Arthroscopic surgical approach and intra-articular anatomy of the equine suprapatellar pouch.
Authors: Vinardell Tatiana, David Florent, Morisset Sophie
Journal: Veterinary surgery : VS
Summary
# Arthroscopic Access to the Suprapatellar Pouch: Expanding the Surgical Toolkit for Femoropatellar Joint Disease Understanding the anatomy and surgical approach to the suprapatellar pouch (SPP) represents a significant advancement for managing femoropatellar joint pathology, yet the anatomical detail and practical application of this region has been poorly documented in equine surgery. Vinardell and colleagues combined cadaveric dissection and latex injection studies with clinical case review to establish a standardised arthroscopic portal to the SPP, locating the optimal entry point approximately 10 cm lateral to the patellar midline and 2 cm proximal to the patellar base within the intermuscular septum between the biceps femoris and vastus lateralis muscles. Using this approach on 20 cadaveric specimens, they successfully visualised the proximal femoral trochlear ridges, intertrochlear groove, patellar base and synovial recesses—structures often obscured by traditional distal arthroscopic approaches—and demonstrated clinical utility in five horses undergoing debridement for osteochondritis dissecans and septic arthritis. The technique proved particularly valuable for removing debris, fibrin and loose fragments from the proximal joint pouch and accessing OCD lesions with proximal extension. Practitioners managing chronic femoropatellar joint disease, particularly cases with suspected proximal pathology or significant synovial inflammation, now have a safe complementary approach that substantially improves visualisation and surgical access beyond what traditional distal portals provide.
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Practical Takeaways
- •Suprapatellar arthroscopy is a valuable complementary technique to standard femoropatellar arthroscopy for accessing proximal joint structures and removing debris/fibrin from the suprapatellar pouch
- •This approach is particularly useful for OCD lesions that extend proximally and fractures involving the proximal patella where distal-only access is inadequate
- •Safe surgical technique with established anatomical landmarks can improve surgical outcomes for proximal femoropatellar pathology
Key Findings
- •Optimal suprapatellar pouch arthroscopic portal located approximately 10 cm lateral to patellar axis and 2 cm proximal to patellar base
- •Suprapatellar approach successfully visualized proximal femoral trochlear ridges, intertrochlear groove, and patellar base structures
- •Suprapatellar portals used in 5 of 25 horses with femoropatellar joint arthroscopy to complete lavage and debridement for OCD and septic arthritis