Joint Lavage in Dogs

Joint lavage involves draining and flushing an inflamed, infected, or injured joint. It is often performed during joint surgery, prior to wound closure, to flush bacteria from the joint. There are three types of joint lavage: arthrocentesis, arthroscopic lavage, and arthrotomy. Arthrocentesis involves inserting a needle into the affected joint and flushing it with a sterile solution. Arthroscopic lavage uses an arthroscope – a specialized endoscope used to guide joint surgeries – to visualize and flush the joint. Arthrotomy is the most invasive joint lavage technique. The injured joint is incised to allow for lavage. An irrigation catheter may be required to flush larger joints. The flushed joint fluid may be analyzed cytologically after surgery.

Arthrocentesis

1. X-rays are taken to assess the nature of the condition.
2. A short-acting sedative is administered.
3. The surgeon will clip and clean the skin near the affected joint.
4. The joint is then palpated.
5. A needle attached to an empty syringe is inserted into the affected joint. This is used to collect a sample of joint fluid, which is the primary objective or arthrocentesis.
6. Another needle, attached to a syringe filled with a sterile solution, is inserted to flush the joint until the fluid is clear.
7. The sample of joint fluid is transferred to a slide and examined under a microscope.

Arthroscopy 

1. Step 1 from the arthrocentesis procedure is repeated.
2. General anesthesia is administered. The operative area is shaved, clipped, and cleaned.
3. The vet will make one to two small incisions into the skin near the joint.
4. The joint is then lavaged using a sterile solution.
5. An arthroscope is inserted into the joint to take images and/or guide surgery.
6. Necessary surgical procedures will be performed prior to incision closure.

Arthrotomy

1. Steps 1 and 2 from the arthroscopy procedure are repeated.
2. The skin, subcutaneous tissues, and joint capsule are incised.
3. A sample of the joint tissue is collected.
4. Necrotic and diseased tissues are removed prior to joint lavage.
5. An irrigation catheter may be placed for continuous flushing prior to incision closure.
6. The dog will be hospitalized for up to five days.

The efficacy of joint lavage will vary depending on the underlying condition and the technique used. Joint lavage is typically effective in removing bacteria from the joint spaces. However, additional treatment may be required to fully resolve the underlying condition. The less invasive techniques are typically the treatment of choice, except in cases of severe disease.

Dogs will usually not need to recover from arthrocentesis. Dogs undergoing arthroscopic surgery and arthrotomy will need more extensive postoperative care. A bandage or Elizabethan collar may be required to prevent irritation of the surgery until the sutures are removed, approximately two weeks after surgery. Dogs recovering from arthrotomy will not be allowed to exercise normally for up to three weeks after surgery. 

Analgesics, corticosteroids, and nutritional supplements may be prescribed postoperatively. Antibiotics will be prescribed for up to eight weeks after surgery. Physical therapy may also be required to restore normal function to the affected joint. Follow-up appointments will be scheduled to remove sutures and assess healing progress.

The cost of joint lavage will vary based on the technique used, as well as standards of living and additional treatment costs. The price of joint lavage – performed as part of arthrocentesis, arthroscopy, or arthrotomy – ranges from $300 to $4,000.

Joint lavage may be performed on its own for less severe cases. It is often performed as part of exploratory diagnostic surgeries as well as repair procedures. Because it simply involves flushing the joint spaces, there are no complications associated with joint lavage. Postoperative complications that arise are most likely associated with the surgical procedure performed. However, infection may recur after joint lavage.

Arthroscopy is a diagnostic as well as a treatment method. Joint lavage is performed as part of the procedure to clear bacteria from the joint spaces. 

Joint conditions are often associated with aging and genetics. Dogs should not participate in activities that can result in traumatic joint injury. Dogs diagnosed with congenital conditions should not be bred. If signs of joint pain, inflammation, and swelling recur, contact your veterinarian immediately.