Equis ISSN 2398-2977

Fetlock: arthroscopy

Contributor(s): Bud G E Fackelman, Graham Munroe, Jane Boswell

Introduction

  • Arthroscopy is a useful tool for both diagnosis and treatment of fetlock joint lesions Joint: arthroscopy - overview but it is a procedure which should only be carried out by specialists in the field.

Uses

  • Joint lavage and removal of foreign material, fibrin and pannus in the management of joint sepsis or contamination (dorsal and palmar/plantar approach).
  • Proximal dorsal chip fractures of proximal phalanx - dorsal approach Proximal phalanx: fracture Proximal phalanx: fracture 01 - arthroscopy.
  • Avulsion fractures of proximal plantar/palmar proximal phalanx - palmar/plantar approach.
  • Villonodular synovitis (chronic proliferative synovitis) - dorsal approach MCP / MTP joint: chronic proliferative synovitis.
  • OCD of sagittal ridge of distal metacarpus or metatarsus - dorsal approach Bone: osteochondrosis.
  • Subchondral bone cysts of distal metacarpus - dorsal approach.
  • Sesamoid bone fractures - palmar/plantar approach Proximal sesamoid: fracture - arthroscopic removal.
  • Diagnostic arthroscopy during reduction of distal metacarpal/metatarsal condylar fractures - palmar/plantar approach.
  • Diagnostic arthroscopy where the lameness has been localized to the fetlock joint and no specific diagnosis is possible using other non-invasive diagnostic techniques.

Advantages

  • Minimally invasive with reduced trauma and fewer complications.
  • Improved visibility.
  • Multiple arthroscopies can be performed in multiple joints on one occasion.
  • Good cosmetic appearance following surgery.
  • Shorter operating time vs arthrotomy.
  • Reduced convalescence vs arthrotomy.
  • Better prognosis for return to previous level of performance (and beyond) vs arthrotomy.

Disadvantages

  • Expensive equipment.
  • High levels of surgical expertise, knowledge and experience of technique required.

Requirements

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Preparation

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Procedure

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Aftercare

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Outcomes

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Prognosis

  • Uncomplicated proximodorsal P1 chip fractures: excellent.
  • OCD: variable, dependent upon early intervention, hindlimb vs forelimb, secondary osteoarthritis.
  • Villonodular synovitis: excellent.

Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Vanderperren K et al (2009) Arthroscopic visualisation of the third metacarpal and metatarsal condyles in the horse. Equine Vet J 41 (6), 526-533 PubMed.
  • Fraser B & Booth T (2005) Equine arthroscopic surgery Part 5: Metacarpophalangeal joint. UK Vet 10 (1), 17-21.
  • Brommer H et al (2004) Accuracy of diagnostic arthroscopy for the assessment of cartilage damage in the equine metacrpophalangeal joint. Equine Vet J 36 (4), 331-335 PubMed.

Other sources of information

  • McIlwraith C W, Nixon A & Wright I (2014) Eds Diagnostic and Surgical Arthroscopy in the Horse. 4th edn. Mosby Ltd.
  • Richardson D (2004) Arthroscopic Surgery in Standing Horses. In: Proc 43rd BEVA Congress. Equine Vet J Ltd, UK. pp 157.
  • Ross M W & Dyson S J (2003) Eds Diagnosis and Management of Lameness in the Horse. Saunders.
  • McIlwraith C W & Robertson J T (1998) Equine Surgery Advanced techniques. 2nd edn. Williams & Wilkins.


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