Post operative synovial sepsis following endoscopic surgery: Increased risk associated with the carpal sheath

Hawthorn, A.; Reardon, Richard; O'Meara, Bryan; James, Frances M.; Bladon, B. M.

doi:10.1111/evj.12472

Cited by 17 publications

(27 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Overall, 0.65% of the horses developed a SSI without septic arthritis and 1.11% of the horses developed septic arthritis (with or without concurrent SSI). These numbers are similar to those previously reported …”

Section: Discussionsupporting

confidence: 93%

“…However, in this study, 19/21 infections (surgical site and/or septic arthritis) were located in or proximal to the tarsal region. Positioning of the horse in the recovery box may be important when the surgical site cannot be protected by a bandage . However, in this study, the majority of stifles that became infected (6/8) were positioned with the operated limb upwards during recovery.…”

Section: Discussionmentioning

confidence: 94%

“…The debridement of larger lesions and the removal of large or multiple fragments requires more extensive manipulations and repetitive introduction of instruments through the portal, increasing soft tissue trauma, and subcutaneous fluid accumulation in both horses and humans . Similarly, extensive soft tissue disruption has been proposed as the predisposing factor for sepsis after endoscopy of carpal sheaths . In the stifle, fluid accumulates between fascial planes of the M. tensor fascia latae, consisting of poorly vascularized connective tissue.…”

Section: Discussionmentioning

confidence: 99%

“…The term “septic arthritis” commonly refers to severe inflammation associated with the penetration of bacteria into the synovial space . In horses, the frequency of post‐arthroscopic/endoscopic synovial sepsis varies between reports from 0.2% to 1.0% . Although the risk can be considered low, septic arthritis is a serious and potentially life threatening complication …”

Section: Introductionmentioning

confidence: 99%

“…Borg and Carmalt only identified septic arthritis in tibiotarsal (0.9%) and fetlock (0.4%) joints after elective arthroscopy . Most recently, Hawthorn et al reported post‐endoscopic synovial sepsis in 0.3% of carpal joints, 0.13% of fetlock joints, and 0.17% of stifle joints …”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Incidence and risk factors of surgical site infection and septic arthritis after elective arthroscopy in horses

et al. 2017

View full text Add to dashboard Cite

Objective: To determine the incidence of infection and associated risk factors, after elective arthroscopy.Study design: Retrospective case study.Animals: Horses (n51079) undergoing elective arthroscopy.Methods: Medical records of all horses that underwent elective arthroscopy between 2006 and 2013 were reviewed. Age, gender, breed, surgeon, number of joints operated, total anesthetic time, perioperative antimicrobial administration, and the presence and size of osteochondral fragments/subchondral lesions were recorded. For each operated joint, the development of postoperative infection (surgical site infection [SSI] and/or septic arthritis) and long-term outcome (>6 months) were recorded. Multivariate logistic regression was used to test for association between the independent variables and the dependent outcomes.Results: A total of 1741 joints in 1079 horses underwent arthroscopy. SSI without septic arthritis occurred in 1 fetlock joint (0.14%), 1 tibiotarsal joint (0.19%), and 6 femoropatellar joints (1.67%). Thirteen joints (0.75%) were diagnosed with septic arthritis, including 1 fetlock joint (0.14%), 4 tibiotarsal joints (0.74%), and 8 femoropatellar joints (2.23%). The probability of postoperative SSI was higher when large lesions (>40 mm long) were treated, compared to medium (20-40 mm, P 5 .005) and small (<20 mm, P < .001) lesions. SSI was a significant risk factor for the development of septic arthritis (P < .001). Although age did not affect the incidence of SSI, increasing age was associated with a lower rate of septic arthritis rate (P 5 .028).Conclusion: Septic arthritis after elective arthroscopy was more likely in the presence of SSI and younger age. Horses with large lesions were at risk for SSI, which translated into a higher incidence of postoperative septic arthritis after femoropatellar arthroscopy.

show abstract

Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Incidence and risk factors of surgical site infection and septic arthritis after elective arthroscopy in horses

et al. 2017

View full text Add to dashboard Cite

show abstract

Complications of Tendon Surgery

Smith

2021

Complications in Equine Surgery

View full text Add to dashboard Cite

Retrospective evaluation of association between perioperative antimicrobial protocol and complications following elective equine synovial endoscopy

Pezzanite

Griffenhagen

Krause

et al. 2021

Veterinary Medicine & Sci

View full text Add to dashboard Cite

Background: Prophylactic perioperative antimicrobial protocols in equine synovial endoscopy have been described but not compared with respect to post-operative outcomes and complications. Increasing antimicrobial resistance in equine practice and interest in promoting judicious use of antimicrobials has prompted reevaluation of drug selection and dosing strategies. Objectives: To determine the frequency of and compare post-operative complications following elective synovial endoscopy between horses receiving different perioperative antimicrobial protocols. Methods: Records from the Colorado State University Veterinary Teaching Hospital were evaluated (2014-2018) and equine patients undergoing elective synovial endoscopy were identified. Patients undergoing endoscopy for sepsis or internal fixation were excluded. Patient signalment, clinician, joint and limb involved, perioperative antimicrobial regimen, number endoscopic portals and closure technique, and post-operative complications including incidence of joint infection were recorded. Generalized linear models were used to estimate the odds of post-operative complications. Results: Elective synovial endoscopies of 516 horses in 537 procedures evaluating 761 synovial structures were performed. No horses developed post-operative septic synovitis. Administration of post-operative antimicrobials, type used and patient sex were all significantly associated with increased risk of complications, which were predominantly gastrointestinal-related. Complication rates in horses receiving a single preoperative dose of cefazolin were lower than in horses receiving potassium penicillin, gentamicin or multiple doses. Complication rates were lower in females compared to castrated or intact males. Other factors evaluated (breed, age, surgeon, anaesthesia duration or hospitalization, joint/limb operated, number endoscopic portals) were not associated with increased risk of complications post-operatively in this case population. How to cite this article: Pezzanite LM, Griffenhagen GM, Krause DM, Hendrickson DA. Retrospective evaluation of association between perioperative antimicrobial protocol and complications following elective equine synovial endoscopy.

show abstract

Post operative synovial sepsis following endoscopic surgery: Increased risk associated with the carpal sheath

Abstract: Surgeons should be aware that tendon sheaths and the carpal sheath in particular appear to have higher odds of developing sepsis following endoscopic surgery.

Cited by 17 publications

References 14 publications

Incidence and risk factors of surgical site infection and septic arthritis after elective arthroscopy in horses

Incidence and risk factors of surgical site infection and septic arthritis after elective arthroscopy in horses

Complications of Tendon Surgery

Retrospective evaluation of association between perioperative antimicrobial protocol and complications following elective equine synovial endoscopy

Contact Info

Product

Resources

About