Short-term outcomes of 43 dogs treated with arthroscopic suturing for meniscal tears associated with cranial cruciate ligament disease.

OBJECTIVE: To describe short-term outcomes and complications in dogs receiving meniscal suturing and concurrent tibial plateau leveling osteotomy (TPLO) with or without augmentation with an extracapsular suture. STUDY DESIGN: Retrospective case series. ANIMALS: Forty-three client-owned dogs submitted for cruciate ligament disease. METHODS: Dogs were included if meniscal suturing was performed during or after a TPLO procedure. Criteria included an unstable medial meniscus without evidence of a tear, a caudal vertical longitudinal tear with or without displacement, or if a bucket-handle tear was debrided and the remaining rim was unstable. Stifle stabilization was performed by either a standard TPLO or an augmented TPLO (TPLO + internal brace [IB]). Outcome measures included physical examination findings, radiographs, subjective gait examination, Liverpool Osteoarthritis in Dogs (LOAD) scores, and second-look arthroscopy. RESULTS: Forty-four meniscal repairs were performed in 43 dogs. Five types of meniscal tears were treated employing eight suture materials. Complications were documented in 15 cases (34%). The stabilization technique had a significant impact on the outcome (p = .049): TPLO + IB had a 93.3% success rate and the success rate was 71.4% in the TPLO-only group. CONCLUSION: Five types of meniscal pathology were addressed successfully in the study, indicating that currently accepted criteria for meniscal suturing in dogs may be overly conservative. The majority of complications were not related to the meniscal suturing itself and did not compromise the outcome. The stifle stabilization technique had an impact on outcome. CLINICAL SIGNIFICANCE: The authors found arthroscopic meniscal suturing to be practical and successful in this patient population. Postoperative stifle stability had an impact on successful treatment.

Evaluation of viscoelastic coagulation monitoring parameters and fibrinogen concentrations in healthy dogs undergoing stifle arthroscopy and tibial plateau leveling osteotomy.

OBJECTIVE: Evaluation of viscoelastic parameters along with Hct percentages, platelet numbers, and fibrinogen concentrations in healthy dogs undergoing elective stifle arthroscopy and tibial plateau leveling osteotomy (TPLO). These results determine if dogs are in a normal, hypocoagulable, or hypercoagulable state at 4 different time points. ANIMALS: Prospective study of 37 client-owned dogs enrolled between February 2, 2022, and November 10, 2022. METHODS: All dogs received a standardized anesthetic protocol. Patients enrolled in the study underwent stifle arthroscopy using a 3-portal technique with a TPLO performed by board-certified surgeons. Viscoelastic testing, Hct percentage, fibrinogen concentration, and platelet numbers were measured preoperatively, immediately postoperatively, 24 hours postoperatively, and 14 days postoperatively. RESULTS: Stifle arthroscopy and TPLO surgery was not associated with significant effects on viscoelastic coagulation monitoring and fibrinogen concentrations in healthy dogs when comparing the time points. CLINICAL RELEVANCE: Humans have a high risk of thrombotic events when undergoing elective orthopedic surgery and are often placed on prophylactic antithrombotic medication prior to surgery. Viscoelastic coagulation monitoring in dogs undergoing similar orthopedic procedures has been evaluated in veterinary medicine, but the effects on platelets and fibrinogen concentrations from similar orthopedic procedures and uniform anesthesia protocols have not been documented. Cranial cruciate ligament insufficiency is the most common orthopedic injury in dogs. Treatment requires elective surgical correction for the best results and improved long-term prognosis. The findings of this study suggest that similar preoperative prophylactic antithrombotic intervention is not needed for canine patients.

The use of lateral arthroscopy portals for the management of a fragmented lateral coronoid process in an English Bulldog.

