Treatment of Septic Arthritis With Acoustic Cavitation and Lavage: A Case Report

A 2-year-old Quarter Horse filly was admitted to our facility with a two-day history of trauma caused by barbed wire on the front face of the right front limb fetlock joint. A septic arthritis was confirmed with the synovial fluid examination. The cytologic evaluation of synovial fluid showed 101,000 leukocytes/mm³, 90% neutrophils, and a total protein concentration of 4 g/dL. It was, therefore, decided to perform an arthroscopic lavage using an ultrasonic device with the tip inserted inside the synovial cavity to exploit the phenomenon of acoustic cavitation. After the removal of the synovial pannus, the probe was left to vibrate in the area near the visible penetrating wound inside the joint until three liters of saline was finished. Further studies are needed for understanding and applying this technology in different equine fields and with different bacterial species. However, these first results are promising for the efficacy of this innovative procedure.