Arthroscopic lavage and implantation of gentamicin-impregnated collagen sponges for treatment of chronic septic arthritis in cattle - 14 cases (1995-1997)

The object of this retrospective clinical study was to evaluate the efficac y of arthroscopic lavage and debridement, followed by intra-articular impla ntation of resorbable gentamicin-impregnated collagen sponges (GICS) for tr eatment of chronic (greater than or equal to seven days) septic arthritis i n cattle. Fourteen cattle suffering from chronic septic monarthritis refrac tory to previous treatment were included in this study. Age ranged from one month to 7 years (mean = 34 months) and bodyweight from 58 to 640 kg (mean = 422 kg). The degree of lameness and characteristics of synovial fluid we re evaluated before and at days #10 and 20 after the initial operation. The standard surgical procedure consisted of arthroscopic "through-and-through " lavage of the affected joint with a physiological Ringer's solution, part ial synovectomy, and curettage of the articular cartilage when considered n ecessary, followed by the intra-articular administration of GICS. The after care included administration of procaine penicillin, phenylbutazone, and st all confinement. The progress of the cases was monitored at three to 24 mon ths after the initial operation. The tarsocrural joint was affected in six cases, the antebrachiocarpal join t in five and the metacarpophalangeal joint in three cases. The degree of l ameness, total nucleated cell count and total protein of synovial fluid sig nificantly (P < .05) decreased within 10 days after the operation. Treatmen t was successful in 12 of 14 animals (86%). It was therefore concluded that the implantation of GICS after routine "through-and-through" lavage is a v aluable alternative technique for the treatment of chronic septic arthritis in cattle. A subsequent second operation for implant removal was not neces sary, as GICS are fully absorbable. The tarsocrural joint is associated wit h the least favourable prognosis of the joints treated in this study.