Direct arthroscopic approach to the distal pouch of the palmar/plantar recess of the metacarpophalangeal/metatarsophalangeal joint in horses.

Abstract

OBJECTIVE: To describe a direct arthroscopic approach of the distal pouch of the palmar/plantar recess of the fetlock to facilitate fragment removal, highlighting its advantages over previously described arthroscopic methods for the fetlock. Additionally, to evaluate and present a retrospective case series. STUDY DESIGN: Ex vivo and retrospective clinical study. SAMPLE POPULATION: A total of 25 fetlocks in 23 horses. METHODS: A direct approach to the distal pouch of the palmar/plantar recess of the fetlock was developed on five cadaveric limbs. Arthroscopic anatomy and landmarks were examined. The approach was clinically used for fragment removal for 25 joints in 23 horses. An orthopedic examination was performed on all horses prior to surgery. Joints were evaluated for signs of joint disease related to the presence of fragments. RESULTS: Consistent arthroscopic evaluation of the distal pouch of the palmar/plantar recess of the fetlock was achieved. All fragments were free floating and successfully removed. Signs of inflammation were present in all joints, with varying degrees of cartilage damage observed in 18 out of the 25 operated fetlocks. CONCLUSION: This approach is safe and enables the removal of fragments when present. Horses will benefit from fragment removal within the distal pouch of the palmar/plantar recess of the fetlock. CLINICAL SIGNIFICANCE: A new, direct arthroscopic approach to the distal pouch of the palmar/plantar recess of the fetlock is described. The approach facilitates fragment removal and provides new insights into joint health.