Arthroscopic laser extirpation of metacarpophalangeal synovial pad proliferation in eleven horses.

The study looks at a new surgical technique, using arthroscopic laser extirpation, for treating chronic metacarpophalangeal synovial pad proliferation in horses, presenting findings from 11 clinical cases, including long-term follow-ups. The research demonstrates that this method is safe, effective, and efficient with no postoperative complications or recurrence of the lesions.

Methodology

• The researchers reviewed the medical records of all horse lameness cases attributed to metacarpophalangeal synovial pad proliferation that were admitted to the College of Veterinary Medicine at Cornell University between 1991 and 1996. The ones treated surgically by laser extirpation were included in this study.
• The data retrieved included details about the subjects, preoperative lameness, ultrasonography, radiography and synovial fluid evaluations, and lesion histopathology.
• The lesions were ablated using either a CO2 laser or a Nd:YAG laser intra-articularly with arthroscopic guidance.
• The long-term follow-up was provided by conducting telephone conversations with owners or trainers.

Results

• All the treated horses initially had fetlock joint effusion and were presented as lame. The mean synovial pad thickness measured ultrasonographically was found to be 9.0mm (with a range of 6-15mm).
• Around 64% of horses showed radiographic evidence of remodelling of the dorsal cortex of distal McIII and 27% had concurrent dorsal proximal P1 fractures.
• Importantly, no postoperative complications were observed in any treated horse.
• All the horses returned to training within 90 days of surgery without recurrence of the lesions.

Conclusion

• The study concludes that arthroscopic laser extirpation of metacarpophalangeal synovial pad proliferation is a rapid, safe, and efficient technique for surgically removing such lesions in horses without any complications or recurrence.
• The proposed surgical technique is considered a suitable alternative to more conventional treatments for chronic metacarpophalangeal synovial pad proliferation, particularly in the removal of very large, fibrotic masses.