Arthroscopic surgery – how does it work?

Arthroscopic surgery has revolutionised the treatment of joint problems, in man and horses alike. The technique is minimally invasive, causing the patient minimal discomfort. Only short periods of hospitalisation are required, and post-operative care regimes are straight forward.

How does it work?

Examination of the interior of the joint is performed with a 4mm rigid endoscope. The joint needs to be inflated with fluids to distend and push the soft tissues away from the cartilage surfaces, creating a space in which the scope can be moved around in to examine the internal structures. A light source is needed to illuminate the joint. To enable all of the above, a sleeve is first inserted into the joint, through which the scope is passed, and the light source and fluids can be attached to.

Modern equipment consists of high definition digital cameras, recording systems and viewing screens. In experienced hands, the technology enables the most detailed and comprehensive means by which the interior of a joint can be examined. In addition to extensive use in joints in the horse, the techniques have been transferred to tendon sheaths (tenoscopy) and bursae (bursoscopy) with great success for diagnosis and management of many common causes of lameness.

Once the joint has been evaluated, the surgeon then uses specialised instruments, inserted under direct visualisation into the joint through further short incisions, to treat injuries identified. This may consist of removal of chip fractures, debridement of damaged cartilage, tendons or ligaments, or even repair of injuries.

Arthroscopic surgery is technically demanding and requires a high level of visuomotor skills, training and practice.  The best arthroscopic surgeons in all species are those that do the most. The surgeons at NEH are at the forefront of the discipline, and the annual hospital log shows the numbers required to develop and maintain the necessary skills.

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