Incidence and risk factors of surgical site infection and septic arthritis after elective arthroscopy in horses.
Authors: Brunsting Julie Y, Pille Frederik J, Oosterlinck Maarten, Haspeslagh Maarten, Wilderjans Hans C
Journal: Veterinary surgery : VS
Summary
# Surgical Site Infection and Septic Arthritis Following Elective Arthroscopy in Horses Between 2006 and 2013, researchers retrospectively analysed 1,079 horses (1,741 joints) undergoing elective arthroscopy, recording patient demographics, surgical variables, lesion characteristics, and postoperative complications to identify infection risk factors using multivariate logistic regression. Surgical site infection (SSI) occurred in 0.75% of joints overall, though distribution varied by location—femoropatellar joints were most susceptible at 1.67%, compared to 0.14% in fetlock joints—whilst septic arthritis developed in 13 joints (0.75%), again predominantly affecting the femoropatellar joint (2.23%). Lesion size emerged as the most clinically significant predictor: horses treated for large osteochondral fragments or subchondral lesions (>40 mm) had substantially higher SSI rates than those with medium (20–40 mm) or small (<20 mm) lesions (P=0.005 and P<0.001 respectively), and critically, SSI substantially increased the risk of subsequent septic arthritis (P<0.001). Younger horses faced increased septic arthritis risk despite age having no protective effect against SSI itself, suggesting age influences the inflammatory response to infection rather than infection prevention. For practitioners, these findings highlight that femoropatellar arthroscopy in younger horses with extensive lesions warrants heightened infection vigilance, and that SSI development—even apparently mild—demands aggressive intervention to prevent joint involvement.
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Practical Takeaways
- •Femoropatellar arthroscopy carries the highest infection risk (~1.67% SSI, 2.23% septic arthritis); extra vigilance with asepsis and perioperative antimicrobials is warranted for this joint
- •Horses undergoing arthroscopy for large lesions (>40 mm) need enhanced infection prevention protocols and close post-operative monitoring, as SSI risk increases substantially
- •Younger horses developing SSI after arthroscopy are at heightened risk of progressing to septic arthritis and warrant aggressive early intervention if infection signs emerge
Key Findings
- •SSI occurred in 0.14% of fetlock joints, 0.19% of tibiotarsal joints, and 1.67% of femoropatellar joints after elective arthroscopy
- •Septic arthritis developed in 0.75% of joints overall (1.67% in femoropatellar joints), with SSI being a significant risk factor (P<0.001)
- •Large osteochondral lesions (>40 mm) carried significantly higher SSI risk compared to medium (20-40 mm, P=0.005) and small (<20 mm, P<0.001) lesions
- •Younger age was associated with higher septic arthritis rates (P=0.028), while age did not affect SSI incidence