Resection

Arthroscopic removal is recommended to relieve clinical signs of effusion and lameness and to reduce the long term effects of articular fragmentation.

This procedure is performed with the patient placed in dorsal recumbency through an arthroscopic approach.

The arthroscope is placed in the cranial aspect of the femoro-patellar joint distal to the patella.

Examination of the proximal articular surface of the patella reveals the fragment.
The fragments are usually attached to the joint capsule.
Arthroscopic view of the articular portion of the proximal patella, fragment off apex of patella (arrow).

Appropriate instrument portal(s) are made in the suprapatellar pouch.

An arthroscopic scalpel is used to sharply dissect the soft tissues off the fragment. The fragment is removed using Ferris-Smith rongeurs.

The fragment bed is debrided as needed and the joint lavaged to remove debris.
Arthroscopic view of debridement of apical fragment of patella with Ferris-Smith rongeurs.

The horse is held in box stall rest for 4 weeks with hand-walking during weeks 3-4 followed by pasture turn out for 4 weeks.
At 8 weeks return to training is recommended.