Vet Comp Orthop Traumatol 1999; 12(02): 64-69
DOI: 10.1055/s-0038-1632464
Clinical Communication
Schattauer GmbH

Arthroscopic Lavage and Implantation of Gentamicin-impregnated Collagen Sponges for Treatment of Chronic Septic Arthritis in Cattle

14 Cases (1995–1997)
A. Steiner
1   From the Clinic for Food Animals and Horses
,
G. Hirsbrunner
1   From the Clinic for Food Animals and Horses
,
R. Miserez
2   Institute for Veterinary Bacteriology, School of Veterinary Medicine, University of Berne, Switzerland
,
P. Tschudi
1   From the Clinic for Food Animals and Horses
› Author Affiliations
Further Information

Publication History

Received 13 February 1998

Accepted 14 September 1998

Publication Date:
08 February 2018 (online)

Summary

The object of this retrospective clinical study was to evaluate the efficacy of arthroscopic lavage and debridement, followed by intra-articular implantation of resorbable gentamicin-impregnated collagen sponges (GICS) for treatment of chronic (≥ seven days) septic arthritis in cattle. Fourteen cattle suffering from chronic septic monarthritis refractory to previous treatment were included in this study. Age ranged from one month to 7 years (mean = 34 months) and bodyweight from 58 to 640 kg (mean = 422 kg). The degree of lameness and characteristics of synovial fluid were evaluated before and at days #10 and 20 after the initial operation. The standard surgical procedure consisted of arthroscopic “through-and-through” lavage of the affected joint with a physiological Ringer’s solution, partial synovectomy, and curettage of the articular cartilage when considered necessary, followed by the intra-articular administration of GICS. The aftercare included administration of procaine penicillin, phenylbutazone, and stall confinement. The progress of the cases was monitored at three to 24 months after the initial operation.

The tarsocrural joint was affected in six cases, the antebrachiocarpal joint in five and the metacarpophalangeal joint in three cases. The degree of lameness, total nucleated cell count and total protein of synovial fluid significantly (P <.05) decreased within 10 days after the operation. Treatment was successful in 12 of 14 animals (86%). It was therefore concluded that the implantation of GICS after routine “throughand- through” lavage is a valuable alternative technique for the treatment of chronic septic arthritis in cattle. A subsequent second operation for implant removal was not necessary, as GICS are fully absorbable. The tarsocrural joint is associated with the least favourable prognosis of the joints treated in this study.

The efficacy of arthroscopic “through-and-through” lavage and debridement, followed by intra-articular implantation of absorbable gentamicin-impreg-nated collagen sponges (GICS) for treatment of chronic (≥ seven days) septic arthritis in cattle was evaluated. Treatment was successful in 12 of 14 cattle (86%). This suggests that the described technique is a valuable alternative to established treatment regimens for prolonged intra-articular administration of gentamicin. When compared to gentamicin-impregnated polymethylmethacrylate beads, GICS have the advantage that a second operation for implant removal is not necessary.

