Standing NanoNeedle Arthroscopy of the Distal Interphalangeal Joint for Removal of Osteochondral Fragments of Distal P2 and the Extensor Process in a Horse

Background: In horses, standing arthroscopy offers a valuable alternative to general anesthesia for the reduction of anesthetic-associated risks, and provides improved visualization in joints where access is facilitated by weightbearing. These techniques are particularly advantageous for patients with increased anesthetic risk or financial limitations. To the authors’ knowledge, the removal of osteochondral fragments from the distal interphalangeal joint in a standing, sedated horse using small-diameter arthroscopic equipment has not been previously reported. Case Presentation: A 7-year-old American Quarter Horse–Thoroughbred cross presented on referral for treatment of osteochondral fragmentation in the right fore distal interphalangeal joint. A standing arthroscopic approach to the distal interphalangeal joint was performed. In a weight-bearing position, debridement of the dorsal osteochondral fragments from the second and third phalanx was successfully completed, using a 2 mm NanoNeedle scope and 3.2 mm high-flow 10- degree cannula (Arthrex®). At one year follow-up, the horse had returned to competition and was sound at veterinary examination. Conclusion: This case demonstrates the feasibility of standing NanoNeedle arthroscopy of the equine coffin joint with improved maneuverability, surgical ergonomics, and reduced iatrogenic injury compared to a standard rigid arthroscope. The successful execution of this technique effectively expands our collection of standing arthroscopic procedures in the equine patient.