OBJECTIVE: To report a case of unilateral lateral coronoid process fragmentation in a dog treated via lateral elbow arthroscopy portals. ANIMAL: A 9-month old male intact English Bulldog. STUDY DESIGN: Case report. METHODS: The dog presented with a history of intermittent right thoracic limb lameness. Orthopedic examination on presentation was unremarkable. Computed tomography of the right thoracic limb was pursued and revealed a mineralized focus along the lateral margin of the lateral coronoid process as well as sclerosis of the medial coronoid process and subtrochlear region of the ulna. Elbow arthroscopy was performed via a lateral approach and revealed chondromalacia of the entire lateral coronoid process. Abrasion arthroplasty of the lateral coronoid process was performed. RESULTS: Complete resolution of the lameness was achieved within two weeks of surgery. At 6 weeks postoperatively, the dog remained sound and a gradual return to normal activity was recommended. At the final follow up assessment, 5 months after surgery, no abnormalities were found on orthopedic examination and the owners reported excellent limb function with no observable lameness. CONCLUSION: Lateral coronoid disease can occur as a rare component of elbow dysplasia in dogs. Abrasion arthroplasty via lateral arthroscopic portals may have resulted in a successful outcome in this case and may form an effective treatment option for lateral coronoid disease in dogs.

Quantification of the Field of View for Standard Lateral Arthroscopy of the Canine Shoulder.

OBJECTIVE: The aim of this study was to define the extent of the biceps tendon, subscapularis tendon, and cranial border of the medial glenohumeral ligament within the field of view during standard lateral shoulder arthroscopy in the dog. We also examine the effect of joint flexion on the field of view of the biceps tendon. STUDY DESIGN: This was a cadaveric study using 21 shoulders of large breed dogs. Each shoulder was explored with a 30-degree arthroscope using standard lateral ports. For each supporting structure, the margins within the arthroscopic field of view were marked with ink. In 11 shoulders, the distal margin of the biceps tendon was identified and marked first with the limb at a standing angle and then in flexion. The margins of the cranial border of the medial glenohumeral ligament were marked at the standing angle. In 10 additional shoulders, the margins of the subscapularis tendon were evaluated. Each joint was fully dissected and the portion of each stabilizing structure within the field of view was quantified. RESULTS: Fifty-eight percent of the cranial border of the medial glenohumeral ligament was within the arthroscopic view. At a standing angle, 48% of the intra-articular length of the biceps tendon was within the arthroscopic view, compared to 63% with the limb flexed. Twenty percent of the subscapularis tendon was within the arthroscopic view. CONCLUSION: A significant portion of the biceps tendon and medial stabilizing structures of the canine shoulder are outside the field of view of arthroscopy through a standard lateral approach. The limitations of the arthroscopic field of view should be appreciated when evaluating the shoulder.

Diagnosis of medial meniscal lesions in the canine stifle using multidetector computed tomographic positive-contrast arthrography.

OBJECTIVE: To assess diagnostic value and clinical utility of multidetector computed tomographic positive contrast arthrography (CTA) for meniscal lesions in dogs. STUDY DESIGN: Prospective case series. STUDY POPULATION: Client-owned dogs (n = 55) with cranial cruciate ligament injuries. METHODS: Sedated dogs underwent CTA using a 16-slice scanner, and subsequently received mini-medial arthrotomy for meniscal assessment. Scans were anonymized, randomized, and reviewed twice for meniscal lesions by three independent observers with varying experience. Results were compared with surgical findings. Reproducibility and repeatability were assessed with kappa statistics, intraobserver changes in diagnosis by McNemar's test, and interobserver differences using Cochran's Q test. Test performance was calculated using sensitivity, specificity, proportion correctly identified, and positive and negative predictive values and likelihood ratios. RESULTS: Analysis was based on 52 scans from 44 dogs. Sensitivity for identifying meniscal lesions was 0.62-1.00 and specificity was 0.70-0.96. Intraobserver agreement was 0.50-0.78, and interobserver agreement was 0.47-0.83. There was a significant change between readings one and two for the least experienced observers (p < .05). The sum of sensitivity and specificity exceeded 1.5 for both readings and all observers. CONCLUSION: Diagnostic performance was suitable for identifying meniscal lesions. An effect of experience and learning was seen in this study.

