In this Simini Equine Surgery Podcast episode, we break down two clinical studies from the August 2025 issue of Veterinary Surgery, both centered on smarter, more effective approaches to fetlock joint management—from first-line lavage to deep-pocket fragment removal.

We cover:

✅ Beggan et al. — An ex vivo study comparing needle-through-and-through lavage (NTA) to endoscopic lavage (EL) for equine joints. In both the fetlock and DFTS, NTA cleared debris just as well—especially in the first 2 liters, and even outperformed EL in early-stage flushing. But remember: EL remains essential for established sepsis and foreign body removal, and saline alone may leave up to 42% of bacteria behind.

✅ Foucaud et al. — A study introducing a direct dorsal arthroscopic approach to the distal palmar/plantar fetlock pouch, used in 25 horses. It yielded 100% successful fragment removal with zero complications—and was especially useful in horses over 4 years, where 100% had cartilage damage, 73% of which was full-thickness. Flexed radiographs and ultrasound are key to identifying these hidden lesions.

🎓 Journal Articles Discussed:

• Beggan et al. — Efficacy of needle and endoscopic lavage on the
  recuperation of microspheres from the adult equine
  metacarpo/metatarsophalangeal joint and digital
  flexor tendon sheath
• Foucaud et al. — Direct arthroscopic approach to the distal pouch of
  the palmar/plantar recess of the metacarpophalangeal/
  metatarsophalangeal joint in horses
  📚 From the August 2025 issue of Veterinary Surgery

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