Iatrogenic cartilage injury associated with the use of stainless-steel cannulas and silicone-guarded cannulas for canine stifle arthroscopy.

Type
Journal Article
Year of Publication
2019
Authors
Cortés I, Warnock JJ, Ranganathan B, Bobe G
Journal
Vet Surg
Volume
48
Issue
8
Pagination
1456-1465
Date Published
2019 Nov
Abstract

OBJECTIVE: To determine the ability to reduce iatrogenic cartilage injury (IACI) during canine stifle arthroscopy by using a silicone arthroscope cannula guard.

 

STUDY DESIGN: Ex vivo canine cadaver experimental study.

 

ANIMALS: Paired canine stifles from 14 cadavers (≥20 kg).

 

METHODS: Stifles (N = 28) were assigned to unguarded traditional or silicone-guarded arthroscopy. Stifle arthroscopy and full joint exploration with meniscal probing was performed by a second-year surgery resident (I.C.) in fourteen canine cadavers, alternating between left and right stifles for guarded vs unguarded arthroscopy. After arthroscopy, stifles were disarticulated, and india ink assay was performed to identify IACI. Total IACI number, lesion length and area, duration of procedure, and procedure difficulty score were recorded for each stifle.

 

RESULTS: Unguarded arthroscopy resulted in more total IACI per joint (unguarded 5.2 ± 3.0, guarded 2.4 ± 1.4; P = .02), larger IACI area (unguarded 5.2 ± 4.2 mm , guarded 2.3 ± 1.5 mm ; P = .02), and IACI length (unguarded 13.6 ± 6.9 mm, guarded 8.6 ± 5.9 mm; P = .03). No difference was identified in duration of procedure (unguarded 11.8 ± 5.2 minutes, guarded 13.8 ± 4.3 minutes; P = .79) or procedure difficulty score (unguarded 1.7 ± 0.6, guarded 1.6 ± 0.6 P = .73).

 

CONCLUSION: Silicone-guarded arthroscope cannulas decreased IACI number and size during canine cadaveric stifle arthroscopy without increasing duration of procedure or surgical difficulty.

 

CLINICAL SIGNIFICANCE: Silicone-guarded arthroscope cannulas may be safer than traditional cannulas for novice veterinary surgeons performing stifle arthroscopy.