 
  • REFERENCES

  • 1 Van Huffel X, Steenhaut M, Imschoot J. et al Carpal joint arthrodesis as a treatment for chronic septic carpitis in calves and cattle. Vet Surg 1989; 18: 304-11.
  • 2 Verschooten F, De Moor A, Steenhaut M. et al Surgical and conservative treatment of infectious arthritis in cattle. J Am Vet Med Assoc 1974; 165: 271-5.
  • 3 Van Pelt RW. Idiopathic septic arthritis in dairy cattle. J Am Vet Med Assoc 1972; 161: 278-84.
  • 4 Orsini JA. Strategies for treatment of bone and joint infections in large animals. J Am Vet Med Assoc 1984; 185: 1190-3.
  • 5 Desrochers A, St-Jean G, Anderson D. Use of facilitated ankylosis in the treatment of septic arthritis of the distal interphalangeal joint in cattle: 12 cases (1987-1992). J Am Vet Med Assoc 1995; 206: 1923-7.
  • 6 Schneider RK, Bramlage LR, Mecklenburg LM. et al Open drainage, intra-articular and systemic antibiotics in the treatment of septic arthritis/tenosynovitis in horses. Equine Vet J 1992; 24: 443-9.
  • 7 Leitch M. Diagnosis and treatment of septic arthritis in the horse. J Am Vet Med Assoc 1979; 175: 701-4.
  • 8 Trostle SS, Hendrickson DA, Stone WC. et al Use of antimicrobial-impregnated polymethylmethacrylate beads for treatment of chronic, refractory septic arthritis and osteomyelitis of the digit in a bull. J Am Vet Med Assoc 1996; 208: 404-7.
  • 9 Butson R, Schramme M, Smith R. et al The use of gentamicin impregnated beads in small tarsal joint infection. Proc. of the Sixth Annual Scientific Meeting of the ECVS. 1997: 49.
  • 10 Butson RJ, Schramme MC, Garlick MH. et al Treatment of intrasynovial infection with gentamicin-impregnated polymethylmethacrylate beads. Vet Rec 1996; 138: 460-4.
  • 11 Hirsbrunner G, Steiner A. Treatment of nonunion and septic osteomyelitis of metacarpus III/IV in a calf using gentamicinimpregnated collagen sponges and minimal external coaptation. VCOT 1998; 11: 19-2.
  • 12 Hirsbrunner G, Steiner A. Bovine radiocarpal joint infective arthritis treated with gentamicin-impregnated collagen sponges. Vet Rec 1998; 142: 399-2.
  • 13 Mcllwraith WC. Diagnostic and surgical arthroscopy in the horse. Mcllwraith WC. (ed) Philadelphia, London: Lea & Febiger; 1990
  • 14 Devitt C. Treatment of severe orthopedic infections with antibiotic impregnated polymethylmethacrylate beads. Proc. of the 23rd Annual Conference of Veterinary Orthopedic Society. 1996: 10.
  • 15 Holcombe S, Schneider R, Bramlage L. et al Use of antibiotic-impregnated polymethylmethacrylate in horses with open or infected fractures or joints: 19 cases (1987-1995). J Am Vet Med Assoc 1997; 211: 889-93.
  • 16 Letsch R, Rosenthal E, Joka T. Vergleichsstudie Sulmycin implant vs. Septopal-Ketten - Pharmakokinetische und klinische Ergebnisse. Proc. of the Forum Orthopädie, München. 1988: 45-7.
  • 17 von Hasselbach C. Kollagen/Gentamicin als adjuvante Lokaltherapie bei infizierten Hüftendoprothesen. In: Kollagen als Wirkstoffträger. Stemberger A, Ascherl R, Lechner F, Blümel G. (eds) Stuttgart, New York: Schattauer; 1989: 80-90.
  • 18 Stemberger A, Sorg KH, Machka K. et al Technologische und biochemische Aspekte von Kollagen-Implantaten. In: Kollagen als Wirkstoffträger. Stemberger A, Ascherl R, Lechner F, and Blümel G. (eds) Stuttgart, New York: Schattauer; 1989: 17-29.
  • 19 von Hasselbach C. Klinik und Pharmakokinetik von Kollagen-Gentamicin als adjuvante Lokaltherapie knocherner Infektionen. Unfallchirurg 1989; 92: 459-70.
  • 20 Greenough PR, McCallum FJ, Weaver AD. Synovial fluid. In: Lameness in cattle. Weaver AD. (ed) Bristol: Wright Scientechnica; 1981: 263-6.
  • 21 Tschudi P. Personal communication. 1997
  • 22 Wilson G, Miles A. The Growth of Bacteria. In: Principles of bacteriology, virology and immunity. Wilson G, Miles A. (eds) London: Butler and Tanner Ltd; 1975: 116-44.