Authors of section

Author

Alan Ruggles

Executive Editor

Jörg Auer

Open all credits

Resection

1. Indications

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

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2. Preparation and approach

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

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3. Surgical technique

Arthroscope placement

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

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Arthroscopic examination

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).

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Instrument portal(s)

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

Fragment removal

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

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Debridement

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.

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4. Overview of rehabilitation

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.

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