Arthroscopic removal of axial osteochondral fragments of the proximoplantar aspect of the proximal phalanx using electrocautery probes in 23 standardbred racehorses.

The research article reports on a study examining the use of arthroscopic electrosurgery for the removal of axial osteochondral fragments in the joints of race horses, specifically Standardbred racehorses. The results showed that this surgical approach had minimal complications and allowed the majority of treated horses to return to racing.

Background and Methods

• The objective of this analysis was to assess the impacts and safety of arthroscopic electrosurgical excision of axial osteochondral fragments in the proximal plantar aspect of the first phalanx (P1) in race horses. This is a novel surgical process where small pieces of bone and cartilage—which may cause pain and inflammation in horses—are removed using an electrically-activated probe.
• The cohort under investigation was made up of 23 Standardbred racehorses, a breed specifically raised for harness racing.
• For the surgical procedure, the horses were placed in dorsal recumbency, meaning they were positioned on their backs. A 1.5% solution of glycine was used to maintain joint distension, creating a necessary space to access and operate on the joint.
• The arthroscopic portal—the entry point for the surgical tool—was created in the proximal plantar joint pouch, and the osteochondral fragments were removed via either an ipsilateral (same side) or contralateral (opposite side) triangulation technique. These fragments were then dissected using loop and hook electrocautery probes.

Results

• In total, 33 axial osteochondral fragments were removed from 28 metatarsophalangeal joints (the joint between the long bone in the foot and the first bone of the toe).
• There were no significant operative or postoperative complications observed in the subjects. This outcome suggests that the procedure has a good safety profile.
• The study also looked at the horses’ ability to race post-surgery. A significant majority, 79% of horses that had previously raced were able to return to racing post-surgery. Additionally, 36% of horses that had not raced before the surgery were able to race afterward.

Conclusions

• The research concludes that intra-articular electrosurgery is a safe and effective method for the removal of problematic osteochondral fragments from a horse’s joint. This alternative method can be an effective replacement for conventional excision.
• Arthroscopic excision using electrocautery, as per the authors, is a valid method for addressing this issue, and the dorsal recumbency position makes the removal process easier, even when multiple fragments are present.