Fragment size is associated with post-operative complications following elective arthroscopy of the tibiotarsal joint of horses

The objective of this retrospective study was to determine the occurrence of joint-related complications after elective arthroscopy of the tibiotarsal joint (TTJ) in 329 horses, and the association with specific clinical parameters. Data were collected from medical records of horses undergoing elective tibiotarsal joint arthroscopy for fragment removal. Exact conditional univariate regression was used to determine significant risk factors for joint-related post-operative complications.Of 485 joints, 2 (0.4%) developed surgical site infection, 4 (0.8%) developed septic arthritis, 1 (0.2%) developed synovial fistula. There was a significantly increased odds of having septic arthritis as height and length of the distal intermediate ridge of the tibia (DIRT) lesion increased. The median height and length of the DIRT fragments in affected cases was 13.5 mm and 18.0 mm, respectively. For each unit (1 mm) increase in height, there was a 42% increase in the risk of septic arthritis occurrence (P = 0.0042), and a 15% increase for each unit increase in length (P = 0.035). Horses were significantly less likely to develop septic arthritis when suture smaller than USP 0 was used.Horses with larger osteochondritis dissecans lesions of the DIRT region have an increased risk of developing septic arthritis following fragment removal.