Assessment of Outcome of Arthroscopic Subtotal Coronoidectomy in Treating Medial Coronoid Disease and Effect of Concurrent Autologous Conditioned Plasma in Dogs Using Force Plate Analysis.

OBJECTIVE: The aim of this study was to assess the outcome of arthroscopic subtotal coronoidectomy in treating medial coronoid disease and the effect of concurrent autologous conditioned plasma (ACP) in dogs using force plate analysis. STUDY DESIGN: This study included 16 dogs with unilateral medial coronoid disease based on computed tomographic imaging. Treatment consisted of an arthroscopic subtotal coronoidectomy. As concurrent therapy, eight dogs received ACP at the end of the arthroscopy and eight dogs a placebo. Force plate analysis, including vertical forces, braking and propulsive forces, corresponding impulses and symmetry indices, was performed prior to arthroscopy and at 4, 12 and 26 weeks postoperatively. RESULTS: After an initial reduction of all force plate analysis parameters, vertical and propulsive parameters gradually improved to the level of healthy dogs at 26 weeks postoperatively. In contrast, braking parameters did not reach normal values at 26 weeks, demonstrating ongoing loss of elbow joint function. The ACP and placebo group did not show any significant difference in force plate analysis parameters during the 26 weeks study period. CONCLUSION: Arthroscopic subtotal coronoidectomy did not result in complete normalization of ground reaction forces, impulses and symmetry indices. Concurrent treatment with ACP, immediately after arthroscopy, did not improve outcome. Our results show that outcome of arthroscopic subtotal coronoidectomy in treating medial coronoid disease is less favourable than previously reported.

Racing Performance and Sale Result in 145 Thoroughbreds after Arthroscopic Removal of Osteochondral Fragments from the Lateral Femoral Trochlear Ridge as a Yearling (2012-2015).

OBJECTIVES: The lateral trochlear ridge (LTR) of the femur is the most common predilection site for osteochondritis dissecans (OCD) in the equine stifle. The objective was to investigate the relationship between lesion size, racing performance, and sale result of Thoroughbreds with LTR OCD following arthroscopic removal as a yearling. METHODS: In this retrospective study, medical records of 145 Thoroughbreds from one equine hospital that underwent surgery for LTR OCD were reviewed; the length and depth of the lesions were measured on preoperative radiographs. Horses were allocated to group S if they were presented to a public yearling sale post-surgery, and horses in group NS were not. Each horse from group S was matched with two control horses from the same sale (group C). Influence of lesion size on racing performance and sale result was analyzed. Racing performance and sale results were compared between different categories of OCD lesion sizes and between the groups. RESULTS: Lesion length and depth did not affect racing performance and did not differ between group S and group NS. However, group S did perform significantly better than group NS. When comparing groups S and C, there were no significant differences in racing performance and sale result. CONCLUSION: Thoroughbreds that had arthroscopic surgery for LTR OCD as a yearling and were presented on a public yearling sale performed comparable to Thoroughbreds that showed similar potential as a yearling. Sale result is not significantly affected in our study.

Histo-morphological effects on equine synovium after arthroscopic synovectomy using two different motorized synovial resectors and two different intensities.

The purpose of the study was to determine the histo-morphological effects on villous synovium after synovectomy using two different motorized synovial resectors and two different intensities ex-vivo. Thirty-three (n = 33) equine metacarpophalangeal/metatarsophalangeal joints were used. Synovectomy was performed along the dorsomedial/dorsolateral synovium (n = 66) using two motorized synovial resectors (aggressive full radius resector, AFRR, used at two intensities: single treatment, n = 24 vs. triple treatment, n = 21 vs. aggressive meniscus side cutter, AMSC, n = 21). Arthroscopic images were evaluated blindly for resector type and intensity. Histological images were evaluated descriptive for synovial morphology and the extent of tissue loss using a microscopic scale. Scanning electron microscopy described the synovial morphology. The synovectomized areas were specific for each resector used and distinguishable from arthroscopic images. The AFRR demonstrated a clear demarcation between treated and non-treated areas and removed the stratum synoviale completely including parts of the underlying stratum fibrosum. In contrast, the AMSC showed less clear demarcation, villous scaffolds and no involvement of the stratum fibrosum. Triple intense treated AFFR samples resulted in significantly deeper lesions compared to single treatments (p = 0.037) but could not be distinguished on arthroscopic images. The morphological effects on villous synovium differ according to the resector type used. The extent of synovial tissue loss cannot be estimated from arthroscopic images but histologically. The type and use of motorized synovial resector determines the morphological alterations of the treated synovium. Arthroscopic control is considered unsuitable to control synovectomy depth.

