Needle arthroscopy of the radiocarpal and middle carpal joints in standing sedated horses.
Authors: Kadic Dimitri T N, Miagkoff Ludovic, Bonilla Alvaro G
Journal: Veterinary surgery : VS
Summary
Diagnostic arthroscopy of the equine carpus traditionally requires general anaesthesia, which carries inherent risks and expense; Kadic and colleagues developed a standing needle arthroscopy technique using sedation and a custom-made splint to evaluate the radiocarpal and middle carpal joints in six cadaveric limbs followed by six live horses. In the cadaveric phase, thorough visualisation of both dorsal and palmar recesses was achieved using conventional arthroscopic portals, though the live horse phase revealed practical limitations, with successful radiocarpal assessment in all six horses but only three of six middle carpal joints adequately evaluated due to limb movement during the procedure. Complications were minimal and largely manageable—mild to moderate movement, occasional iatrogenic cartilage trauma, and mild hemarthrosis—and all horses tolerated the procedure well without requiring general anaesthesia. The technique represents a valuable diagnostic option for detecting intra-articular carpal pathology that may not be apparent radiographically, offering a lower-risk entry point to joint investigation before committing to general anaesthesia; however, practitioners should recognise the movement-related limitations and consider limiting each procedure to a single joint to maximise diagnostic success and minimise iatrogenic damage. This advance expands the diagnostic toolkit for subtle carpal injuries in working horses and may facilitate earlier clinical decision-making in lameness investigations.
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Practical Takeaways
- •Consider standing needle arthroscopy as a cost-effective first diagnostic step for suspected carpal lesions that don't show on radiographs, avoiding general anesthesia in many cases
- •Limit procedures to single joint evaluation to minimize complications from limb movement during the procedure
- •Expect good visualization of dorsal carpal structures; palmar recesses may require general anesthesia if critical to diagnosis
Key Findings
- •Standing needle arthroscopy successfully visualized dorsal and palmar recesses of radiocarpal and middle carpal joints in cadaveric limbs (phase 1)
- •In live horses (phase 2), thorough dorsal joint evaluation was achieved in all 6 radiocarpal joints but only 3 of 6 middle carpal joints due to limb movement
- •Procedure was quick, well-tolerated under sedation with mild complications including movement, minor cartilage trauma, and mild hemarthrosis
- •Standing needle arthroscopy offers a lower-cost, lower-risk alternative to general anesthesia for diagnosing radiographically occult carpal lesions