of the regular portals. The hook lifted the edge of the communication between the Tarsocrural joint (TCJ) and the PIJ.
- A third direct portal into the PIJ was designed under arthroscopic visualization. The loose osteochondral fragments were subsequently removed through this new portal.
- Outcome and case details were established by reviewing medical records, race records, and owner surveys.
Results
- The described technique successfully allowed removal of all fragments in all 11 cases.
- There were no complications noted that were associated with the procedure.
- Long term follow-ups were available for 9 out of the 11 horses. Of these, 7 continued to be used as planned: 4 as riding horses and 3 as racehorses.
- Two of the horses did not pursue an athletic career but the reasons were not related to the procedure of fragment removal.
Conclusions
- A direct technique for the arthroscopic removal of osteochondral fragments in a horse’s PIJ is presented. The technique utilizes a third portal into this joint, without the need for a resection of the membrane between the TCJ and PIJ.
- The research shows that this procedure potentially presents a viable alternative for removing fragments in the said location.
Cite This Article
APA
Compagnie E, Drumm NJ, de Heer N, ter Braake F.
(2016).
An Alternative, Direct Approach for Arthroscopic Removal of Osteochondral Fragments in the Dorsal Pouch of the Proximal Intertarsal Joint of Horses.
Vet Surg, 45(2), 182-186.
https://doi.org/10.1111/vsu.12431 Publication
Researcher Affiliations
- Equine Department, Veterinary Clinic Emmeloord, Emmeloord, The Netherlands.
- Equine Department, Veterinary Clinic Emmeloord, Emmeloord, The Netherlands.
- Tierklinik Lüsche, Bakum, Germany.
- Equine Department, Veterinary Clinic Emmeloord, Emmeloord, The Netherlands.
- Equine Department, Veterinary Clinic Emmeloord, Emmeloord, The Netherlands.
MeSH Terms
- Animals
- Arthroscopy / veterinary
- Female
- Horse Diseases / surgery
- Horses / injuries
- Horses / surgery
- Joint Diseases / surgery
- Joint Diseases / veterinary
- Male
- Pedigree
- Retrospective Studies
- Tarsal Joints / injuries
- Tarsal Joints / surgery
- Treatment Outcome
Citations
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