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Home / Equine Research Bank / Vet Surg / The influence of tenoscopic approaches on radiocarpal joint ...
Veterinary surgery : VS2019; 49(2); 274-280; doi: 10.1111/vsu.13316

The influence of tenoscopic approaches on radiocarpal joint perforation during carpal sheath tenoscopy in horses.

Abstract: To report the frequency of radiocarpal joint (RCJ) perforation during two proximolateral carpal sheath (CS) approaches and to investigate whether the presence or absence of a natural communication between the RCJ and CS. Methods: Experimental, randomized, controlled study. Methods: Twelve adult horses and 12 cadaver front limbs. Methods: Proximolateral CS tenoscopy was performed on both carpi of 12 horses under general anaesthesia. Limbs were randomly assigned into two groups. In group 1, the instrument portal was centered at the level of the distal radial physeal remnant (PR). In group 2, the instrument portal was centered 2 cm proximal to the PR. Immediately after tenoscopy, dye-coloured fluid was instilled arthroscopically into the dorsolateral RCJ, and the open tenoscopic portals were evaluated for leakage. Twelve cadaver front limbs were examined for naturally occuring RCJ and CS communication by using positive-contrast computed tomography (CT). Frequency of perforations were compared with McNemar's test for two matched proportions. Results: In group 1, 10 of 12 RCJ were perforated during tenoscopy, and, in group 2, four of 12 RCJ were perforated (P = 0.03). No diffusion of contrast from the RCJ to the CS was detected by CT. Conclusions: Perforation of the RCJ was common when CS instrument portals were placed at the level of the PR. No natural communication was detected between the RCJ and CS. Conclusions: Carpal sheath tenoscopic instrument portals may need to be placed >2 cm proximal to the PR to prevent inadvertent RCJ perforation, especially in horses undergoing tenoscopic treatment of a septic CS.
© 2019 The American College of Veterinary Surgeons.
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Publication Date: 2019-08-29 PubMed ID: 31468554DOI: 10.1111/vsu.13316Google Scholar: Lookup
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  • Journal Article
  • Randomized Controlled Trial
  • Veterinary

Summary

This research summary has been generated with artificial intelligence and may contain errors and omissions. Refer to the original study to confirm details provided. Submit correction.

This research investigates the frequency of radiocarpal joint perforation during two approaches of carpal sheath tenoscopy in horses. It also explores the possibility of natural communication between the radiocarpal joint and carpal sheath.

Research Methodology

  • The study was designed as an experimental, randomized, controlled study undertaken on twelve adult horses and twelve cadaver front limbs.
  • Two approaches to the carpal sheath were compared, centered at different positions relative to the distal radial physeal remnant (PR), a landmark in the horse’s limb.
  • In Group 1, the instrument portal was centered at the level of the PR, whereas in Group 2, the instrument portal was positioned 2 cm proximal to the PR.
  • After the completion of the tenoscopy, a dye-colored fluid was instilled into the radiocarpal joint to confirm whether there was any leakage from the tenoscopic portals.
  • The cadaver front limbs were examined using positive-contrast computed tomography (CT) to detect any naturally occurring communication between the radiocarpal joint and carpal sheath.

Research Findings

  • The results showed that radiocarpal joint perforations were more frequent in Group 1, where the instrument portal was positioned at the level of the PR. Specifically, ten out of twelve radiocarpal joints were perforated in this group.
  • In Group 2, where the instrument portal was sited 2cm proximal to the PR, only four out of twelve radiocarpal joints were perforated.
  • No evidence of natural communication between the radiocarpal joint and carpal sheath was detected in the CT scans.

Conclusions and Recommendations

  • These findings suggest that radiocarpal joint perforation is quite common when the carpal sheath instrument portal is located at the level of the PR. This implies that the selection of the portal site is critical in preventing inadvertent joint perforations.
  • Given the results of this study, it is advisable that the carpal sheath tenoscopic instrument portals should be placed greater than 2 cm proximal to the PR to avoid accidental radiocarpal joint perforation, particularly in horses treated for a septic carpal sheath.

Cite This Article

APA
Skov Hansen S, Tóth T. (2019). The influence of tenoscopic approaches on radiocarpal joint perforation during carpal sheath tenoscopy in horses. Vet Surg, 49(2), 274-280. https://doi.org/10.1111/vsu.13316

Publication

Veterinary surgery : VS
ISSN: 1532-950X
NlmUniqueID: 8113214
Country: United States
Language: English
Volume: 49
Issue: 2
Pages: 274-280

Researcher Affiliations

Skov Hansen, Sabrina
  • Department of Surgery, University Animal Hospital, Equine Clinic, Swedish University of Agricultural Sciences, Uppsala, Sweden.
Tóth, Tamás
  • Department of Surgery, University Animal Hospital, Equine Clinic, Swedish University of Agricultural Sciences, Uppsala, Sweden.

MeSH Terms

  • Animals
  • Arthroscopy / adverse effects
  • Arthroscopy / veterinary
  • Cadaver
  • Carpus, Animal / pathology
  • Forelimb / surgery
  • Horse Diseases / etiology
  • Horse Diseases / pathology
  • Horses
  • Tendons / surgery

Grant Funding

  • University Animal Hospital
  • Equine Clinic
  • Swedish University of Agricultural Sciences

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