Computed tomographic imaging and surgical management of distal insertional avulsion fragments of the caudal cruciate ligament in four horses.

OBJECTIVE: To describe cases with caudal cruciate ligament (CdCL) avulsion fragments diagnosed based on computed tomography (CT) examination and report on arthroscopic fragment removal. ANIMALS: Four Warmblood horses with hindlimb lameness and osseous fragments located in the caudal medial femorotibial joint (mFTJ). STUDY DESIGN: Short case series. METHODS: CT and arthroscopic evaluation of the caudal mFTJ were performed. The caudal mFTJ and the insertion of the CdCL on the tibia were assessed and removal of the avulsion fragments was attempted in three horses using a cranial intercondylar approach. RESULTS: The fragment was not accessible via caudomedial approaches in one horse. A cranial intercondylar approach was used in three horses, allowing removal of the intra-articular fragment in two horses, and removal of two-thirds of the proximal fragment in the last horse. Acute, profuse, arterial bleeding occurred in this horse during surgery with transient postoperative soft tissue swelling. Comorbidities included medial femoral condyle cartilage defects (3), cranial cruciate ligament lesions (2), and medial collateral ligament lesions (2). Horses were followed up for 16 months (median, range 11-28 months), at which point all were back in ridden exercise; owners' satisfaction was good. CONCLUSION: CT examination confirmed the diagnosis and allowed evaluation of the stifle joint for comorbidities. A cranial intercondylar arthroscopic approach facilitated the removal of CdCL insertional avulsion fragments, although not always complete. CLINICAL SIGNIFICANCE: A cranial intercondylar approach can allow access to CdCL avulsion fragments, but complications and incomplete removal remain possible.

Feasibility of feline coxofemoral arthroscopy using a supratrochanteric lateral portal: A cadaveric study.

OBJECTIVE: To evaluate the feasibility of feline diagnostic coxofemoral arthroscopy. STUDY DESIGN: Ex vivo feline cadaveric descriptive study. ANIMALS: Seven feline cadavers (14 hips). METHODS: Gross dissection of two feline hips was performed to evaluate anatomic landmarks, guide arthroscopic portal development, and determine optimal limb positioning. A 1.9 mm, 0° arthroscope, inserted through a supratrochanteric lateral portal, was used to assess intraarticular structures in 12 feline cadaver hips. Arthroscopy was followed by gross dissection of periarticular soft tissues. Relative portal locations and damage to periarticular structures were recorded. Hips were disarticulated, and an India ink assay was performed to assess whether there was iatrogenic cartilage injury (ICI). RESULTS: Scope insertion was achieved in all hips. Articular cartilage of the femoral head and acetabulum, round ligament, joint capsule, transverse acetabular ligament, and dorsal acetabular rim were identified arthroscopically in all hips. Probe insertion and intra-articular structure palpation was achieved in all hips. Scope and instrument portals resulted in minimal periarticular muscle trauma. No sciatic nerve damage was detected. Minor partial thickness ICI was observed in all hips at the site of scope insertion. Focal full thickness ICI was noted in one hip. CONCLUSION: Arthroscopy of the feline coxofemoral joint allowed visual and probe evaluation of intra-articular structures without evidence of major periarticular neurovascular trauma. Iatrogenic cartilage injury occurred in all hips but severity of lesions was considered mild. CLINICAL SIGNIFICANCE: Coxofemoral arthroscopy is feasible in cats and can be utilized as a diagnostic tool for minimally invasive joint evaluation.

