Comparison of four techniques of arthrocentesis of the lateral compartment of the femorotibial joint of the horse.

The research paper analyzes the accuracy of four different techniques used for centesis (puncture and drainage of a joint) in the lateral compartment of the femorotibial joint in horses. The study found that the most successful method was through the long digital extensor tendon; the other techniques were less successful.

Research Objective

• The purpose of this research was to determine the accuracy of two existing published techniques and two new, unpublished techniques for performing centesis of the lateral compartment of the femorotibial joint, a procedure often unsuccessful based on clinical experiences.
• The authors hypothesized that the most accurate method would be to administer a drug into the joint via a passage that surrounds the long digital extensor tendon.

Methods

• Twenty-four stifles (knee joints) from 12 horses were equally divided into four groups. Each group received an injection of a radiocontrast medium (a substance that improves the visibility of internal structures in X-ray images) into the joint using a different technique.
• The injections were done with a hypodermic needle placed in four different ways: caudal to the lateral patellar ligament and proximal to the tibial plateau; caudal to the long digital extensor tendon and proximal to the tibial plateau; between the long digital extensor tendon and bone of the extensor groove of the tibia; and directly through the long digital extensor tendon until it contacted bone.
• The injections were performed by twelve veterinary students with no prior experience of these techniques.
• The accuracy of each method was evaluated by examining X-ray images taken after the contrast medium was injected.

Results

• The research found the most successful technique for arthrocentesis was done by inserting a needle through the long digital extensor tendon, a method that was successful in all attempted cases.
• The success rates were lower for the other techniques. This result indicates that the choice of technique can significantly affect the success rate of femorotibial joint arthrocentesis.

Conclusion

• The research concluded that the most accurate method to access the lateral compartment of the femorotibial joint is to insert a needle through the long digital extensor tendon as it lies within the extensor groove. This method could be especially beneficial for clinicians inexperienced in arthrocentesis of this specific joint.
• The study’s findings could lead to improved medical procedures for horses, by significantly increasing the success rate of femorotibial joint arthrocentesis.