[Direct endoscopic approach improves prognosis of septic-synovitis in the horse]

The medical records of 71 horses with sepic arthritis, bursitis, or tenosynovitis, treated between 1996 and 2001 at Dierenkliniek Enmeloord, were reviewed. A total number of 81 joints, tendon sheaths and bursae were treated (21 tarsi, 17 digital tendon sheaths, 14 metacarpo/metatarso-phalangeal joints, 12 stifles, 6 carpi, 4 coffin joints, 2 navicular bursae, 1 elbow joint, 1 proximal-interphalangeal joint, 1 tarsal sheath, 1 bursa calcanei subtendineum). The aetiology in 42 cases was a penetrating wound (group 1), in 4 cases an intra-articular injection, and in 2 cases arthroscopic surgery (group II), and in 13 cases septic arthritis in young foals (group III); in 10 cases the aetiology was unknown (group V). A total of 93 endoscopic lavages was performed on 81 joints, tendon sheaths, and bursae (1-3 lavages, mean 1.18 lavage per synovial structure). Survival rates were 95% for group I, 100% for group II, 73% for group III and 100% for group IV. Horses were discharged after 4-73 days of hospitalization (mean 20 days). Longterm follow-up revealed a survival rate of 92% for group I, 100% for group II, 67% for group III, and 90% for group IV. Of the surviving horses, 89% were sound and 11% had some degree of residual lameness. It is concluded that instant aggressive treatment using endoscopic techniques yields the best results so far and is therefore recommended.