Arthroscopic Approach to the Subextensorius Recess of the Lateral Femorotibial Joint of the Foal

Hennessy, Simon; Cudmore, Lucy; Jackson, Leisa; Vasey, J. R.; Russell, Thomas A.

doi:10.1111/j.1532-950x.2012.00963.x

Cited by 5 publications

(5 citation statements)

References 11 publications

(17 reference statements)

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“…It has been reported that sepsis of the LFTJ usually occurs as an extension of infection from the FPJ, as the two communicate in 1-17% of cases (Reeves, Trotter and Kainer, 1991;Vacek, Ford and Honnas, 1992;Hennessy et al , 2012). In this case series, only one of the three foals was presented with additional joints affected in the stifle (Foal 2), with the other two foals having only LFTJ involvement.…”

Section: Discussionmentioning

confidence: 68%

“…The stifle is a commonly-reported site for sepsis in foals (Wrightet al , 2017;O'Brien et al , 2021). Compared to other stifle compartments, sepsis of the lateral femorotibial joint (LFTJ) is relatively rare (Reeves, Trotter and Kainer, 1991;Vacek, Ford and Honnas, 1992;Hennessy et al , 2012). It has been estimated that up to 1% of all foals, and 13% of those in neonatal intensive care, are affected by septic arthritis and osteomyelitis (McIlwraith, 1983;Martens, Auer and Carter, 1986;Richardson DW and Stewart S, no date).…”

Section: Introductionmentioning

confidence: 99%

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Meniscal Disruption Associated with Septic Arthritis in 3 Neonatal Foals

Johnson

Pompermayer

Oikawa

et al. 2023

Preprint

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Objective: To report clinical characteristics, surgical management, and medium-term outcomes of 3 Arabian neonatal foals with meniscal disruption associated with septic arthritis of the lateral femorotibial joint. Methods: Three neonatal Arabian foals with septic arthritis of the lateral femorotibial joint (LFTJ), were diagnosed with lateral meniscal (LM) tears, based on persistent lameness despite improving synovial parameters, ultrasound (US) findings (protrusion of meniscal tissue beyond the level of the condyles, with hypoechoic regions), contrast Computed Tomography findings, and confirmed on arthroscopy. Treatment included arthroscopic debridement and lavage of the joint with debridement of the meniscal tear. Postoperative care included systemic and intra-articular antimicrobials, based on culture and sensitivity results. Two of the foals received intra-articular injections of autologous mesenchymal stem cells. Results: Grade III meniscal tears were observed in the LFTJ of the affected joints of all foals, involving the meniscal body (n=3) and caudal horn (n=1). Purulent material within the torn tissue, was debrided with a synovial resector. Foal 1 was lame-free as a yearling. Foal 2 was lame at walk at 7.5 months and euthanatized due to poor prognosis. Foal 3 showed mild lameness at trot in a straight line at 6 months. Disruption of the LM continued to be visible on US in both foals at these time-points. Conclusion: Meniscal disruption and infection should be considered a differential in neonatal foals with persistent femorotibial septic arthritis. In such cases, the LM could be the primary nidus of infection.

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Section: Discussionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Meniscal Disruption Associated with Septic Arthritis in 3 Neonatal Foals

Johnson

Pompermayer

Oikawa

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…It has been reported that sepsis of the LFTJ usually occurs as an extension of infection from the FPJ, as the two communicate in 1%–17% of cases (Hennessy et al., 2012; Reeves et al., 1991; Vacek et al., 1992). In this case series, only one of the three foals was presented with additional joints affected in the stifle (Foal 2), with the other two foals having only LFTJ involvement.…”

Section: Discussionmentioning

confidence: 99%

“…The stifle is a commonly reported site for sepsis in foals (O'Brien et al., 2021; Wright et al., 2017). Compared to other stifle compartments, sepsis of the lateral femorotibial joint (LFTJ) is relatively rare (Hennessy et al., 2012; Reeves et al., 1991; Vacek et al., 1992). It has been estimated that up to 1% of all foals, and 13% of those in neonatal intensive care are affected by septic arthritis and osteomyelitis (Martens et al., 1986; McIlwraith, 1983; Richardson & Stewart, 2019).…”

