Arthroscopically accessible anatomy of the tarsal collateral ligaments in the horse.
Authors: Kümmerle Jan M, Kummer Martin R
Journal: Veterinary surgery : VS
Summary
# Arthroscopic Access to Equine Tarsal Collateral Ligaments: What You Can Actually Visualise Understanding the spatial anatomy of tarsal collateral ligaments (CLs) is essential for arthroscopic diagnosis and treatment of hock pathology, yet their precise arthroscopic accessibility had not been systematically mapped. Kümmerle and Kummer examined 24 cadaveric equine hind limbs without pre-existing tarsal disease, creating silicone models of the tarsocrural joint and using a combination of arthroscopic exploration and careful dissection to identify which ligament structures could be accessed through standard portal positions. The medial structures proved variably accessible: the long medial CL was visualised in 14 of 20 limbs via the plantaromedial pouch, whilst the deep short medial CL was consistently reachable (20/20) only through the dorsomedial recess; conversely, lateral structures were reliably accessible, with both the deep short lateral CL and long lateral CL reached in all 20 limbs from the plantarolateral pouch. For practitioners performing arthroscopic hock surgery, these findings highlight that comprehensive assessment of collateral ligament integrity requires multiple portal approaches—relying on a single approach risks missing significant pathology, particularly in medial structures where accessibility is unpredictable across individuals. The variable anatomy underscores why negative arthroscopic findings shouldn't exclude collateral ligament disease as a diagnosis, and why complementary imaging modalities remain valuable in equine hock lameness investigation.
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Practical Takeaways
- •Choice of arthroscopic portal determines which tarsal collateral ligament structures can be accessed for diagnosis and treatment—select portals based on which ligament is suspected of being damaged
- •The deep short lateral collateral ligament is consistently reachable via plantarolateral portal, making this the preferred approach for assessing lateral collateral injuries
- •Medial collateral ligament injuries may require multiple portals (plantaromedial and dorsomedial) to fully visualize and treat all affected structures
Key Findings
- •Plantaromedial arthroscopic approach allows access to long medial collateral ligament (14/20 limbs) and variable portions of short medial collateral ligaments
- •Plantarolateral approach provides consistent access to both deep short lateral and long lateral collateral ligaments (20/20 limbs)
- •Dorsomedial approach reliably accesses deep short medial collateral ligament (20/20 limbs)
- •Dorsolateral approach permits visualization of superficial and/or middle short lateral collateral ligaments (9-10/20 limbs)