Concurrent bucket handle meniscal tear treated with arthroscopic partial meniscectomy does not influence midterm outcomes after tibial plateau leveling osteotomy.

OBJECTIVE: To assess the effect of arthroscopic partial meniscectomy in dogs with bucket handle meniscal tears and tibial plateau leveling osteotomy (TPLO), compared with dogs with cranial cruciate ligament rupture and no meniscal tear treated by TPLO alone. ANIMALS: 30 client-owned dogs with cranial cruciate rupture treated by either TPLO and arthroscopy alone if the meniscus was normal (normal meniscus [NM] group, n = 14) or by TPLO and an arthroscopic partial meniscectomy if a bucket handle tear was diagnosed (meniscal tear [MT] group, n = 16). METHODS: Medical records, lameness score, and symmetry gait analysis parameters were retrospectively collected from patient records preoperatively (PreO), then at 1, 3, and 6 months postoperatively (M1, M3, and M6, respectively). Osteoarthritic (OA) radiographic score was performed and compared at PreO and M6. RESULTS: PreO gait analysis parameters were lower in the MT group (P < 0.005). In the MT group, the lameness score significantly improved between PreO and M1, and there were no significant differences between groups at M6. OA score was significantly higher in the MT group at PreO and M6. However, postoperative progression of OA did not differ between the 2 groups (P = 0.16). CLINICAL RELEVANCE: Treatment for meniscal tear results in a significant improvement in lameness, with postoperative outcomes at 6 months comparable with dogs with intact menisci. Despite having significant osteoarthritic lesions at all time points, the progression of osteoarthritis is similar between dogs with meniscal tears and those with intact menisci.

Review of minimally invasive surgical procedures for assessment and treatment of medial coronoid process disease.

OBJECTIVE: To summarize the current peer-reviewed publications on minimally invasive surgery (MIS) for medial coronoid process disease (MCPD) in dogs. STUDY DESIGN: Invited review. METHODS: Pubmed, CAB Abstracts and Scopus databases were utilized for literature review (1990-2023). RESULTS: More than 60 papers have been published that involve MIS evaluation or treatment of MCPD. Six prospective trials incorporated quantitative gait analysis evaluating outcome following MCPD debridement, of which three included a control group. Whilst case numbers were limited, all studies employing a control group failed to demonstrate superiority of surgery over nonsurgical management. Of three studies employing gait analysis and no control group, all documented some improvement in function compared to pretreatment lameness. Multiple studies document progression of osteoarthritis in dogs following MCPD debridement although this may not be synonymous with worsened function. Subtotal coronoid osteotomy (SCO) is described as an alternative to MCP fragment removal, although the long-term biomechanical consequences are currently unclear and quantitative data on the efficacy of this treatment in isolation for MCPD is awaited. CONCLUSION: Arthroscopy of the canine elbow joint is a safe means by which to evaluate MCP pathology. Quantitative longitudinal analysis of outcome following minimally invasive surgery for MCPD is required. Correlation with clearly defined subclassification inclusion criteria such as age, incongruity and the precise arthroscopic findings in each case are required to more accurately differentiate any superiority of surgery over nonsurgical management for this disease.

Long-term outcomes after arthroscopic treatment of dogs affected by osteochondrosis dissecans of the humeral trochlea, with or without medial coronoid disease: 23 cases (2012-2020).

