General Technique and Diagnostic Arthroscopy

McIlwraith, C. Wayne

doi:10.1016/b978-0-7234-3693-5.00003-5

Cited by 8 publications

(5 citation statements)

References 70 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Fracture fragments were successfully removed in all 4 horses. Although an open technique through the carpal sheath has previously been described where the horse returned to work at 20 months post‐surgery, 5 minimally invasive techniques are now preferred as they allow for better visualization, reduced soft tissue trauma and a quicker return to exercise 17,18 . Access to ICB fragments with an arthroscopic approach to the palmaromedial antebrachiocarpal joint can be limited by the working space within this synovial joint, and the size and location of the fragments in the cases presented in this report may have precluded this approach for removal 1,4 .…”

Section: Discussionmentioning

confidence: 96%

“…Although an open technique through the carpal sheath has previously been described where the horse returned to work at 20 months post-surgery, 5 minimally invasive techniques are now preferred as they allow for better visualization, reduced soft tissue trauma and a quicker return to exercise. 17,18 Access to ICB fragments with an arthroscopic approach to the palmaromedial antebrachiocarpal joint can be limited by the working space within this synovial F I G U R E 5 Anatomy of the medial aspect of the carpal sheath simulating a patient in dorsal recumbency. The superficial neurovascular structures have been superimposed over the radius and carpal bones.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Arthroscopic removal of palmar intermediate carpal bone fracture fragments in four horses using a transthecal approach through the carpal flexor tendon sheath

Hewitt-Dedman

O'Neill²,

Bladon³

2022

Veterinary Surgery

View full text Add to dashboard Cite

Objective To describe the removal of palmar intermediate carpal bone (ICB) fracture fragments using a transthecal approach through the carpal flexor tendon sheath. Study design Case series. Animals Four horses with fractures of the palmar aspect of the ICB. Methods Two horses were injured when falling and two during recovery from general anesthesia. Three horses underwent MRI to supplement conventional imaging. Three horses had concurrent fractures of the radial and/or accessory carpal bones. Conventional proximolateral carpal sheath arthroscope and instrument portals were used, supplemented with a medial instrument portal through the carpal flexor retinaculum to access the palmar carpal ligament. Optimized dissection through the latter was facilitated by needle guidance and radiography. The fragment was dissected from the soft tissue attachments and the palmar ICB fragments retrieved through the carpal sheath in all horses. Surgery time was 85 to 142 min. Results Limitations of this technique include a long surgery time and the potential for hemorrhage to impair visibility during surgery. All four horses were discharged 3 to 8 days postoperatively. Three horses returned to full athletic work within 9 months postoperatively and one horse was euthanized due to persistent lameness. Conclusion A tenoscopic transthecal carpal flexor tendon sheath approach provides access for removal of palmar ICB fracture fragments but should be viewed as an advanced arthroscopic procedure. Clinical significance A transthecal approach through the carpal flexor tendon sheath offers an alternative technique for removal of palmar ICB fracture fragments.

show abstract

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 99%

Arthroscopic removal of palmar intermediate carpal bone fracture fragments in four horses using a transthecal approach through the carpal flexor tendon sheath

Hewitt-Dedman

O'Neill²,

Bladon³

2022

Veterinary Surgery

View full text Add to dashboard Cite

show abstract

“…[11][12][13] Briefly, high-frequency alternating electrical currents pass through electrodes resulting in either cutting or electrocoagulation of local tissue. 14,15 One of the main advantages of electrosurgery is hemostasis, 16 reducing of intraoperative hemorrhage events, improving visibility, and reducing operative time. [17][18][19][20] For example, superior hemostasis has been demonstrated when an electrosurgery probe rather than a conventional scalpel blade was used in an experimental surgical model of oral surgery in rodents.…”

Section: Introductionmentioning

confidence: 99%

Vascularity evaluation of the equine tarsocrural and proximal intertarsal joint septum, and comparative analysis of two arthroscopic transection techniques

