Evaluation of traction stirrup distraction technique to increase the joint space of the shoulder joint in the dog: A cadaveric study.

The objective of this study was to evaluate technical feasibility and efficacy of a joint distraction technique by traction stirrup to facilitate shoulder arthroscopy and assess potential soft tissue damage. Twenty shoulders were evaluated radiographically before distraction. Distraction was applied with loads from 40 N up to 200 N, in 40 N increments, and the joint space was recorded at each step by radiographic images. The effects of joint flexion and intra-articular air injection at maximum load were evaluated. Radiographic evaluation was performed after distraction to evaluate ensuing joint laxity. Joint distraction by traction stirrup technique produces a significant increase in the joint space; an increase in joint laxity could not be inferred by standard and stress radiographs. However, further clinical studies are required to evaluate potential neurovascular complications. A wider joint space may be useful to facilitate arthroscopy, reducing the likelihood for iatrogenic damage to intra-articular structures.

Evaluation of a distractor to increase joint space of the stifle joint in dogs: a cadaveric study.

OBJECTIVE: To evaluate the technical feasibility and efficacy of a joint distraction technique to increase the stifle joint space and assess potential soft tissue damage due to the distraction. METHODS: Twenty stifle joints of twelve canine cadavers without evidence of disease were radiographically evaluated by medio-lateral, cranio-caudal and varus-valgus stressed projections. Joint distraction was applied with loads from 40 N up to 200 N, and the joint space achieved was measured on radiographic images. Distraction plus distension with saline was subsequently applied and measured. Varus-valgus stressed projections were repeated after distraction to evaluate a potential increase in joint laxity. RESULTS: Distraction produced a significant increase of the joint space for most of the evaluated loads. Distraction plus distension produced a significant increase for most of the loads compared to the distraction alone. No ensuing joint laxity could be inferred from the post-distraction radiographic evaluation. CLINICAL SIGNIFICANCE: Stifle distraction produces an increase of the joint space, which is wider when intra-articular saline is injected. This may be potentially useful for improving joint structure visualization and facilitating arthroscopic procedures, thus reducing the potential for iatrogenic damage to intra-articular structures. No soft tissue damage could be inferred by radiographic pre- and post-procedure comparison. Further clinical studies are required to evaluate potential neurovascular complications.

Evaluation of a joint distractor to facilitate arthroscopy of the hip joint in dogs.

OBJECTIVE: To evaluate the technical feasibility and efficacy of a hip joint distraction technique, any potential ligamentous damage linked to the procedure, and the effect of joint venting on the maximum distraction achieved. METHODS: Twenty hip joints from 11 canine cadavers were evaluated radiographically by standard and stressed projections. Joint distraction was applied with loads from 40 up to 200 N, in 40 N increments, and fluoroscopic images were obtained at each load. At 200 N, a needle was inserted into the joint to achieve a venting effect, and the space was measured again. Standard and stressed radiographs were performed to evaluate potential laxity changes. RESULTS: Distraction caused a significant increase in joint space at each load of distraction, although there were some variations. Joint venting produced a significant increase in joint space. A statistically significant difference in joint laxity evaluated radiographically before and after the procedure was recorded. CLINICAL SIGNIFICANCE: Use of the distraction apparatus resulted in an increase in joint space. This could be useful for clinical situations where a larger joint space is required such as for arthroscopic procedures. However, loads in excess of 200 N may induce significant increases in joint laxity.

Evaluation of a joint distractor to facilitate arthroscopy of the tibio-tarsal joint in dogs.

OBJECTIVE: To evaluate the technical feasibility, efficacy and potential soft tissue damage of a joint distraction technique to facilitate arthroscopy of the tibio-tarsal joint and to test the effect of joint venting on the maximum distraction achieved. METHODS: Twenty hocks were preliminarily evaluated radiographically by standard and stressed projections. Joint distraction was applied with loads from 40 N up to 200 N, in 40 N increments, and radiographic images were obtained at each load. The effect of joint venting by an intra-articular needle was evaluated at the maximum load. Standard and stressed radiographs were repeated to evaluate potential laxity changes. RESULTS: Joint distraction caused a significant increase in the joint space at each load of distraction except for the 40 to 80 N load increase. Joint venting produced a significant increase in the joint space. No increase of joint laxity could be inferred from the postdistraction radiographic evaluation. CLINICAL SIGNIFICANCE: Hock distraction can be useful to facilitate arthroscopic procedures, increasing the joint space available for intra-articular manoeuvres. Further clinical studies are required to evaluate potential neurovascular complications.