Effect of arthroscopic lavage and repeated intra-articular administrations of antibiotic in adult horses and foals with septic arthritis.
Authors: Cousty Matthieu, David Stack John, Tricaud Cyril, David Florent
Journal: Veterinary surgery : VS
Summary
# Editorial Summary: Arthroscopic Management of Equine Septic Arthritis Septic arthritis remains a serious condition in horses and foals, yet optimal monitoring strategies during treatment remain poorly defined. This retrospective analysis of 62 cases examined how synovial fluid parameters changed following arthroscopic lavage combined with repeated intra-articular antibiotic injections, tracking nucleated cell counts, neutrophil percentages, and total protein levels across the treatment course. Both cell counts and protein concentrations decreased significantly from baseline and continued to improve throughout treatment; however, the relationship between these improvements and clinical outcome was inconsistent—whilst nucleated cell counts at days 10–14 did correlate with favourable prognosis, neutrophil percentages and total protein showed little predictive value. These findings suggest that whilst arthroscopic lavage with serial intra-articular antibiotics reduces synovial inflammation markers, clinicians should not rely on individual synovial parameters as standalone indicators of treatment success, and clinical assessment combined with serial cytology trends likely provides more reliable prognostic information than single time-point measurements.
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Practical Takeaways
- •Arthroscopic lavage combined with repeated intra-articular antibiotics effectively reduces synovial inflammation markers in septic arthritis cases, supporting continued use of this treatment protocol.
- •Monitor synovial nucleated cell counts through mid-treatment (days 10-14) as a potential prognostic indicator, but do not rely on total protein or neutrophil percentages alone to predict clinical outcome.
- •Plan for serial synovial fluid sampling every 48 hours throughout hospitalization to track treatment response, as these parameters provide objective evidence of therapeutic effect.
Key Findings
- •Synovial nucleated cell counts decreased progressively after arthroscopic lavage and repeated intra-articular antibiotic administration, remaining lower than baseline at all measured timepoints.
- •Total protein content in synovial fluid decreased progressively and was significantly lower than baseline from day 2 through day 14 post-treatment.
- •Neutrophil percentages were lower than baseline only at days 8 and 10, suggesting limited utility as a monitoring parameter.
- •Nucleated cell count at days 10, 12, and 14 was lower in horses with favorable outcomes compared to unfavorable outcomes, but total protein content did not differentiate outcome groups at any timepoint.