Successful treatment of a medial intercondylar eminence fracture in a stallion by arthroscopic removal

Abstract

Before surgery, an indwelling intravenous catheter was placed in the left jugular vein and the horse was given potassium penicillin (Penicillin Natrium; G. Streuli) at 30,000 U/ kg bodyweight, intravenously, every six hours and gentamicin (Vetagent; Veterinaria) at 6·6 mg/kg bodyweight, intravenously, every 24 hours. Phenylbutazone (Equipalazone Paste E-PP; Arnolds Veterinary Products) was given orally at a dose of 1 g, every 12 hours. The horse was sedated using romifidine (Sedivet; Boehringer Ingelheim) at 0·04 mg/kg bodyweight intravenously, and I-methadone (L-Polamivet; Veterinaria) at 0·05 mg/kg bodyweight intravenously. General anaesthesia was induced with intravenous guaifenesin (Myolaxin; Vétoquinol) using 15 g of a 7·5 per cent solution, plus ketamine hydrochloride (Narketan; Vétoquinol) at 1·4 mg/kg bodyweight and thiopental (Pentothal; Abbott) at 1·4 mg/ kg bodyweight.Following tracheal intubation, anaesthesia was maintained with isoflurane (Attane; Minrad) and double drip (ketamine hydrochloride, 6 per cent and guaifenesin, 15 per cent). The stallion was positioned in dorsal recumbency with the hindlimbs secured to an overhead crossbar and hoist. Following routine aseptic preparation of the surgical field, the left hindlimb was positioned with the stifle flexed approximately 60°.A cranial approach (Peroni and Stick 2002) to the stifle joints was used as follows: the medial compartment of the femorotibial joint was distended with 20 ml sterile polyionic fluids (Ringerlaktat-Lösung; Dr G. Bichsel), 10 ml lidocaine (Lidocain 2 per cent; G. Streuli) and 10 ml bupivacaine (Bupivacain; Sintetica) by means of an 18 G, 1·5 inch needle. A 1 cm skin incision and transection of the superficial and deep fascia were made 2 cm medial to the middle patellar ligament and 3 cm distal to the palpable distal end of the patella. Without previous joint distension an arthroscopic cannula containing a blunt trocar was introduced through the incision into the femoropatellar joint in a caudal and distal direction. The trocar was replaced by a 30° arthroscope (Karl Storz) and sterile polyionic fluids were infused into the femoropatellar joint through the cannula. A systematic examination of the femoropatellar joint was performed and revealed no abnormalities.The synovial membrane between the medial compartment of the femorotibial joint and the femoropatellar joint was identified. An instrument portal was developed into the femoropatellar joint lateral to the middle patellar ligament by using similar landmarks as described for the arthroscope portal. An arthroscopic hook scissor was placed in the femoropatellar joint through this second portal. The synovial membrane between the femoropatellar and medial femorotibial joints was incised and the arthroscope advanced into

Fracture of the medial intercondylar eminence of the tibia in horses treated by arthroscopic fragment removal (21 horses)

“…During the rehabilitation period, a horsewalker was used in 3 horses, and a treadmill was used in 3 horses. Post-operative intra-articular medication included triamcinolone (Cases 2, 6, 8, 13, 16), betamethasone (Cases 17, 18, 19), methylprednisolone (Case 9), hyaluronic acid (Cases 2, 5,9,13,16,17,18,19,20,21), IRAP (Cases 14, 20, 21) and bone derived mesenchymal stem cells (Case 14) at variable time periods after surgery. Polysulfated glycosaminoglycans and chondroitin sulfate were administered orally to horse 18.…”

“…Although internal fixation has been reported in one case [4], arthroscopic treatment is currently the treatment of choice for affected animals [7]. However, to the authors' knowledge, full description of clinical and diagnostic findings in affected animals and results of arthroscopic treatment are limited to single case reports [2,4,5,9]. The objective of this study was to report the clinical and diagnostic findings, surgical treatment and outcome in a series of horses presented with MICET fracture.…”