Standing Arthroscopic Treatment of Temporomandibular Joint Sepsis in a Horse.

The study describes a case where a 15-year-old Thoroughbred gelding had swelling and pain in its temporomandibular joint, diagnosed as sepsis, and was successfully treated with arthroscopic debridement and lavage without complications, suggesting this treatment approach is viable for standing horses.

Objective of Research

• This study was aimed at exploring and providing insights into the diagnosis and management of temporomandibular joint (TMJ) sepsis in a Thoroughbred gelding horse. The study also aimed to establish if standing arthroscopy could effectively address such cases.

Methodology and Diagnostic Process

• The researchers presented the case of a 15-year-old Thoroughbred gelding that was brought in for examination due to an observed fever, swelling, and apparent pain when opening the mouth.
• The horse was subjected to a synovial fluid analysis to evaluate and diagnose the real nature of the issue.
• For a more comprehensive understanding and confirmatory diagnosis, the horse was further examined through sonographic imaging and standing robotic cone-beam computed tomography.
• The results of these assessments revealed a case of sepsis in the right temporomandibular joint, accompanied by otitis media and temporohyoid osteoarthropathy (THO).

Treatment Procedure

• To address the TMJ sepsis, the horse underwent arthroscopic debridement and lavage. This procedure was done while the horse was standing and under sedation.
• Following the arthroscopic procedure, local and systemic antimicrobial therapy was administered for further treatment.

Results and Observations

• The treatment process was completed successfully without any consequent complications linked to the surgical procedure.
• Significant improvement was observed in the horse’s health as previously reported clinical signs ceased after the procedure.
• This case, thus, serves as valid evidence that arthroscopy can be feasibly performed on a standing horse when dealing with TMJ afflictions.

Significance of the Case

• The case is remarkable as it is the first of its kind to report otitis media, TMJ sepsis, and THO simultaneously.
• This discovery underscores the possibility of septic otitis media facilitating pathological conditions in the TMJ and temporohyoid joint due to their close anatomic proximity, a situation similar to what has been reported in human cases.