New NeedleView Procedure: Lavage of Septic Joints

From Biovision’s Views Newsletter, Issue 1, Q1 2016

Every day, all around the world, veterinarians are using Biovision’s 1.2mm NeedleView^® arthroscope to provide a higher standard of care for animals both large and small. Many are investigating or developing new procedures for the technology (see Views newsletter, Issue 2, 2^nd quarter 2015 at https://biovisionvet.com/about-us/news-events/archived-news/ for details).

Recently, we learned that Shane Miller, DVM, DACVS of Comstock Equine Hospital in Reno, NV has been using NeedleView^® in the diagnosis and treatment of septic arthritis in horses. We caught up with him on the phone to learn more.

Biovision (BV): How long have you been using Biovision’s NeedleView^® arthroscope in your practice?
Shane Miller (SM): I purchased the NeedleView^® Arthroscope Suite in October, 2012, so a little more than three years.

BV: How do you use the NeedleView^® most days?
SM: I do a lot of stifle diagnostics, primarily because of my practice’s population and caseload. I also use it for exploration in areas like the tendon sheath, coffin, fetlock, and carpus. I even use it for sinuses to see masses, tumors, and fluid. I think I like it best in the navicular bursa when there has been penetration of a foreign object – although I don’t do those cases with the horse standing.

BV: Was it difficult for you to learn to use the NeedleView^® and incorporate it into your practice?
SM: It was really simple for me, because I had already done a lot of surgery and arthroscopy. Once you are comfortable with the anatomy of whatever space you’re in, using the NeedleView becomes a lateral move to a tool that gives you enhanced access and allows you to do more procedures with the animal standing and conscious.

BV: Tell us about the new way you’re using the NeedleView^®.
SM: I recently started using the NeedleView^® on horses that present with septic arthritis. [Editor’s note: septic arthritis is inflammation of a joint caused by bacteria or other micro-organisms.]  The typical approach is to lay the horse down with general anesthesia and use a standard 4mm arthroscope to lavage or flush the joint. With the NeedleView^®, I can leave the horse standing and conscious but sedated, I can flush the joint, and I can generally get further into the joint than with a 4mm scope. If I see lots of fibrin deposition, I can put an instrument in from the other side – using the NeedleView^® to guide me – and pull it out.

BV: How have clients responded to your use of the NeedleView^®?
SM: Whenever I can do an effective procedure without laying a horse down, it’s a win for the animal, the client, and me. When there’s no general anesthesia, there’s typically less morbidity and it’s almost always more cost-effective for the client. I’ve found that clients are more willing to move forward with the procedures – even if they are more expensive – if it means the horse can remain standing and conscious.