title: An Alternative, Direct Approach for Arthroscopic Removal of Osteochondral Fragments in the Dorsal Pouch of the Proximal Intertarsal Joint of Horses.
abstract: OBJECTIVE
  To describe an alternative technique and resulting outcomes for arthroscopic removal of osteochondral (OC) fragments from the proximal intertarsal joint (PIJ) using a direct approach without resection of the membrane between the tarsocrural joint (TCJ) and the PIJ.
  
  
  METHODS
  Retrospective case series.
  
  
  METHODS
  Client owned horses (n = 11) with Category 1 OC fragments in the PIJ.
  
  
  METHODS
  Arthroscopic examination of the dorsal pouch of the TCJ was performed with horses positioned in dorsal recumbency using routine portals. A hook probe placed through one of the standard portals was used to lift the edge of the communication between TCJ and PIJ to help pass the arthroscope into the PIJ from the opposite standard portal. A third direct portal into the PIJ was created under arthroscopic visualization, and loose OC fragments (Category 1) were removed using the direct portal. Medical records, race records, and owner surveys were reviewed for case details and outcome.
  
  
  RESULTS
  The described technique allowed removal of all fragments in all 11 cases. No complications associated with the procedure were observed. Of the 9 horses with long term follow-up available, 7 were used as intended (4/4 riding horses, 3/5 racehorses). Two horses did not enter an athletic career because of reasons unrelated to fragment removal.
  
  
  CONCLUSIONS
  A direct approach for arthroscopic removal of OC fragments of the PIJ using a third portal into this joint, without resection of the membrane between the TCJ and PIJ is a good alternative for removal of fragments at this site.
authors.affiliation: Equine Department, Veterinary Clinic Emmeloord, Emmeloord, The Netherlands.
authors.forename: Ellen
authors.initials: E
authors.lastname: Compagnie
authors.affiliation: Equine Department, Veterinary Clinic Emmeloord, Emmeloord, The Netherlands.|Tierklinik Lüsche, Bakum, Germany.
authors.forename: Niklas J
authors.initials: NJ
authors.lastname: Drumm
authors.affiliation: Equine Department, Veterinary Clinic Emmeloord, Emmeloord, The Netherlands.
authors.forename: Natascha
authors.initials: N
authors.lastname: de Heer
authors.affiliation: Equine Department, Veterinary Clinic Emmeloord, Emmeloord, The Netherlands.
authors.forename: Frerik
authors.initials: F
authors.lastname: ter Braake
mesh_terms: D000818:Animals; D001182:Arthroscopy / Q000662:veterinary; D005260:Female; D006734:Horse Diseases / Q000601:surgery*; D006736:Horses / Q000293:injuries* / Q000601:surgery; D007592:Joint Diseases / Q000601:surgery / Q000662:veterinary*; D008297:Male; D010375:Pedigree; D012189:Retrospective Studies; D013640:Tarsal Joints / Q000293:injuries* / Q000601:surgery; D016896:Treatment Outcome