Endoscopy of the intertubercular bursa in horses

Forelimbs from 3 anesthetized horses and 16 fresh cadaver horses were used to describe the endoscopic anatomy of the intertubercular bursa and outline the surgical portals that provide the greatest access to structures within the bursa. A lateral arthroscopic portal was made proximal to the deltoid tuberosity of the humerus into the distal bursal recess. A second portal was created proximal to the humeral tubercles that entered the proximal bursal space. These approaches provided consistent viewing and instrument access to the lateral intertuberal groove, the greater and intermediate humeral tubercles, and the synovial membrane of the proximal and distal bursal recesses. The intermediate tubercle and heavy muscle mass restricted access to the medial intertuberal groove and lesser tubercle. This technique may provide a less invasive alternative to bursotomy in the surgical management of selected horses with intertubercular bursitis. Clinical applications include cartilage debridement, fragment removal, partial synovectomy, and high-volume lavage.