The objective of this study was to report long-term clinical and radiographic outcomes following arthroscopic reparative treatment - flap removal, curettage, and osteostixis of subchondral bone - in dogs with humeral trochlea osteochondritis dissecans (OCD). Dogs were included in this retrospective multicenter case series if they had a computed tomography diagnostic of humeral trochlear OCD, with or without medial coronoid disease, that was treated by arthroscopic reparative technique, and a detailed follow-up at least 6 mo postoperatively. The latter included a clinical examination, assessment of lameness, measurement of the brachial circumference and elbow amplitude, International Elbow Working Group (IEWG) radiographic score, owner-completed canine brief pain inventory (CBPI) score, and visual analogue scale (VAS) rating. A generalized linear model and tests for symmetry and marginal homogeneity were used to compare data. Twenty-three dogs (30 affected elbows) were included. Long-term (median: 22 mo; range: 6 to 98 mo) postoperative lameness, CBPI, VAS, joint distension, and pain scores were significantly improved compared with the preoperative values. Long-term postoperative range of motion and brachial circumference did not reveal any significant difference between OCD-affected and unaffected elbows. Long-term IEWG scores were similar to preoperative values in 56% of elbows and had progressed by 1 grade in 44%. Long-term complications included persistent Grade-1 lameness and occurred in 23% of dogs. Long-term outcomes based on lameness and CBPI scores were considered excellent in 67% of dogs, good in 27%, and intermediate in 6%. Arthroscopic treatment is thus a suitable surgical procedure for OCD of the humeral trochlea in dogs and provides good long-term results.

Cette étude rapporte les résultats cliniques et radiographiques à long terme après un traitement arthroscopique chez des chiens atteints d'ostéochondrite disséquante (OCD) de la trochlée humérale. Les chiens inclus ont reçu un diagnostic d'OCD de la trochlée humérale par tomographie, un traitement réparateur par arthroscopie et un suivi post-opératoire d'au moins 6 mois. Ce dernier comprenant un examen clinique et orthopédique, la mesure de la circonférence brachiale et de l'amplitude du coude, le score radiographique de l'International Elbow Working Group (IEWG), le score Canine Brief Pain Inventory (CBPI) et l'échelle visuelle analogique (EVA). Un modèle linéaire généralisé et des tests de symétrie et d'homogénéité marginale ont permis de comparer les données. Vingt-trois chiens (30 coudes affectés) ont été inclus. Les scores postopératoires à long terme (médiane, 22 mois), de boiterie, de CBPI, d'EVA, de distension articulaire et de douleur étaient significativement améliorés. L'amplitude de mouvement et la circonférence brachiale postopératoires à long terme entre les coudes affectés et non affectés n'ont pas révélé de différence significative. Les scores IEWG à long terme étaient similaires aux valeurs préopératoires dans 56 % des coudes et avaient progressé d'un grade dans 44 %. Les résultats à long terme basés sur la boiterie et les scores CBPI ont été considérés comme excellents chez 67 % des chiens, bons chez 27 % et intermédiaires chez 6 %. Le traitement arthroscopique est donc une procédure chirurgicale appropriée pour l'OCD de la trochlée humérale chez le chien et donne de bons résultats à long terme.(Traduit par les auteurs).

Axial twisting within an ending loop of a continuous suture pattern affects the biomechanical properties of knots of certain suture sizes and types.

OBJECTIVE: To determine whether axial twisting within an ending loop negatively impacts maximum load to failure and failure mode of suture knots. SAMPLES: 525 knots (15 samples each of 7 different suture types/sizes tested in 5 knot-twist configurations each). PROCEDURES: Each suture type (polydioxanone [PDO], Monoderm [polyglecaprone 25], and Nylon) and size (1, 0, 2-0, 3-0) were used to create a starting square knot, and each of the following ending square knot configurations: 0 twists, 1 twist, 4 twists, and 10 twists. Each suture was tested for failure using a universal testing machine (Instron, Instron Corp) with a 100 kg load cell at a speed of 100 mm/min. Each suture and knot was evaluated for a mode of failure using gross evaluation of the knots and video footage recorded during testing. Maximum load at failure (P-value set at .005) and failure mode (p-value set at 0.003) were recorded for each group. RESULTS: Maximum load at failure was decreased in knots tied within ending loops containing more twists for some types and sizes of the suture. With 4 twists, 0-PDO, 1 PDO, and 2-0 Nylon was more likely to fail at the knot than knots with 0 twists. All sutures containing 10 twists, except 3-0 Monoderm, were more likely to fail at the knot than knots with 0 twists. CLINICAL RELEVANCE: The number of twists within the ending loop may not increase the risk of failure at the knot; however, it can decrease the maximum load to failure at a knot, particularly as the suture size increases.

