A scoping review of the current evidence on treatment and outcomes following synovial sepsis

de Souza, Therese C.; Suthers, Joanna M.; Busschers, Evita; Burford, John H.; Freeman, Sarah L.

Abstract

Background
Synovial sepsis is a frequent cause of morbidity and mortality in horses. Despite advances in diagnostics and treatments, persistent infection or chronic lameness can occur.

Objectives
To perform a scoping review to identify and evaluate the current evidence on factors implicated in the success of treatment for synovial sepsis.

Study design
Joanna Briggs Institute scoping review.

Methods
A protocol was registered and a systematic literature search was performed on CAB abstracts, Medline, Scopus and Embase. Inclusion and exclusion criteria were developed and studies systematically reviewed against this. Studies relating to factors affecting treatment success following synovial sepsis were retained and data was extracted on study method, population characteristics and factors significantly associated with treatment outcome.

Results
In total, 2338 studies were identified, and 61 were included to full paper analysis. Eight papers reported significant factors, identifying 15 risk factors associated with two measurements of outcome, either survival and/or return to athletic function. The 15 factors were identified and categorised into pre-, intra- and post-operative factors. Risk factors that were identified included the number or type of synovial structures involved, the presence of pannus, tendon and bone pathology, and the use of systemic antimicrobials. There were many discrepancies in inclusion criteria of cases of synovial sepsis as well as measurement and description of outcome variables.

Main limitations
Non-English language studies or conference proceedings were not included. Only small numbers of papers had similar findings.

Conclusions
Standardisation of inclusion criteria is essential to enable comparisons and analysis between studies on synovial sepsis. Future studies should use methodologies to reduce bias including multicentre and multinational studies, prospective study design, and robust statistical modelling.

Citation

de Souza, T. C., Suthers, J. M., Busschers, E., Burford, J. H., & Freeman, S. L. (2022). A scoping review of the current evidence on treatment and outcomes following synovial sepsis. Equine Veterinary Journal, 54(3), 467-480. https://doi.org/10.1111/evj.13527

• Journal Article Type: Article
• Acceptance Date: Oct 27, 2021
• Online Publication Date: Oct 27, 2021
• Publication Date: 2022-05
• Deposit Date: Oct 29, 2021
• Publicly Available Date: Oct 28, 2022
• Journal: Equine Veterinary Journal
• Print ISSN: 0425-1644
• Electronic ISSN: 2042-3306
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 54
• Issue: 3
• Pages: 467-480
• DOI: https://doi.org/10.1111/evj.13527
• Keywords: General Medicine
• Public URL: https://nottingham-repository.worktribe.com/output/6544183
• Publisher URL: https://beva.onlinelibrary.wiley.com/doi/10.1111/evj.13527