Evaluation of a cranial arthroscopic approach to the stifle joint for the treatment of femorotibial joint disease in horses: 23 cases (1998–1999)

John F. Peroni Department of Large Animal Clinical Sciences, Veterinary Teaching Hospital, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824-1314.
Current address is the Department of Large Animal Medicine, College of Veterinary Medicine, University of Georgia, Athens, GA 30602.

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 DVM, MS
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John A. Stick Department of Large Animal Clinical Sciences, Veterinary Teaching Hospital, College of Veterinary Medicine, Michigan State University, East Lansing, MI 48824-1314.

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 DVM, DACVS

Abstract

Objective—To describe a single-portal cranial arthroscopic approach to the stifle joint in horses and to determine the clinical outcome in horses with femorotibial joint disease in which this approach was used.

Design—Retrospective study.

Animals—23 adult horses.

Procedure—Medical records were reviewed to obtain information on clinical outcome in horses in which the single-portal cranial arthroscopic approach was used.

Results—Twenty-nine stifle joints of 23 horses were examined arthroscopically, using the described approach. Subchondral bone cysts were treated in 19 medial femoral condyles of 12 horses. Unilateral cruciate ligament desmitis (4 horses), meniscal tearing (3), or both (2) were identified in 9 horses. Evidence of degenerative joint disease without cystic lesions or soft tissue trauma was found in 2 horses. Information on clinical outcome was obtained for 21 of 23 horses. A successful outcome was obtained in 15 of 21 horses and was defined as return to sound performance at a degree equal to or better than that prior to injury and lameness. Eight of 12 horses treated for medial femoral condylar cysts had a successful outcome. Four show horses treated for cruciate ligament lesions alone successfully returned to showing activity. None of the 3 horses with meniscal tearing were able to perform successfully.

Conclusions and Clinical Relevance—The femorotibial joint was evaluated through a single-portal cranial arthroscopic approach, using the femoropatellar joint as the point of access. This approach was easy to perform, allowed controlled access to the femorotibial joint, avoided accidental damage to articular structures, and required fewer access portals. (J Am Vet Med Assoc 2002;220: 1046–1052)

Abstract

Objective—To describe a single-portal cranial arthroscopic approach to the stifle joint in horses and to determine the clinical outcome in horses with femorotibial joint disease in which this approach was used.

Design—Retrospective study.

Animals—23 adult horses.

Procedure—Medical records were reviewed to obtain information on clinical outcome in horses in which the single-portal cranial arthroscopic approach was used.

Results—Twenty-nine stifle joints of 23 horses were examined arthroscopically, using the described approach. Subchondral bone cysts were treated in 19 medial femoral condyles of 12 horses. Unilateral cruciate ligament desmitis (4 horses), meniscal tearing (3), or both (2) were identified in 9 horses. Evidence of degenerative joint disease without cystic lesions or soft tissue trauma was found in 2 horses. Information on clinical outcome was obtained for 21 of 23 horses. A successful outcome was obtained in 15 of 21 horses and was defined as return to sound performance at a degree equal to or better than that prior to injury and lameness. Eight of 12 horses treated for medial femoral condylar cysts had a successful outcome. Four show horses treated for cruciate ligament lesions alone successfully returned to showing activity. None of the 3 horses with meniscal tearing were able to perform successfully.

Conclusions and Clinical Relevance—The femorotibial joint was evaluated through a single-portal cranial arthroscopic approach, using the femoropatellar joint as the point of access. This approach was easy to perform, allowed controlled access to the femorotibial joint, avoided accidental damage to articular structures, and required fewer access portals. (J Am Vet Med Assoc 2002;220: 1046–1052)

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