Gas arthroscopy for removal of osteochondral fragments of the palmar/plantar aspect of the metacarpo/metatarsophalangeal joint in horses.

OBJECTIVE

To evaluate the use of carbon dioxide (CO(2)) gas for joint distention during arthroscopy for removal of osteochondral (OC) fragments of the palmar/plantar aspect of the metacarpo (MCP)/metatarsophalangeal (MTP) joints in horses.

STUDY

DESIGN

Clinical study.

ANIMALS: Horses (26) with OC fragment(s) of palmar/plantar aspect of 1 or 2 MCP/MTP joint(s).

METHODS

OC fragments were removed using arthroscopic technique. Joint distention was maintained by isotonic Ringer's acetate at the beginning and at the end of the procedure but during fragment removal, CO(2) was used for joint distention. After surgery, fragment removal was confirmed by radiography. Horses were discharged the day after surgery, and outcome was determined by telephone contact 3-24 months later.

RESULTS

CO(2) joint distention resulted in a sharp image without villi obscuring the operative field. Fragments were identified and completely removed in all horses except one where a 1 mm x 3 mm radiodense body was seen on postoperative radiographs. In 5 horses, bleeding from the arthroscopic or instrument portal precluded optimal visualization when the joint was distended by gas; however, repeatedly rinsing the tip of the arthroscope with Ringer's acetate solution delivered from the fluid ingress line easily restored joint visualization. No specific complications were observed postoperatively.

CONCLUSIONS

Joint distention by CO(2) permitted optimal visualization of the palmar/plantar aspect of the MCP/MTP joints, which facilitated fragment removal.

CLINICAL RELEVANCE: Gas arthroscopy is a useful technique for removal of OC fragments of the palmar/plantar aspect of the MCP/MTP joints in horses.