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Home / Equine Research Bank / Vet Surg / Efficacy of needle and endoscopic lavage on the recuperation...
Veterinary surgery : VS2025; 54(6); 1157-1166; doi: 10.1111/vsu.14298

Efficacy of needle and endoscopic lavage on the recuperation of microspheres from the adult equine metacarpo-/metatarsophalangeal joint and digital flexor tendon sheath.

Abstract: To measure microsphere recovery following needle-through-and-through lavage (NTAT) of the metacarpo-/metatarsophalangeal joint (fetlock) and digital flexor tendon sheath (DFTS) compared to endoscopic lavage (EL). Methods: Ex vivo experimental study. Methods: Adult equine cadavers immediately following euthanasia (n = 10). Methods: Colored 15 μm microspheres (2 million) were injected into fetlock joints and DFTS. Synovial structures were assigned to NTAT or EL groups. Each lavage was performed using 5 L of 0.9% NaCl, sequentially collecting egress fluid for microsphere quantification. Recovery was compared using a full-factorial general linear model. Results: There was a significant effect of the liter of egress fluid and microsphere recovery in both fetlocks (p < .01) and DFTS (p < .01), with most microspheres recovered in the first 2 L (79%-83%) for both techniques. More microspheres were recovered in the first liter using NTAT than EL (p < .01) in both fetlocks (659 883 ± 20 820 vs. 567 601 ± 24 452) and DFTS (644 341 ± 17 460 vs. 550 637 ± 38 022). No difference in total recovered microspheres was observed between NTAT lavage of fetlock (981 600 ± 46 839) and DFTS (957 419 ± 45 729) across 5 L (p = .88). Conclusions: Needle-through-and-through lavage was more effective than EL at recovering microspheres in the first liter from cadaveric equine fetlock joints and DFTS. Both techniques demonstrated comparable efficacy between fetlock and DFTS in microsphere recovery following increased lavage volumes. Conclusions: Needle-through-and-through lavage (NTAT) is a viable alternative for suspected synovial contamination when EL is delayed or not feasible. This study does not evaluate NTAT's efficacy for treating established sepsis or removing pannus/foreign bodies.
© 2025 The Author(s). Veterinary Surgery published by Wiley Periodicals LLC on behalf of American College of Veterinary Surgeons.
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Publication Date: 2025-06-25 PubMed ID: 40556484PubMed Central: PMC12344216DOI: 10.1111/vsu.14298Google Scholar: Lookup
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Summary

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Overview

  • This study compares two methods—needle-through-and-through lavage (NTAT) and endoscopic lavage (EL)—for washing out and recovering small particles (microspheres) from specific joint and tendon sheath areas in adult horses.
  • It examines how efficiently these techniques recover microspheres injected into the fetlock joint and digital flexor tendon sheath using ex vivo equine cadaver limbs.

Background and Purpose

  • The fetlock joint (metacarpo-/metatarsophalangeal joint) and the digital flexor tendon sheath (DFTS) are synovial structures in horses prone to infection or contamination, often needing lavage—a washing procedure—to remove debris or contaminants.
  • Endoscopic lavage (EL) is a common technique requiring specialized equipment and time to perform.
  • Needle-through-and-through lavage (NTAT) is a simpler technique where saline solution is passed through with needles, potentially useful when EL is not immediately available.
  • The goal was to compare the effectiveness of NTAT versus EL in flushing out injected microspheres (simulating contaminants) to evaluate NTAT as a possible alternative lavage method.

Methods

  • Ten cadaveric limbs from adult horses euthanized immediately prior to the study were used.
  • Two million colored microspheres, each 15 micrometers in diameter, were injected separately into the fetlock joint and the DFTS.
  • Synovial structures were divided between the two lavage techniques — each limb was assigned to either NTAT or EL.
  • Both lavage techniques used 5 liters of 0.9% saline (NaCl) solution, administered sequentially.
  • The lavage fluid exiting the joint/tendon sheath was collected in liters (i.e., first liter, second liter, etc.) to quantify how many microspheres were recovered in each portion.
  • Recovery data was analyzed statistically with a full-factorial general linear model to compare between NTAT and EL techniques and between the fetlock and the DFTS sites.

Results

  • Both techniques recovered the majority of microspheres within the first 2 liters of lavage fluid—about 79%-83% of total particles.
  • NTAT recovered significantly more microspheres within the first liter than EL in both fetlock joints (659,883 ± 20,820 vs. 567,601 ± 24,452 microspheres) and DFTS (644,341 ± 17,460 vs. 550,637 ± 38,022 microspheres).
  • Over the total 5 liters of lavage fluid, there was no significant difference in total microspheres recovered between NTAT and EL for the fetlock (about 981,600 ± 46,839) or DFTS (about 957,419 ± 45,729).
  • Recovery efficiency was similar for both synovial structures—fetlock joint and DFTS—across both lavage methods with increasing lavage volume.

Conclusions and Implications

  • Needle-through-and-through lavage is an effective method for recovering particulate contaminants from equine synovial structures and performs better than endoscopic lavage in the initial volume of fluid used.
  • Both NTAT and EL are similarly effective in total microsphere recovery when larger amounts of lavage fluid are used.
  • NTAT can be considered a viable alternative for initial management of suspected synovial contamination, especially in situations where endoscopic lavage is delayed or equipment is unavailable.
  • The study was performed on cadaver limbs and thus does not address tissue responses or clinical efficacy in live horses, nor does it evaluate NTAT’s ability to treat established joint infections (sepsis) or effectively remove other debris such as pannus or foreign bodies.
  • Further clinical investigations would be needed to confirm the practical therapeutic benefits and safety of NTAT in a clinical setting.

Cite This Article

APA
Beggan CP, Panizzi L, Oliver LJ. (2025). Efficacy of needle and endoscopic lavage on the recuperation of microspheres from the adult equine metacarpo-/metatarsophalangeal joint and digital flexor tendon sheath. Vet Surg, 54(6), 1157-1166. https://doi.org/10.1111/vsu.14298

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 54
Issue: 6
Pages: 1157-1166

Researcher Affiliations

Beggan, Christopher P
  • Waikato Equine Veterinary Center, Cambridge, New Zealand.
Panizzi, Luca
  • School of Veterinary Science, Equine Veterinary Centre, Massey University, Palmerston North, New Zealand.
Oliver, Laurinda J
  • Waikato Equine Veterinary Center, Cambridge, New Zealand.

MeSH Terms

  • Animals
  • Horses
  • Microspheres
  • Therapeutic Irrigation / veterinary
  • Therapeutic Irrigation / methods
  • Cadaver
  • Tendons
  • Metacarpophalangeal Joint
  • Metatarsophalangeal Joint
  • Endoscopy / veterinary
  • Needles / veterinary

Grant Funding

  • N/A / New Zealand Equine Research Foundation

Conflict of Interest Statement

The authors have no conflicts of interest.

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