Arthroscopic-assisted stabilization of medial shoulder instability in a Miniature Poodle

Abstract

A 12-year old female miniature Poodle was presented because of a 4/4 right fore-limb lameness. The orthopedic examination demonstrated pain at palpation of the right shoulder and an abduction angle of 55 °. MRI examination confirmed injuries consistent with a traumatic medial shoulder instability with no evidence of shoulder dysplasia. A partial rupture of the subscapularis tendon and complete detachment of the cranial gleno- humeral ligament were confirmed with arthroscopy. The joint was successfully stabilized using an arthroscopic assisted prosthetic suture.

Long-Term Clinical Outcome of Medial Shoulder Instability in a Dog Treated with Synthetic Implant, Cortical Button, and Interference Screw

“…The safety implantation of anchors has only been studied in dogs above 20 kg, 30 31 whereas sutures with buttons have been used for scapular fixation in small dogs under 10 kg. 7 15 The wide flat implant required broad tunnels, which could be a limitation for the safety of the implantation and a risk for glenoid integrity. Using a cortical button avoided any concerns about the safety angle of the anchor or screw insertion and the associated risks of loosening.…”

“…Using a cortical button avoided any concerns about the safety angle of the anchor or screw insertion and the associated risks of loosening. 15 27 30 31 Suture toggles have been suggested to have biomechanical advantages over knotless anchors, owing to the difficulty to implant and angulate anchors. 27 31 Indeed, reaching the optimal anchor insertion angle for the greatest pullout resistance (i.e., “deadman's angle”) is difficult yet essential to achieve satisfactory implantation and decrease the risks of loosening.…”

“…3 7 Treatments include, among others, the imbrication of the SM 12 and prosthetic MGHL repair using synthetic implants fixed by suture anchors, 13 screws with spiked washers, 14 toggle sutures, 4 7 or knotless anchors. 15 Although interference screws (IS) associated with synthetic implants have already been used in various ligament reconstructions, 16 17 they have never been explored to treat MSI. We thus report the surgical management and long-term outcome of traumatic MSI in a small-breed dog treated by imbrication of the SM and extra-articular stabilization using a synthetic implant and an IS.…”

Medial Shoulder Instability: Prevalence and Treatment Outcomes in 17 Poodles and 31 Dogs of Other Breeds

“…Current described treatment options include both nonsurgical and surgical management (see ►Table 1). 6,7, 14,15,[17][18][19][20][21][22][23][24] Surgery aims to reconstruct medial stability via tendon augmentation or prosthesis implantation. There are variations in MGHL reconstruction techniques and implants, with the consistent aim to reconstruct the medial support for the glenohumeral joint, 14,15,[19][20][21][22]25 maintaining joint alignment and normal biomechanics.…”

“…6,7, 14,15,[17][18][19][20][21][22][23][24] Surgery aims to reconstruct medial stability via tendon augmentation or prosthesis implantation. There are variations in MGHL reconstruction techniques and implants, with the consistent aim to reconstruct the medial support for the glenohumeral joint, 14,15,[19][20][21][22]25 maintaining joint alignment and normal biomechanics. Biceps and supraspinatus tendon transpositions have independently been shown to provide improved medial stability.…”