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Controlling Effusion Following Arthroscopic Removal of Tarsocrural Joint OCDs
Dolan Jack Paraic - year 5
University of Veterinary Medicine Budapest, Department and Clinic of Equine Medicine
Supervisor: Dr. Gábor Bodó

Abstract:

Osteochondrosis (OC) is a general term used to describe an abnormality in the growth and maturation of joint cartilage. It is one of the most important and most common developmental orthopedic disorders affecting joints in horses. One of the most affected joints is the tarsocrural joint which has several predilection sites, the most common being the distal intermediate ridge of the tibia (DIRT), followed by the lateral trochlear ridge and the medial malleolus of the talus. Common signs of an osteochondritis dissecans (OCD) lesion in a tarsocrural joint include non-painful joint effusion without lameness. The typical radiograph series for diagnosing an OCD lesion of the tarsocrural joint include DPl, LM, DL-PlMO, DM-PlLO views. The best view for visualisation of DIRT lesions is a DM-PlLO oblique view.

33 horses over a period of one and a half years were presented to the clinic for tarsocrural joint OCD arthroscopy. From the 33 horses, 47 joints were affected, and 49 OCD lesions were diagnosed and treated. 43 distal intermediate ridge of the tibia lesions, 4 lateral trochlear ridge of the talus lesions and 2 medial malleoli of the talus lesions were diagnosed in horses varying in age from 10 months to 12 years. The study included 13 different breeds, with the Hungarian sport horse the most common. During the study we considered factors such as the age, sex, breed, site of lesion, comparison of preoperative and postoperative effusion. Any medications given to attempt to reduce the effusion post-operatively were also noted. Post operative rehab included box rest for 2 weeks until suture removal followed by hand-walking twice a day from week 2 till week 6-8 followed by a slow return to full work. During this period the referring vet was asked to administer IV hyaluronic acid and IA triamcinolone acetate to help reduce remaining effusion if the owner could afford it. A telephone questionnaire with the owner or referring vet was used to evaluate postoperative status of the patients.

Of the 33 operated horses 26 (79%) have returned to full work. 24 (73%) received post operative treatment in the form of iv hyaluronic acid and 22 of which also received intra-articular triamcinolone acetate in addition to the hyaluronic acid. Fifteen (45%) of the patients had no effusion post-surgery, 13 (39%) reported lower levels of effusion postoperatively, 4 (12%) still had the same level of effusion as before surgery, and 1 horse was reported to have an increased level of effusion than before surgery.

In summary we can conclude that tarsocrural joint arthroscopy had a positive impact on postoperative effusion as well as for continuing performance.



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