Arthroscopic removal of palmar/plantar osteochondral fragments from the proximal interphalangeal joint in four horses.
Authors: Radcliffe Rolfe M, Cheetham Jon, Bezuidenhout Abraham J, Ducharme Norm G, Nixon Alan J
Journal: Veterinary surgery : VS
Summary
# Editorial Summary Osteochondral fragments within the proximal interphalangeal joint present a challenging diagnostic and therapeutic problem, yet arthroscopic management of palmar/plantar lesions remains poorly described in the equine literature. This retrospective case series of four horses demonstrates that arthroscopic removal of such fragments via a palmar/plantar approach is technically feasible when performed under general anaesthesia with the horse in dorsal recumbency, providing a minimally invasive alternative to traditional open surgical methods. Notably, whilst all four horses had radiographic evidence of fragmentation, only two presented with lameness definitively localised to the PIP joint, highlighting the variable clinical significance of these lesions and the importance of thorough lameness examination before surgical intervention. Three of the four horses returned to their previous level of athletic performance post-operatively, with only one horse transitioning to lighter work, suggesting reasonable functional outcomes despite the inherent difficulty in fully assessing the joint through this approach. For practitioners managing chronic or intermittent pastern lameness unresponsive to conservative treatment, this technique warrants consideration as a diagnostic and therapeutic tool, particularly where radiographic evidence of palmar/plantar osteochondral disease correlates with clinical signs.
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Practical Takeaways
- •Arthroscopy can successfully remove palmar/plantar osteochondral fragments from the PIP joint and should be considered as a treatment option when lameness is localized to the pastern region
- •Most treated horses (3/4) returned to their previous athletic level, suggesting this surgical approach has reasonable functional outcomes
- •The palmar/plantar arthroscopic approach provides limited joint visualization, so imaging and clinical localization are critical before attempting this technique
Key Findings
- •Osteochondral fragments were successfully removed arthroscopically via palmar/plantar approach in all 4 horses
- •Three of four horses returned to previous levels of athletic performance; one horse was limited to trail riding instead of reining
- •Arthroscopic approach allowed limited but functional assessment of the PIP joint