High pressure gas distention in equine arthroscopy. 425 cases

The aim of this study is to underline the suitability of high pressure (250-300 mmHg) joint distension by use of CO2 for arthroscopic procedures and to evaluate and identify technical advantages and disadvantages that might be associated with this technique in horses. The choice of the medium used to obtain joint distension has been critically reviewed and for each distension medium advantages and disadvantages have been detected. Fluids and gases can be used to the purpose and currently Ringer’s sterile solution is mostly used. Main advantages in using gases vs fluids as distension media have been described more in human than in veterinary medicine literature. They are due to 3 major physical principles: better dioptric effect, evenly distributed wall pressure, and gravity without floating effect. In all of the papers describing gas arthroscopy techniques it is suggested not to increase the gas pressure above a threshold of 100-150 mmHg depending on the experiences of the authors to minimize the risk of both venous gas embolism and subcutaneous emphysema.