Detection of fragment migration into the biceps tendon sheath originating from a humeral osteochondrosis lesion - A case report and review of the literature.

The purpose of this report is to demonstrate that radiographic evaluation of the canine shoulder joint alone is not sensitive enough to detect migrated osteochondral fragments within the biceps tendon sheath, as a sequela to osteochondrosis dissecans of the caudal humeral head. A 6-months-old, male, 35 kg Hovawart was referred due to chronic intermittent lameness on the left forelimb. Survey radiographs revealed a semilunar radiolucency surrounded by a moderately sclerotic rim at the caudal aspect of the left humeral head, referred to as osteochondrosis dissecans. However, only computed tomography combined with ultrasonography could clearly confirm a dislodged osteochondral fragment within the left biceps tendon sheath and a consequent tenosynovitis. Arthroscopic treatment on the clinically affected left forelimb followed by an additional approach over the left biceps tendon sheath to remove the migrated fragment resulted in a complete remission of the lameness until the last follow-up one year after surgery. In our opinion, computed tomography should be applied in the medical work up of canine shoulder osteochondrosis (OC) as standard. Combined with ultrasonography, it can further aid in complete evaluation of the shoulder joint and reliable exclusion of displaced osteochondral fragments, which might also be missed during arthroscopy when located too far distally.

The use of radiofrequency in equine orthopedic surgery.

The use of radiofrequency energy (RFE) has become increasingly popular in equine orthopedic surgery in recent years, particularly for the debridement of cartilage lesions and soft tissue resection. However, despite considerable advancements in the technology, the safety and efficacy of RFE have continued to be questioned. While studies investigating the use of RFE for chondroplasty in the equine population are lacking, there is an abundance of research studies in the human literature assessing its effect on healthy chondrocytes, and researchers are seeking to develop guidelines to minimize collateral damage. This review article provides a concise and thorough summary of the current use of RFE in equine orthopedics, in addition to discussing the recent evidence surrounding its use for chondroplasty in both the human and equine populations.

MRI appearance of multiple displaced osteochondritis dissecans cartilage fragments in the bicipital tendon sheath of a juvenile dog.

A 1-year-old Bernese Mountain dog presented with an acute onset of left thoracic limb lameness. Magnetic resonance imaging (MRI) of the left shoulder was performed, showing a subchondral bone defect in the caudomedial aspect of the humeral head. In addition, several round hypointense structures were visible in the biceps tendon sheath. A left shoulder arthroscopy was performed, which confirmed an osteochondritic lesion. Exploration of the biceps tendon sheath via a small open approach allowed retrieval of the fragments, which likely migrated from the joint. Histopathology confirmed the structures to be multiple osteochondritic fragments.

Comparison of dorsal and medial arthroscopic approach to canine coxofemoral joint: a cadaveric study.

BACKGROUND: Arthroscopic exploration of ventromedial part of canine coxofemoral joint is limited in conventional dorsal approach. OBJECTIVES: We evaluated the efficacy of a medial arthroscopic approach to the coxofemoral joint of dogs by analyzing the joint visible area and performing a safety analysis. METHODS: Arthroscopic approaches to the coxofemoral joint were made in five cadavers using a traditional (dorsal) and novel (medial) approach. Three observers scored the visible area of images and videos of the acetabulum and femur. A safety analysis was performed via dissection of the medial hind limb. The distance between neurovascular structures and arthroscopic portals was measured. RESULTS: The acetabulum was more visible in the dorsal than in the medial approach, with mean visualization scores of 16 ± 0.00 and 11.83 ± 1.26, respectively. The medioventral side of the femur was significantly more visible in the medial than in the dorsal approach, with mean visualization scores of 3.9 ± 0.99 and 6.93 ± 0.58, respectively. Safety analysis confirmed the medial portal site was safe, provided that the surgeon has comprehensive knowledge of the joint. The minimum distance from the arthroscopic medial portals to the nearest neurovascular structures was 2.5 mm. CONCLUSIONS: A medial arthroscopic approach to the canine coxofemoral joint has potential clinical application. Dorsal and medial approaches differ significantly and have distinct purposes. The medial approach is useful to access the ventromedial joint, making it an eligible diagnostic method for an arthroscopic evaluation of this area.

