AAEP Convention: Standing Arthroscopy Can Be Used On More Than Stifles

When traditional diagnostic tools such as X-ray and ultrasound provide no definitive diagnosis for an equine lameness, a vet may perform an arthroscopy. While this procedure typically requires putting the horse under general anesthesia, a needle arthroscopy can be done while the horse is under standing sedation, Dr. Alvaro Bonilla said at the virtual 2020 American Association of Equine Practitioners Convention and Trade Show.

A safe, reliable procedure, needle arthroscopy is less risky and less costly to the owner; putting a horse under general anesthesia for surgery has its own risks, including recovery. While typically used for diagnostics, a standing arthroscopy can also be used therapeutically for septic joints and small osteochondral fragments, specifically for dorsal fragments of the first phalanx in the fetlock, Alvaro says. However, the procedure does still have limitations.

Previously, needle arthroscopy was used only in the stifle joint; Alvaro reports that now it can be used successfully to evaluate multiple synovial structures, including shoulders, fetlocks, hocks, radiocarpal and middle carpal joints, and carpal sheaths.

When using this diagnostic tool, it’s important that the horse is sedated, but not overly so, which could make him unsteady and make the procedure not only difficult, but dangerous. Additionally, the surgical site must be sterile, which can be difficult as debris can fall onto the joint or the horse can urinate. Potential for both complications can be decreased by using blankets and inserting a urinary catheter.

An adjustable, lightweight splint made from stainless steel and aluminum is used during the procedure; to ensure as successful an outcome as possible, horses should be acclimated to wearing the brace before being sedated for the surgery.

The surgical area should be bandaged for four to five days following the procedure; horses that had the procedure for diagnostic reasons can go back to work as soon as the bandages are removed.

Read more at EquiManagement.

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