Gas arthroscopy for removal of osteochondral fragments of the palmar/plantar aspect of the metacarpo/metatarsophalangeal joint in horses.

This research study evaluates the effectiveness of using carbon dioxide gas for expanded view during arthroscopy, a minimally invasive surgical procedure, to remove fragments of bone and cartilage from specific joints in horses.

Research Methods:

• The study involved a clinical trial with 26 horses that had osteochondral (OC) fragments in one or two metacarpo/metatarsophalangeal (MCP/MTP) joints, located in the lower limbs of the horse.
• The OC fragments were removed via an arthroscopic technique, a minimally invasive surgical procedure which uses an arthroscope, a type of endoscope that is inserted into the joint through a small incision.
• During the procedure, the researchers used isotonic Ringer’s acetate, a solution that mimics the body’s fluids, at the beginning and end of the procedure for joint distention (expansion of the joint space), while using carbon dioxide (CO2) gas for joint distention during the fragment removal.
• Post-surgery, radiography (a type of X-ray) was used to confirm the complete removal of fragments, and horses were discharged the day after the surgery.
• Afterward, outcome records were collected via telephone contact after three to 24 months.

Results:

• The use of carbon dioxide for joint distention provided a clear visualization of the operating field, without any overlapping tissue obstructing the view.
• All horses, with an exception of one, had fragments completely removed which was confirmed via postoperative radiographs.
• In 5 horses, bleeding from the arthroscopy or instrument portal obstructed the view when the joint was distended by gas. However, the visualization was easily restored by rinsing the arthroscope’s tip with the Ringer’s acetate solution.
• No specific postoperative complications were observed.

Conclusion:

• The research concluded that expanding the joint with carbon dioxide gas during arthroscopy enabled optimal visualization of the MCP/MTP joints, which facilitated fragment removal.
• The study suggests that gas arthroscopy can be a useful technique for the removal of OC fragments from the MCP/MTP joints in horses.