Arthroscopic surgery in the management of contamination and infection of joints,tendon sheaths,and bursae

Arthroscopic surgery has been reported to provide advantages in the management of infected joints in man and the use of endoscopy (arthroscopy) is now common in treating infected synovial structures in horses. It is proposed that the objectives in managing contaminated and infected joints, tendon sheaths, and bursae are optimized by inclusion of arthroscopy in their evaluation and treatment. This requires no additional equipment over and above that commonly used for equine arthroscopy, although motorized apparati are highly advantageous. This paper describes the author's current protocol in managing such cases and discusses the role of arthroscopy and its relationship with other concurrently employed treatment modalities. Its principal contributions to case management are considered to be comprehensive evaluation of the cavity, identification and removal of foreign material and contaminated or infected tissues, and by concurrent directed high-pressure lavage. These produce efficient mechanical cleansing of the cavity, which is combined with minimal tissue trauma and uncomplicated postoperative care.