Arthroscopic laser extirpation of metacarpophalangeal synovial pad proliferation in eleven horses

A. new surgical technique for treatment of chronic metacarpophalangeal syno vial pad proliferation in the horse and the findings and long-term follow-u p from II clinical cases are described. The medical records of all equine l ameness cases attributed to metacarpophalangeal synovial pad proliferation admitted to the College of Veterinary Medicine at Cornell University (1991- 1996) were reviewed and all those treated surgically by Laser extirpation w ere included in this study. Retrieved data included subject details, preope rative lameness, ultrasonography, radiography and synovial fluid evaluation s and lesion histopathology, Lesions were ablated using a CO2 or a Nd:YAG l aser intra-articularly with arthroscopic guidance. Long-term follow-up was provided by telephone conversation with owners or trainers. Ah horses had f etlock joint effusion and were lame at presentation. Mean synovial pad thic kness measured ultrasonographically was 9.0 mm (range 6-15 mm), Seven horse s (64%) had radiographic evidence of remodelling of the dorsal cortex of di stal McIII and 3 horses (27%) had concurrent dorsal proximal PI fractures. No postoperative complications were noted. All II horses returned to traini ng within 90 days of surgery without recurrence of the lesion(s). Laser ext irpation of metacarpophalangeal synovial pad proliferation using arthroscop ic guidance provided a rapid, safe and efficient method for surgical remova l of such lesions without complications or recurrence. This surgical techni que provides a suitable alternative to more conventional treatments for chr onic metacarpophalangeal synovial pad proliferation in horses, particularly for removal of very large, fibrotic masses.