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Arthroscopy is a surgical procedure performed on your horse with an arthroscope, which is a special type of endoscope that can be inserted into small areas such as a joint or the bursa of a joint. The arthroscope contains a tiny camera that provides a view of the interior of the bursa allowing for surgical procedures to be completed through a keyhole incision.
The bursa is a fluid-filled sac that counteracts friction at a joint. If injured or infected, the bursa can swell with fluid or burst and may require surgical treatment. Arthroscopy of the bursa in horses is commonly referred to as bursoscopy and is used to treat infection or contamination of the synovial fluid in the bursa. Arthroscopy, when performed on the bursa, allows for the removal of foreign bodies or contaminated tissue and excess fluid without making a large incision, as the arthroscope can be inserted into small incision and provides a visual of the bursa sac, which then allows an experienced surgeon to insert small surgical tools to remove or drain contaminated tissue and fluid. A veterinarian with special training and equipment is required to perform this procedure.
Where bursoscopy is required to treat infected bursa sacs, antibiotics will be started intravenously as soon as possible. Arthroscopy is usually performed under general anesthesia, although local anaesthetic and sedation may be used in some cases. Radiographs such as MRI and ultrasound may be used before surgery to provide guidance. Your horse will be administered intravenous general anesthetic and may have anesthesia maintained by gas.
Under anesthesia, they will be put in the dorsal recumbent position or may be in a standing position under local anaesthetic, although this is less common. If general anesthetic is being used, which is much more common, your horse's vital signs will need to be closely monitored during the procedure.
The area where the incision is to be made will be shaved and prepared antiseptically and drapes used to isolate the area and maintain a sterile site. An incision is made to allow insertion of the arthroscope and hand instruments that will be used to drain excess fluid or repair bursa tissues are also inserted via a small incision. The arthroscope is used to access and visualize joint structures; a light will also be required to allow the camera to provide images of the bursa. A video screen may be used so the arthroscope projects images onto a video screen for viewing during the surgery. Images are used for diagnosis of joint disorder and surgical instruments inserted in the incision are used to remove foreign objects or infected tissues and to drain excess infected fluids. If lesions are present, removal of diseased tissue and repair is conducted as required. The bursa is flushed with sterile solution and incisions are sutured. The procedure may take approximately 90 minutes.
The effectiveness of this procedure is very good with minimal invasiveness. Most horses affected return to soundness and are free from discomfort and pain. This procedure has replaced the “street nail” procedure previously used by veterinarians to access navicular bursa through the sole of the foot, or open surgery of bursa sacs, due to its minimal invasiveness and complications and its good prognosis.
If infection of bursa fluid is being treated, antibiotics may continue post surgery. Because the incisions for arthroscopy are small, they usually do not experience complications such as infection or rupture, however, incisions should be monitored post-surgery for complications. Your horse will need to be put on rest post surgery, but return to activity will be significantly quicker than with traditional open surgery. Recovery time is usually of short duration although this will depend on the medical condition that was present in the joint. Phenylbutazone may be administered if discomfort is present in your horse.
Because specialized training and equipment is required for this procedure and it is usually performed under general anesthetic, the cost of arthroscopy of the bursa may range from $1,000 to $5,000 depending on the cost of living in your area, anesthetic requirements, and the location of the procedure.
Because specialized training and equipment is required for this procedure and it is usually performed under general anesthetic, the cost of arthroscopy of the bursa may range from $1,000 to $5,000 depending on the cost of living in your area, anesthetic requirements, and the location of procedure.
Arthroscopy requires specialized training and equipment. It is associated with much fewer complications than traditional surgery and prognosis is good. If general anesthesia is required, complications related to anesthetic administration and recovery are present. Treatment for lesions may not result in full recovery but should return your horse to basic soundness and relieve their discomfort.
Trauma is often the result of infected bursa at your horse's joints, especially puncture into the navicular bursa. Ensuring your horse has a turn out, performance space, and housing free from hazards that would cause puncture to the navicular bursa will greatly reduce the chance of this condition developing. Repetitive injury or strain can also cause problems with bursa of the joints. If injury or strain to your horses bursa occurs precaution to prevent re injury or strain, and ensuring adequate healing time before participating in activities that would stress joints and the cushioning bursa is necessary.
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