Arthroscopic Lavage and Implantation of Gentamicin-impregnated Collagen Sponges for Treatment of Chronic Septic Arthritis in Cattle

Arthroscopic approaches to and anatomy of the shoulder joint of cattle: a cadaver study

Background

Arthroscopic surgery is described as a minimally invasive technique for diagnosis, exploration and treatment of joint disorders. It allows intraarticular structures to be assessed accurately, thereby improving the diagnostic capabilities, and it broadens the spectrum of surgical techniques feasible for treatment of articular pathologies in cattle.

This study aimed to assess for cattle the described arthroscopic approaches to the shoulder joint of horses, and to describe the appearance of the corresponding intraarticular structures of the shoulder joint. Additionally, to perform histological examination where tissues were identified and assessed arthroscopically, but the tissue type was uncertain using cadaveric limbs from cattle of different age categories without any signs of orthopedic diseases of the front limbs.

Results

An anatomic and arthroscopic investigation with 34-cadaveric forelimbs from 20-cattle was performed. The arthroscope was inserted either immediately cranial or 1-cm caudal to the tendon of the infraspinatus muscle for the cranial and caudal approaches, respectively. The shoulder joints were examined with the limbs in either horizontal non-pulled position, abducted non-pulled position using a three-pod limb holder adjustable in height, or horizontal manually pulled position. Arthroscopy was performed using a rigid 30°arthroscope (18-cm length, 4-mm outer diameter) to view the synovial pouches with their synovial villi and the following structures: cranial rim of the glenoid, cranial portion of the humeral head, incisura-glenoidalis, caudal rim of the glenoid, caudal portion of the humeral head, and cranial and caudal cul-de-sac. Abduction of the limb allowed improved visualization of the lateral portion of the joint. Pulling the limb facilitated investigation of the medial portion of the joint. Generally, the distention range was higher in younger as compared to adult cattle, and visualization of the medial portion of the joint was, therefore, facilitated in younger animals. The main complications observed were subcutaneous fluid extravasations and partial-thickness articular cartilages wear-lines.

Conclusion

The described arthroscopic techniques allowed good overall visualization of the most relevant anatomical structures within the healthy cadaveric joint. Further investigations are warranted to evaluate the diagnostic and therapeutic applications of these techniques and the prognosis of arthroscopic surgery as a tool for the treatment of joint lesions.

Arthroscopic approach and intra-articular anatomy of the dorsal and plantar synovial compartments of the bovine tarsocrural joint

OBJECTIVE

To determine arthroscopic approaches to the dorsal and plantar synovial compartments of the tarsocrural joint in adult cattle, and to describe the arthroscopic intra-articular anatomy from each approach.

STUDY DESIGN

Ex vivo study.

ANIMALS

Fresh adult bovine cadavers (n = 7).

METHODS

Two tarsocrural joint were injected with latex to determine arthroscopic portal locations and arthroscopy of the tarsocrural joint of 12 tarsi was performed. The dorsolateral approach was made through the large pouch located between the long digital extensor and peroneus longus tendons. The dorsomedial approach was made just medial to the common synovial sheath of the tibialis cranialis, peroneus tertius, and long digital extensor tendons. The plantarolateral and plantaromedial approaches were made lateral and medial to the tarsal tendon sheath, respectively.

RESULTS

Each approach allowed visualization of the distal tibia articulating with the proximal trochlea of the talus. Consistently observed structures included the distal intermediate ridge of the tibia, and the medial and lateral trochlear ridges and trochlear groove of the talus. Lateral and medial malleoli were best assessed from dorsal approaches. From the lateral approaches evaluation of the abaxial surface of the lateral trochlear ridge allowed visualization of the fibulocalcaneal joint. From the plantar approaches additional observed structures included the coracoid process of the calcaneus, plantar trochlea of the talus, and plantar talotibial and talofibular ligaments.

CONCLUSION

In cattle, the dorsolateral and plantarolateral approaches allowed for the best evaluation of the dorsal and plantar aspects of the tarsocrural joint, respectively.

Dorsal Arthroscopic Approach and Intra-Articular Anatomy of the Bovine Antebrachiocarpal and Middle Carpal Joints

OBJECTIVE

To determine arthroscopic approaches to the dorsal synovial compartments of the antebrachiocarpal and middle carpal joints in adult cattle, and to describe the arthroscopic intra-articular anatomy from each approach.

STUDY DESIGN

Ex vivo study.

ANIMALS

Six fresh adult bovine cadavers.

METHODS

Two carpi were injected with latex and dissected to determine the ideal location for arthroscopic portals. Arthroscopy of the antebrachiocarpal and middle carpal joints of 10 carpi was then performed. The dorsolateral approach was made between the extensor carpi radialis and common digital extensor tendons. The dorsomedial approach was made medial to the extensor carpi radialis tendon, midway between the distal radius and proximal row of carpal bones (antebrachiocarpal joint) and midway between the two rows of carpal bones (middle carpal joint), with the joint in flexion.

RESULTS

Arthroscopy of the antebrachiocarpal joint allowed visualization of the distal radius, proximal aspect of the radial, intermediate and ulnar carpal bones, and a palmar ligament located between the radius and the intermediate carpal bone. The approach to the middle carpal joint allowed visualization of the distal aspect of the radial, intermediate, and ulnar carpal bones, the proximal aspect of the fourth and fused second and third carpal bones and an interosseous ligament. The most lateral articular structures (lateral glenoid cavity of the distal radius, ulnar carpal and fourth carpal bones) were difficult to assess.

CONCLUSION

Dorsal approaches to the antebrachiocarpal and middle carpal joints allowed visualization of most intra-articular dorsal structures in adult cattle.

Clinical management of septic arthritis in cattle

Synovial fluid, ultrasound, and radiographic imaging are common diagnostic tools for septic arthritis. Mycoplasma septic arthritis is suspected in calves with clinical signs of otitis and pneumonia. Commonly affected joints are carpus, stifle, and tarsus. Treatment strategy must include long-term antibiotics, anti-inflammatories, and joint lavage. Knowledge of communication and boundaries for commonly affected joints is essential to perform joint lavage and arthrotomy.

Diagnosis and Treatment of Septic Arthritis

Septic arthritis (SA) is a common orthopedic condition encountered in horses that are presented to equine veterinarians. Successful out-come is dependent on prompt and thorough evaluation and treatment. This article briefly reviews the pathophysiology, outlines diagnostics, describes treatment options and prognostics, and discusses current research in diagnosis and treatment of SA.

Management of MRSA septic arthritis in a dog using a gentamicin-impregnated collagen sponge

Methicillin-resistant Staphylococcus aureus septic arthritis occurred in a dog following elective joint surgery for cranial cruciate ligament rupture. Resolution of the infection was assisted by using a surgically implanted absorbable gentamicin-impregnated sponge.

Fenestration of the abaxial hoof wall and implantation of gentamicin-impregnated collagen sponges for the treatment of septic arthritis of the distal interphalangeal joint in cattle

A novel surgical approach to the distal interphalangeal joint of cattle, through the abaxial hoof wall, for the treatment of septic arthritis is described. In seven cattle a rectangular piece of horn (15 x 40 mm) was excised from the abaxial hoof wall and the joint was lavaged with Ringer's solution. Infected and/or necrotic tissue was removed from the joint and gentamicin-impregnated collagen sponges were introduced. The piece of horn was reattached, a rubber block was glued to the contralateral claw, and a bandage applied. Aftercare consisted of changes of bandage, systemic administration of antimicrobial drugs and box rest. At follow-up, six of the cattle were sound but one cow which had been slaughtered five months after surgery had remained slightly lame.