Key Hole Surgery For Horses – Arthroscopy
Lameness is not infrequently caused by damage to joints. This may be damage to the cartilage, which lines the joint, to the fibrous capsule that surrounds a joint (the synovium) or may include a chip fracture of the underlying bone. Which joint is damaged can be determined by clinical examination, regional nerve blocks (numbing the area responsible for the lameness), and then by intra articular nerve blocks (injection of local anaesthetic into the suspect joint) to make the horse sound. The next stage is usually radiography. Ultrasound is also useful to check for ligament or cartilage damage within a joint. Where lameness has been confirmed to emanate from a joint ‘key hole’ surgery – arthroscopy is frequently indicated. This is performed under general anaesthesia by our specialist surgeon Jonathan Withers.
.Strict hygiene (asepsis) is required during this kind of surgery. A small hole is made surgically into the joint (this is known as a portal). A small fibreoptic instrument (the arthroscope) is introduced through this portal, and a second portal created through which various instruments can be introduced. The inside of the joint is displayed on a large television set, so that the surgeon can manipulate the instruments within the joint to help repair the damaged area.
Arthroscopy can take up to an hour and a half, careful monitoring of the horse whilst it is anaesthetised is essential. Ian is checking the horses pulse in the illustration above. He also monitors the E.C.G. (a measure of electrical activity in the heart), the level of oxygen in the blood stream, and the average arterial blood pressure.