Discussion

Barker, W.H.J., Smith, M.R.W., Minshall, G.J., Wright, I.M.
Aims: Intra-articular soft tissue injuries of the tarsocrural joint are encountered with reasonable frequency in clinical practice, but to date have been poorly defined, the aims of this retrospective study was to document the clinical, diagnostic and arthroscopic observations and report on the results of cases treated at the Newmarket Equine Hospital. Methods: All horses over a 10 year period which underwent arthroscopic surgery of a tarsocrural joint were identified. Those with primary intra- articular soft tissue injuries were selected for inclusion and cases evaluated retrospectively. Results: A total of 281 horses underwent TCJ arthroscopy during the study period, of which 30 met the inclusion criteria. A combination of soft tissue lesions was more common than injury to a single structure. Structures injured included the joint capsule (n = 25), collateral ligaments (n = 20), extensor bundle (n = 7) and dorsal plica (n = 8). Following arthroscopic debridement 81% horses were able to return to their previous function.
There were no demonstrable associations between injury type and outcome; however, of the
5 cases that failed to return to work 3 were found to have widespread capsular tearing and the other 2 had extensive collateral ligament damage. Conclusions: Intra-articular soft tissue injuries of the tarsocrural joint can be a primary cause of lameness in the horse and this series represented 11% of the total number of TCJ arthroscopic surgeries referred. Arthroscopic surgery allows accurate definition of the injuries and facilitates appropriate lesion management. Cases treated by arthroscopic debridement had a favourable outcome. Potential relevance: In lame horses with signs localising to the tarsocrural joint, disrupted intra-articular soft tissues should be considered in the list of differential diagnoses when there are no other identifiable lesions. In such cases clinicians should consider further evaluation arthroscopically.