TDK conference 2024

Nowadays, the majority of musckoloskeletal problems affecting high-performance sport horses manifest in the form of joint damage, and the resulting lameness and diminished athletic function are the leading complaint for veterinary referral. The tarsocrural joint is particularly highly predisposed to the development of various abnormalities affecting the articular surface, and osteochondral fragments are also very common in this area.

Arthroscopy is one of the most commonly used tools for the diagnosis and treatment of pathological changes in the joints, allowing the identification of intra-articular bony and soft tissue structures that cannot be adequatly visualised by X-ray or ultrasound. However, as with all diagnostic imaging modalities, it has limitations.

The main aim of our research was to compare arthroscopic findings with macroscopically identified cartilage lesions during pathological examination and to assess the sensitivity and possible limitations of arthroscopy in the detection of articular surface damage, with particular emphasis to plantar pouch, for which limited information is available in the literature to date.

Arthroscopic and pathological examinitation was performed on a total of 20 cadaver hind limbs. During the arthroscopic examinitation, the tarsocrural joint was first imaged dosromedially and then dorsolaterally, finally plantarolaterally. This work was followed by macroscopical examination after dissection and opening the joint. Findings were described and photographed.

In the dorsal pouch, arthroscopic lesions were found in 16/20 cases (80%) on the DIRT and medial trochlea, and in 15/20 cases (75%) on the medial malleolus. Pathological examination revealed lesions on the DIRT in 17/20 cases (85%), on the medial trochlea in 19/20 cases (95%) and on the medial malleolus in 18/20 cases (90%). For dorsal pouch, the sensitivity of arthroscopy was found to be 80%. In the plantar pouch, a total of 9 lesions were found in 6 limbs by arthroscopy, while 16 lesions were found in 11 limbs by macroscopic examination. For plantar pouch, the sensitivity of arthroscopy was 56% according to our results. In total, 54/75 lesions (75%) were classified as first grade and 21/75 lesions (25%) as second grade lesions by arthroscopy, while macroscopically 51/99 lesions (52%) were classified as first grade, 38/99 lesions (38%) as second grade and 10/99 lesions (10%) as third grade lesions.

The results of this study will help in the proper diagnosis of tarsocrural joint lesions, accouting the limitations of arthroscopy, and will serve as a reference for the routine examination of plantar pouch.