An Alternative, Direct Approach for Arthroscopic Removal of Osteochondral Fragments in the Dorsal Pouch of the Proximal Intertarsal Joint of Horses.

Summary

# Editorial Summary Osteochondral fragments within the proximal intertarsal joint present a surgical challenge due to difficult access, yet removal is essential for returning horses to athletic function. Compagnie and colleagues described an arthroscopic technique using dorsal recumbency and standard tarsocrural joint portals, with a novel third portal created directly into the proximal intertarsal joint under visualisation, avoiding the need to resect the communicating membrane between joints. Across 11 horses with Category 1 fragments, all fragments were successfully removed with no perioperative complications, and long-term follow-up of 9 cases showed 78% returning to their intended use (4 riding horses and 3 of 5 racehorses, with 2 cases failing to progress for unrelated reasons). This direct portal technique offers equine surgeons a viable alternative that preserves anatomical integrity whilst achieving complete fragment removal and good functional outcomes. For practitioners managing horses with intra-articular tarsal pathology, this approach expands the technical toolkit and may improve prognosis when osteochondral fragmentation is identified at this challenging site.

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Key Findings

• •Direct arthroscopic approach to proximal intertarsal joint successfully removed osteochondral fragments in all 11 cases without complications
• •Technique avoids resection of the membrane between tarsocrural and proximal intertarsal joints
• •7 of 9 horses with long-term follow-up (78%) returned to intended athletic use including racehorses and riding horses

Conditions Studied