Ex vivo evaluation of arthroscopically assisted shoulder stabilization in dogs using an intra-articular aiming device.

OBJECTIVE: To evaluate the use of an intra-articular aiming device (IAD) for medial shoulder stabilization with a suture-toggle repair or an interference screw repair using bone anchors in dogs. STUDY DESIGN: Ex-vivo Study METHODS: Specimens were randomly divided into 2 groups (anchor and suture-toggle) with 10 shoulders each. Abduction angles were measured by goniometry prior to and following medial glenerohumeral ligament transection and after receiving arthroscopically assisted stabilization with either bone anchors or suture-toggle constructs. Bone stock and insertion angles were measured with computed tomography scans. All specimens were inspected by dissection. RESULTS: Abduction angles increased post-transection in both groups, and were restored to normal in the anchor group, but 2° smaller than normal in the suture-toggle group following stabilization. Median magnitude of bone stock surrounding all tunnels ranged between 5.9 and 12.9 mm in the anchor group and 8.8 and 15.6 mm in the suture-toggle group (p = .002). Median insertion angles at the cranial glenoid, caudal glenoid, and humerus were 17.3°, 36.8 ° and 43.4° in the anchor group, respectively, and median insertion angles at the glenoid and humerus were 38.2° and 35.6° in the suture-toggle group, respectively (p = .91). Placement of anchors were not feasible in 3 specimens in the anchor group, and mild violations of the articular surfaces were detected in 3 specimens overall. CONCLUSION: Arthroscopically assisted shoulder stabilization with an IAD was feasible in canine cadavers. CLINICAL SIGNIFICANCE: An IAD may facilitate arthroscopic shoulder stabilization in dogs. Further studies are warranted to evaluate safety and efficacy in a clinical setting.

Arthroscopic-assisted hip toggle stabilization in cats: An ex vivo feasibility study.

OBJECTIVE: To describe arthroscopic-assisted hip toggle stabilization (AA-HTS) in cats, evaluate its feasibility and associated rate of iatrogenic injury, and assess deviations from planned surgical technique. STUDY DESIGN: Ex vivo study. ANIMALS: Skeletally mature cat cadavers (n = 7). METHODS: Preoperative pelvic computed tomography (CT) was performed for surgical planning and to identify the ideal femoral bone tunnel projection. Ultrasound-guided transection of ligament of head of femur was performed. Following exploratory arthroscopy, AA-HTS was performed using a commercially available aiming device. Surgical time, intraoperative complications, and feasibility of technique were recorded. Iatrogenic injury and technique deviations were assessed by postoperative CT and gross dissection. RESULTS: Diagnostic arthroscopy and AA-HTS were successfully performed in all 14 joints. Median (range) surgical time was 46.5 (29-144) min, including 7 (3-12) min for diagnostic arthroscopy and 40 (26-134) min for AA-HTS. Intraoperative complications occurred in 5 hips, related to bone tunnel creation (4) and toggle dislodgment (1). Toggle passage through the femoral tunnel was the most challenging component of technique, recorded as mildly difficult in 6 joints. No damage to periarticular/intrapelvic structures was identified. Minor articular cartilage damage (<10% total cartilage area) was identified in 10 joints. Thirteen deviations (8 major, 5 minor) in surgical technique from preoperative planning were identified in 7 joints. CONCLUSION: In feline cadavers AA-HTS was feasible but was associated with a high rate of minor cartilage injury, intraoperative complications, and technique deviations. CLINICAL SIGNIFICANCE: Hip toggle stabilization using an arthroscopic-assisted approach may be an effective technique for management of coxofemoral luxation in cats.