Standing NanoNeedle Arthroscopy of the Distal Interphalangeal Joint for Removal of Osteochondral Fragments of Distal P2 and the Extensor Process in a Horse.

Standing arthroscopy using very small scopes allows effective removal of bone and cartilage fragments from a horse’s hoof joint without needing general anesthesia. This minimally invasive approach led to a successful recovery in a horse with joint injury.

Introduction to Standing NanoNeedle Arthroscopy

• Traditional arthroscopy in horses often requires general anesthesia, which carries inherent risks and higher costs.
• Standing arthroscopy is an alternative procedure performed while the horse is awake and bearing weight, lowering anesthetic risk and improving access to certain joints.
• The distal interphalangeal joint (coffin joint) is challenging to access, and small-diameter scopes allow better visualization and maneuverability during surgery.
• This report presents the first known case of removing osteochondral fragments from this joint using a 2 mm NanoNeedle arthroscope in a standing sedated horse.

Case Presentation and Surgical Technique

• A 7-year-old horse with osteochondral fragments in the distal interphalangeal joint was referred for treatment.
• The surgery was conducted with the horse sedated and standing, avoiding general anesthesia.
• A 2 mm NanoNeedle arthroscope and 3.2 mm cannula with a 10-degree viewing angle were used to access the joint.
• The horse was weight-bearing during the procedure, allowing natural joint positioning and improved visual access.
• Dorsal osteochondral fragments on the second and third phalanges were precisely debrided using this setup.

Advantages Observed

• Use of the small NanoNeedle scope enhanced maneuverability inside the small joint space.
• Ergonomics of surgery were improved compared to standard rigid arthroscopes.
• Reduced iatrogenic injury risk due to smaller instruments and less invasive entry points.
• The horse remained standing, lowering procedure risks and recovery time associated with anesthesia.

Outcome and Significance

• At one year post-surgery, the horse returned to competition and was clinically sound on veterinary examination.
• This demonstrates the clinical efficacy and safety of the standing NanoNeedle arthroscopic approach for distal interphalangeal joint procedures.
• Expands the portfolio of minimally invasive standing arthroscopic surgeries available to equine practitioners.
• Potentially offers a cost-effective, safer alternative for treating certain joint injuries in horses, especially those with higher anesthetic risk.

Conclusion

• This case highlights how nano-scale arthroscopic equipment can revolutionize joint surgeries in standing horses.
• Smaller scopes improve surgical access and patient safety while enabling effective treatment of osteochondral injuries.
• Further adoption and study of these techniques may lead to widespread changes in equine orthopedic surgical practice.