Efficacy of needle and endoscopic lavage on the recuperation of microspheres from the adult equine metacarpo-/metatarsophalangeal joint and digital flexor tendon sheath.
Authors: Beggan Christopher P, Panizzi Luca, Oliver Laurinda J
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Beggan, Panizzi and Oliver investigated whether needle-through-and-through lavage (NTAT) could match endoscopic lavage (EL) for removing particulate contamination from equine fetlock joints and digital flexor tendon sheaths using an ex vivo cadaveric model with 15 μm microspheres as a proxy for foreign material. Both techniques recovered the majority of microspheres (79–83%) within the first 2 litres of the 5-litre lavage protocol; however, NTAT proved significantly more efficient in initial fluid recovery, retrieving approximately 100 000 more microspheres in the first litre from both locations compared to EL. Total recovery across the full lavage volume was equivalent between techniques and between anatomical sites (approximately 950 000–980 000 microspheres), suggesting that whilst NTAT mobilises contaminant more rapidly, both methods achieve comparable final clearance with adequate fluid volume. For practitioners managing acute synovial contamination when endoscopic facilities are unavailable or delayed, these findings support NTAT as a defensible interim option; however, the cadaveric model cannot assess efficacy against established bacterial biofilms or removal of fibrin and necrotic tissue, limiting extrapolation to clinical septic arthritis or tenosynovitis.
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Practical Takeaways
- •NTAT is a practical alternative to endoscopic lavage for initial synovial contamination management when endoscopy is unavailable or delayed
- •First liter of lavage fluid is most critical for contamination removal regardless of technique—expect 79-83% of particulate recovery by 2 liters
- •NTAT achieves similar total efficacy to endoscopy with 5 liters of saline, making it viable for field or immediate stabilization protocols
Key Findings
- •Needle-through-and-through lavage (NTAT) recovered significantly more microspheres than endoscopic lavage in the first liter from both fetlock joints (659,883 vs 567,601) and DFTS (644,341 vs 550,637)
- •Most microspheres (79-83%) were recovered in the first 2 liters using both techniques
- •Total microsphere recovery across 5 liters showed no significant difference between NTAT of fetlock joints and DFTS (981,600 vs 957,419)