Labordère,

Ruzickova,

Kamus

et al. 2024

Veterinary Surgery

View full text Add to dashboard Cite

ObjectiveTo evaluate vascularity of the synovial membrane covered septum (SMS) separating the tarsocrural (TC) and proximal intertarsal (PIT) joints (Part 1) and compare two methods of transection, electrosurgical or Ferris Smith rongeur (FS rongeur) (Part 2).Study designExperimental study.Sample populationPart 1, 10 SMS (n = 5 horses). Part 2, six horses (n = 12 tarsi).MethodsIn part 1, SMS harvested postmortem were each divided into eight regions of interest (ROIs), processed for histology, and immunostained with anti‐α‐actin antibody for blood vessel identification. Vascular density was calculated for each ROI. Data was compared within and between horses. In part 2, six horses underwent TC arthroscopy. Each limb was randomly assigned to undergo either electrosurgical or FS rongeur SMS transection. SMS transection and total operative time were recorded. Intraoperative hemorrhage was scored. Data was compared between both techniques.ResultsSignificant interindividual variations in SMS vascular density were detected (p = .02), but there were no differences among ROIs. No differences in the transection time were detected between electrosurgery (4.83 ± 0.54 min) and FS rongeur (4.33 ± 0.67 min). No differences were found in intraoperative hemorrhage scores between techniques.ConclusionVascularity within the SMS varies among horses but not within its regions. Electrosurgical or FS rongeur transection of the medial SMS during tarsocrural arthroscopy is a rapid technique and improves surgical access to the dorsal compartment of the PIT.

show abstract

“…Arthroscopic surgical procedures have been widely adopted for the treatment of many conditions in the equine patient including, removal of osteochondral fragments, removal of osteochondritis dissecans lesions, treatment of subchondral bone cysts, and lavage of septic joints. 15 In addition to treatment, arthroscopic procedures are also useful in diagnosis of disease, specifically regarding articular structures for which diagnostic imagining modalities are limited. Arthroscopic procedures in the horse are generally accepted to be a low risk procedure, and the principal risks are often associated with the need for general anesthesia.…”

Section: B Equine Arthroscopymentioning

confidence: 99%

“…When compared to arthrotomy, arthroscopy offers improved visualization of the joint and all its components, decreased post-operative complications, improved cosmetic outcomes, and more rapid return to function. 15 Arthroscopic procedures require a methodology to distend the joint for visualization of the joint surfaces. The most commonly used method for arthroscopic procedures is fluid irrigation, but there are reports of using gas insufflation.…”

Section: B Equine Arthroscopymentioning

confidence: 99%

Evaluation of a relatively hyperosmolar irrigation solution for use in equine femorotibial arthroscopy

Hayden¹

View full text Add to dashboard Cite

Hyperosmolar irrigation solutions have been shown to decrease fluid extravasation during arthroscopic procedures and safety has been demonstrated in canine and human studies. Prospective, blinded, randomized controlled trial was performed to compare lactated Ringer's solution (273 mOsm/L) and a hyperosmolar (600 mOsm/L) irrigation solution for an exploratory medial femorotibial joint arthroscopy. Primary outcomes focused on the amount of periarticular fluid retention based on change in stifle girth and ultrasonographic (US) measurements. The water content of the tissue samples was assessed, and viability of the cartilage tissue was determined. The objectives of this study were to determine: (1) whether an irrigation solution that is hyperosmolar relative to synovial fluid decreases tissue extravasation during an arthroscopic protocol when compared to a relatively hypoosmolar solution, (2) the safety of a hyperosmolar solution by assessing the viability of joint tissues after joint irrigation, (3) if the use of a hyperosmolar solution decreases water content in stifle tissue. There was not a significant difference in joint swelling between hyperosmolar (Hyper) and lactated Ringer's solution (LRS) treatment groups. Percent increments in femorotibial joint dimensions (mean [plus or minus] S.D.) were seen in both treatment groups based on US (LRS, 83.9 [plus or minus] 84.6 percent; HYPER, 131.2 [plus or minus] 144.9 percent) and caliper measurements (LRS 5.5 [plus or minus] 4.3 percent; HYPER 7.5 [plus or minus] 5.8 percent) (p[less than or equal to]0.05). Chondrocyte viability and tissue water content were well maintained in both treatment groups, and differences were not statistically significant. These findings suggest that approximately doubling the osmolarity of the standard irrigation solution used for arthroscopy did not result in detrimental effects on chondrocyte viability or tissue water content, it did not significantly reduce tissue swelling.

show abstract

General Technique and Diagnostic Arthroscopy

Cited by 8 publications

References 70 publications

Arthroscopic removal of palmar intermediate carpal bone fracture fragments in four horses using a transthecal approach through the carpal flexor tendon sheath

Arthroscopic removal of palmar intermediate carpal bone fracture fragments in four horses using a transthecal approach through the carpal flexor tendon sheath

Vascularity evaluation of the equine tarsocrural and proximal intertarsal joint septum, and comparative analysis of two arthroscopic transection techniques

Evaluation of a relatively hyperosmolar irrigation solution for use in equine femorotibial arthroscopy

Contact Info

Product

Resources

About