High-Tech Fetlock Joint Fragment Removal

VIDEO | Joint chips plague many high-performance horses--up to 29% of Standardbred yearlings and 2% of Thoroughbred yearlings. Often the chips must be removed, usually with arthroscopic surgery, before the horse can return to full soundness. At the 2007 American Association of Equine Practitioners Convention, held Dec. 1-5 in Orlando, Fla., Alastair Kay, BVSc, MRCVS, a surgery resident at The Ohio State University Veterinary Teaching Hospital, representing Hagyard Equine Medical Institute in Lexington, Ky., described a high-tech method for removing chips from the rearward portion of the fetlock joint.

"Radiofrequency devices continue to be used extensively in human medicine for both intra-articular (within a joint) and extra-articular (outside the joint) procedures," he noted. The role of the bipolar radiofrequency device is to use high voltage to dissect away any soft tissue holding the fragments so they can be easily removed. The device has a ground electrode within the probe, so there is little risk of inadvertent tissue damage and no need for a grounding pad.

AAEP 2007: This video shows the radiofrequency device in use during surgery.

This video shows the radiofrequency device in use during surgery.
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For this study, 33 cases with axial (near centerline) fragments from the upper first phalanx bone were randomly selected from one year. Forty-one fragments were removed from 36 joints in the study horses, and these were primarily in the hind limbs. Treatment consisted of arthroscopic surgery, including use of the radiofrequency device. Once the fragment was visualized, the device's curved Coblation hook probe was used to release soft tissue holding the fragment. Once released, fragments were physically removed with a rongeur instrument before curetting (smoothing) the fragment bed, if required.

"This is a very targeted approach that causes minimal intra-articular bleeding, provides excellent visualization, minimizes the risk of iatrogenic (physician-caused) injury, reduces surgery time, and minimizes complications," Kay summarized. "This instrument has become an important accessory for intra-articular soft-tissue dissection in this referral center (Hagyard)."

About the Author

Christy M. West

Christy West has a BS in Equine Science from the University of Kentucky, and an MS in Agricultural Journalism from the University of Wisconsin-Madison.

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