Arthroscopy for Meniscal Tears

A meniscus is an interarticular (between joints) synovial cartilage or membrane. Meniscal tears in the stifle joint are well described in human athletes and dogs. Despite a few published reports in horses, however, the condition remains difficult to diagnose and even more difficult to treat because of a paucity of information regarding arthroscopic findings and prognosis. In an effort to better describe clinical, radiographic, and arthroscopic findings of meniscal injuries in horses as well as the efficacy of treatment, surgeons at the Liphook Equine Hospital in Hampshire, United Kingdom, conducted a study to document their clinical experiences diagnosing and treating meniscal injuries in horses using arthroscopy.

The inclusion criteria for the study included a lameness localized to the stifle joint, identification of an abnormality in one or both menisci using arthroscopy, and a final decision by the surgeon that the meniscal injury was the primary injury in the stifle. A total of 80 meniscal injuries were ultimately diagnosed and treated.

"There are two main difficulties with menisci," says Tim Phillips, BVetMed, CertEP, CertEO, DESTS, Dipl. ECVS, MRCVS. "First, damage to them is hard to diagnose prior to surgery, and second, they are difficult to access during surgery. Only the cranial and caudal poles (front and back ends) are accessible." Arthroscopic findings at surgery were graded by severity. Grade 1 meniscal tears (least severe) were left untreated, while grade 2 (moderately severe) and grade 3 (most severe) tears were treated by removing any loose tissue. Horses were then stabled for six weeks. After re-evaluation, horses were corralled for six months before returning to work.

A successful outcome was defined as returning to previous work and remaining sound. Forty-seven percent of horses had a successful outcome. "Horses with simple tears confined to the front of the joint have a good chance for recovery," says Phillips. "Horses with tears that extend out of view during surgery, however, and with tears associated with osteoarthritis, are more likely to stay lame."

In other areas, Phillips and his colleagues are currently investigating an anastomosis technique (rejoining the ends of resected intestine) for surgery of the small intestine. The Liphook Equine Hospital website provides a profile of the staff veterinarians and their facility at www.liphookequinehosp.co.uk.

Walmsley, J.P.; Phillips, T.J.; Townsend, H.G.G. Equine Veterinary Journal, 35 (4), 402-406, 2003.

About the Author

Susan Piscopo, DVM, PhD

Susan Piscopo, DVM, PhD, is a free-lance writer in the biomedical sciences. She practiced veterinary medicine in North Carolina before accepting a fellowship to pursue a PhD in physiology at North Carolina State University. She lives in northern New Jersey with her husband and two sons.

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