Arthroscopy of the Dorsal and Plantar Pouches of the Tarsocrural Joint for the Treatment of Osteochondritis Dissecans in the Horse: Clinical Features and Follow-Up.
Authors: James Oliver, Payne Richard, Bathe Andrew, Greet Tim, Wylie Claire
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Tarsocrusal OCD—The Case for Thorough Joint Examination Osteochondritis dissecans in the tarsocrural joint remains a significant cause of lameness in performance horses, yet surgical management has traditionally focused on the dorsal pouch, potentially overlooking concurrent pathology. Oliver and colleagues reviewed 144 tarsocrural joints treated arthroscopically between 2005 and 2013, with particular attention to findings within both dorsal and plantar pouches; notably, one surgeon routinely examined both compartments in 70 cases, revealing cartilage wear lines in 45.7% of plantar pouches compared to 31.4% dorsal cartilage erosion, with fragments removed from 10% of plantar pouches that may have been missed radiographically. Of the plantar pouches displaying wear lines, 25.7% showed no corresponding dorsal pouch abnormalities, highlighting independent pathology within the plantar compartment. Return to intended use was achieved in 67% of the 102 horses with follow-up data, suggesting reasonable functional outcomes, though outcomes likely varied depending on examination thoroughness. Farriers and veterinarians should consider advocating for comprehensive arthroscopic assessment of both pouches during tarsocrural OCD surgery, as the plantar compartment frequently harbours pathology that routine radiography fails to detect—omitting this examination may compromise both immediate surgical management and long-term joint health.
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Practical Takeaways
- •Examine plantar pouches arthroscopically alongside dorsal pouches in tarsocrural OCD cases—fragments and cartilage damage may be missed on radiographs alone
- •Expect approximately two-thirds of surgically treated horses to return to their intended work, though plantar pouch involvement may indicate more extensive joint pathology
- •Plantar pouch wear lines can exist independently of dorsal pouch lesions, suggesting OCD may not be the only source of joint disease in these cases
Key Findings
- •Of 70 joints with both dorsal and plantar pouch examination, cartilage erosion/degeneration was found in 31.4% of dorsal pouches and cartilage wear lines in 45.7% of plantar pouches
- •Fragments were removed from 10.0% of plantar pouches at surgery, not identified by routine radiography
- •25.7% of plantar pouches with wear lines had no cartilage abnormalities in the dorsal pouch, indicating separate pathology
- •66.7% of 102 horses achieved their intended use post-operatively