Arthroscopic removal of osteochondral fragments in the dorsal pouch of the proximal intertarsal joint in 29 horses.

This research details a procedure for arthroscopically removing osteochondral fragments (OCF) in the proximal intertarsal joint (PIJ) of horses, and presents outcomes based on the examination of 29 cases. The study indicates that the procedure is effective and unaccompanied by major complications, but more research is needed to understand the clinical implications of these fragments in the PIJ.

Methodology

• The study is a retrospective case series involving 29 horses (32 instances of tarsi).
• Data was gathered from the medical records of horses that showed radiographic evidence of OCF in the PIJ.
• The data examined included clinical features, the number of fragments, their location, arthroscopic appearance, and outcomes.
• A specific arthroscopic technique for fragment retrieval was detailed, including technical modifications with visual aids.

Results

• Out of the studied horses, 93% (27 out of 29 horses) exhibited radiographic signs of osteochondritis dissecans (a joint condition that can lead to OCF) in the tarsocrural joint (TCJ).
• The majority of OCF were found distal to the medial trochlear ridge of the talus (a bone in the ankle).
• The arthroscopic technique involved exposing the fragments after resecting the proximal intertarsal joint capsule (PIJC). In this process, fragments were visible from the TCJ prior to resection of the PIJC in 4 out of the 32 tarsi tested.
• In a subset of cases (3 out of 32 tarsi), a third portal (entry point for the arthroscope) was created to access fragments located distal to the lateral trochlear ridge (part of the talus bone).
• Moderate intra-articular bleeding occurred when the PIJC was resected in 3 out of 32 tarsi.
• Mild postoperative swelling was reported in one horse, but this resolved following conservative medical management.

Outcomes and Conclusions

• All horses for which long-term follow-up data was available (16 out of 29) either began training or resumed their sporting careers after the procedure.
• The featured arthroscopic technique, which involved resecting the PIJC, was found to be effective in retrieving OCF in the PIJ, with only minor complications reported.
• The clinical relevance or impact of these fragments in the PIJ remains unknown, indicating a potential area for future research.