Section: Introductionmentioning

confidence: 99%

Meniscal disruption associated with septic arthritis in three neonatal foals

Johnson,

Pompermayer,

Oikawa

et al. 2023

Equine Veterinary Education

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SummaryThe objective of this study was to report clinical characteristics, surgical management and medium‐term (6–12 months) outcomes of three Arabian neonatal foals with meniscal disruption associated with septic arthritis of the lateral femorotibial joint. The three neonatal Arabian foals with septic arthritis of the lateral femorotibial joint (LFTJ), were diagnosed with disruption of the lateral meniscal (LM). Suspicion of meniscal pathology was based on ultrasonography, computed tomography (in 2 foals) and confirmed during arthroscopy. Treatment included arthroscopic debridement and lavage of the joint with debridement of the meniscal disruption. Postoperative care included systemic and intra‐articular antimicrobials, based on culture and sensitivity results. Two of the foals received intra‐articular injections of autologous mesenchymal stem cells. Marked LM disruption was observed in the LFTJ of the affected joints of all foals, involving the meniscal body (n = 3) and caudal horn (n = 1). Purulent material within the torn tissue was debrided with a synovial resector. Foal 1 was lame‐free as a yearling. Foal 2 was lame at walk at 7.5 months and euthanised due to poor prognosis. Foal 3 showed mild lameness at trot in a straight line at 6 months. Disruption of the LM continued to be visible on US in both foals at these timepoints. It was concluded that meniscal disruption and infection should be considered as a differential in neonatal foals with persistent femorotibial septic arthritis. In such cases, the LM could be the primary nidus of infection.

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“…For several decades, diagnostic arthroscopy had been reported as the ‘gold standard’ for diagnosing stifle disorders (Adrian et al ). Although different dorsal (Moustafa et al ; Boening ; McNally et al ; Hennessy et al ) and caudal approaches (Watts and Nixon ) and techniques under sedation (Frisbie et al ) have been described, great portions of the stifle still remain technically inaccessible due to anatomic limitations (Adrian et al ). Recently, a combination of ultrasonography and arthroscopy was suggested to overcome these boundaries and to best evaluate stifle pathology (Barrett et al ; Adrian et al ).…”

Section: Discussionmentioning

confidence: 99%

Magnetic resonance imaging of equine stifles: Technique and observations in 76 clinical cases

Waselau¹,

McKnight

Kasparek³

2020

Equine Veterinary Education

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Magnetic resonance imaging (MRI) of equine stifle disorders is challenging. We describe a routine technique for low-field stifle MRI under general anaesthesia in clinical cases and report the main findings. We hypothesised that MRI can be safely and routinely performed and portray bone and softtissue pathology. In this retrospective study, medical records of 76 stifles with positive response to intra-articular anaesthesia without abnormalities on conventional diagnostic imaging were reviewed for breed, age, gender, MRI anaesthesia time and findings. Under anaesthesia, limbs were extended in a rotating MR gantry. Different sequences in several planes were acquired in an average time of 62 min. In all horses, the stifle examinations were successful and complete. Typical MRI lesions included bone marrow lesions, osseous cyst-like lesions, cruciate desmopathy, meniscal tearing or a combination thereof. Retrospective reviewing confirmed that initial radiographic and ultrasonographic images failed to identify these lesions. Surgically accessible lesions were confirmed in arthroscopy if exploration was indicated. However, MRI was useful to estimate extent of cruciate and meniscal pathology as well as bone marrow lesions and bone cystic-like lesions more thoroughly. Our protocol allows for routine stifle MRI, independent of breed, age and gender. Based on our preliminary results, low-field stifle MRI is safe and can delineate bone and soft-tissue pathology. Low-field MRI appears to be a promising approach for better understanding stifle pathology and thus treatment and prognosis.

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Arthroscopic Approach to the Subextensorius Recess of the Lateral Femorotibial Joint of the Foal

Abstract: The subextensorius recess may be safely accessed arthroscopically in foals.

Cited by 5 publications

References 11 publications

Meniscal Disruption Associated with Septic Arthritis in 3 Neonatal Foals

Meniscal Disruption Associated with Septic Arthritis in 3 Neonatal Foals

Meniscal disruption associated with septic arthritis in three neonatal foals

Magnetic resonance imaging of equine stifles: Technique and observations in 76 clinical cases

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