Surgical treatment of synovial sepsis: Is endoscopy the best approach?

Abstract

Treatment of synovial sepsis (septic arthritis, bursitis and tenosynovitis) typically involves surgical lavage of the infected synovial cavity(ies). The two most used techniques are through-and-through needle lavage and endoscopic lavage. Endoscopic lavage is considered to have several advantages, and anecdotally, there appears to be a general shift towards favouring this technique. However, there are only a limited number of published studies directly comparing the outcomes of the two treatment techniques. The available published literature suggests that the outcomes (short-term survival, return to work) are comparable. Further studies are required to expand the available veterinary literature and to assess such factors as the costs associated with the different treatment methods. A variation in diagnostic values used for diagnosing synovial sepsis is apparent in the current literature and further clarification of inclusion/diagnostic criteria would be useful for clinicians.

Visualizing neutrophil extracellular traps in septic equine synovial and peritoneal fluid samples using immunofluorescence microscopy

“…Synovial cell counts and TP concentrations in septic samples can be highly variable. 23 In addition, the horse had commenced antibiotic treatment prior to sampling, and this may have affected results.…”