Incidence and risk factors of surgical site infection and septic arthritis after elective arthroscopy in horses.
Abstract: To determine the incidence of infection and associated risk factors, after elective arthroscopy. Methods: Retrospective case study. Methods: Horses (n=1079) undergoing elective arthroscopy. Methods: Medical records of all horses that underwent elective arthroscopy between 2006 and 2013 were reviewed. Age, gender, breed, surgeon, number of joints operated, total anesthetic time, perioperative antimicrobial administration, and the presence and size of osteochondral fragments/subchondral lesions were recorded. For each operated joint, the development of postoperative infection (surgical site infection [SSI] and/or septic arthritis) and long-term outcome (>6 months) were recorded. Multivariate logistic regression was used to test for association between the independent variables and the dependent outcomes. Results: A total of 1741 joints in 1079 horses underwent arthroscopy. SSI without septic arthritis occurred in 1 fetlock joint (0.14%), 1 tibiotarsal joint (0.19%), and 6 femoropatellar joints (1.67%). Thirteen joints (0.75%) were diagnosed with septic arthritis, including 1 fetlock joint (0.14%), 4 tibiotarsal joints (0.74%), and 8 femoropatellar joints (2.23%). The probability of postoperative SSI was higher when large lesions (>40 mm long) were treated, compared to medium (20-40 mm, P = .005) and small (<20 mm, P < .001) lesions. SSI was a significant risk factor for the development of septic arthritis (P < .001). Although age did not affect the incidence of SSI, increasing age was associated with a lower rate of septic arthritis rate (P = .028). Conclusions: Septic arthritis after elective arthroscopy was more likely in the presence of SSI and younger age. Horses with large lesions were at risk for SSI, which translated into a higher incidence of postoperative septic arthritis after femoropatellar arthroscopy.
© 2017 The American College of Veterinary Surgeons.
Publication Date: 2017-10-16 PubMed ID: 29034493DOI: 10.1111/vsu.12699Google Scholar: Lookup
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Summary
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The study examines the occurrences and risk factors of postoperative infections, specifically surgical site infection (SSI) and septic arthritis, in horses that underwent elective arthroscopy.
Research Methodology
- The research is a retrospective case study involving 1,079 horses that underwent elective arthroscopy between 2006 and 2013.
- The researchers reviewed medical records of these horses, taking note of factors like age, gender, breed, surgeon, number of joints operated, total anesthetic time, perioperative antimicrobial administration, the presence, and size of osteochondral fragments/subchondral lesions.
- The team also recorded instances of postoperative infection (surgical site infection [SSI] and/or septic arthritis) in each operated joint and the long-term outcome (>6 months) after the surgery.
- They then used multivariate logistic regression to test the association between the independent variables noted from each horse’s record and the dependent outcomes (SSI and/or septic arthritis).
Research Findings
- A total of 1,741 joints in 1,079 horses were operated during arthroscopy.
- Postoperative SSI without septic arthritis occurred in very small percentages across different joint types: one fetlock joint (0.14%), one tibiotarsal joint (0.19%), and six femoropatellar joints (1.67%).
- Thirteen joints (0.75%) were diagnosed with septic arthritis, including one fetlock joint (0.14%), four tibiotarsal joints (0.74%), and eight femoropatellar joints (2.23%).
- The likelihood of postoperative SSI was higher when large lesions (>40 mm long) were treated, compared to medium (20-40 mm) and small (<20 mm) lesions.
- SSI was identified as a significant risk factor for the development of septic arthritis.
- Whilst age did not influence the incidence of SSI, increasing age was associated with a lower rate of septic arthritis.
Research Conclusions
- The study concluded that septic arthritis after elective arthroscopy is more likely in two conditions: the presence of SSI and a younger age of the horse.
- Horses with large lesions were identified as high-risk for SSI, which consequently translated into a higher incidence of postoperative septic arthritis, particularly after femoropatellar arthroscopy.
Cite This Article
APA
Brunsting JY, Pille FJ, Oosterlinck M, Haspeslagh M, Wilderjans HC.
(2017).
Incidence and risk factors of surgical site infection and septic arthritis after elective arthroscopy in horses.
Vet Surg, 47(1), 52-59.
https://doi.org/10.1111/vsu.12699 Publication
Researcher Affiliations
- Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
- Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
- Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
- Department of Surgery and Anaesthesiology of Domestic Animals, Faculty of Veterinary Medicine, Ghent University, Merelbeke, Belgium.
- Bosdreef Equine Hospital, Moerbeke-Waas, Belgium.
MeSH Terms
- Animals
- Anti-Bacterial Agents / therapeutic use
- Arthritis, Infectious / etiology
- Arthritis, Infectious / veterinary
- Arthroscopy / adverse effects
- Arthroscopy / veterinary
- Elective Surgical Procedures / adverse effects
- Elective Surgical Procedures / veterinary
- Female
- Horse Diseases / drug therapy
- Horse Diseases / etiology
- Horses
- Incidence
- Logistic Models
- Male
- Postoperative Complications / veterinary
- Retrospective Studies
- Risk Factors
- Surgical Wound Infection / etiology
- Surgical Wound Infection / veterinary
Citations
This article has been cited 5 times.- Merchán A, Koenig J, Côté N, Cribb N, Monteith G. Fragment size is associated with post-operative complications following elective arthroscopy of the tibiotarsal joint of horses.. Can Vet J 2022 Jan;63(1):74-80.
- Przewoźny M, Senderska-Płonowska M, Rząsa A, Wierzbicki H, Borkowski J, Swagemakers JH, Żak-Bochenek A, Stefaniak T. Usefulness of Selected Acute-Phase Proteins in the Postsurgical Monitoring of Arthroscopy and Splint Bone Removal in Horses.. Animals (Basel) 2021 Oct 13;11(10).
- Ceriotti S, Westerfeld R, Bonilla AG, Pang DSJ. Use of Clinical Audits to Evaluate Timing of Preoperative Antimicrobials in Equine Surgery at a Veterinary Teaching Hospital.. Front Vet Sci 2021;8:630111.
- Pezzanite LM, Griffenhagen GM, Krause DM, Hendrickson DA. Retrospective evaluation of association between perioperative antimicrobial protocol and complications following elective equine synovial endoscopy.. Vet Med Sci 2021 May;7(3):609-620.
- Frietman SK, van Proosdij ER, Veraa S, de Heer N, Ter Braake F. A minimally invasive partial condylectomy and temporal bone resection for the treatment of a suspected chronic synovial sepsis of the temporomandibular joint in a 3.5-year-old paint horse gelding.. Vet Q 2018 Dec;38(1):118-124.
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