“…The results of this human study underscored the difficulties and ergonomic challenges of human stifle arthroscopy and concluded that instruments or systems to decrease these issues should improve patient outcomes and decrease risk of harm . Various techniques and novel tools such as slotted cannulas, fluoroscopic joint entry, and over the guide wire instrumentation have been used in human hip arthroscopy in an effort to reduce IACI and instrument morbidity . To the best of the authors’ knowledge, no companies manufacture similar instrumentation or automated systems specifically designed to reduce IACI in animals.…”
Section: Discussionmentioning
confidence: 97%
“…22 Various techniques and novel tools such as slotted cannulas, fluoroscopic joint entry, and over the guide wire instrumentation have been used in human hip arthroscopy in an effort to reduce IACI and instrument morbidity. 23 To the best of the authors' knowledge, no companies manufacture similar instrumentation or automated systems specifically designed to reduce IACI in animals.…”
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 mm2, guarded 2.3 ± 1.5 mm2; 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.
“…The results of this human study underscored the difficulties and ergonomic challenges of human stifle arthroscopy and concluded that instruments or systems to decrease these issues should improve patient outcomes and decrease risk of harm . Various techniques and novel tools such as slotted cannulas, fluoroscopic joint entry, and over the guide wire instrumentation have been used in human hip arthroscopy in an effort to reduce IACI and instrument morbidity . To the best of the authors’ knowledge, no companies manufacture similar instrumentation or automated systems specifically designed to reduce IACI in animals.…”
Section: Discussionmentioning
confidence: 97%
“…22 Various techniques and novel tools such as slotted cannulas, fluoroscopic joint entry, and over the guide wire instrumentation have been used in human hip arthroscopy in an effort to reduce IACI and instrument morbidity. 23 To the best of the authors' knowledge, no companies manufacture similar instrumentation or automated systems specifically designed to reduce IACI in animals.…”
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 mm2, guarded 2.3 ± 1.5 mm2; 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.
“…Arthroscopic instrumentation systems have been developed to minimize the time and effort necessary to access the hip joint and enable orthopaedic surgeons to treat pathological findings safely and effectively [17]. Consequently, the number of arthroscopists who perform hip arthroscopy has risen.…”
BACKGROUND: Total hip arthroplasty (THA) is a safe and successful procedure for the treatment of osteoarthritis. One of the most common postoperative problems remains persistent hip pain. The arthroscopic evaluation of persistent hip pain following THA can be a valuable diagnostic tool in a select number of patients when carried out by experts in this technique. OBJECTIVE: Indication for arthroscopy was persistent pain after THA. Inclusion criteria were an absence of radiological loosening and a sterile aspiration 6 weeks before arthroscopy. Hip joint function and pain were evaluated pre-and postoperatively using the visual analogue scale (VAS) and the Hip Outcome Score (HOS), which scored the activities of daily living (ADL), and a sports subscale. METHODS: 5 patients (3 female, 2 male) with an average age of 60.2 ± 4.27 years (range 51-72 years) were included in the study. Arthroscopy with biopsy, adhesiolysis and psoas tendon release was performed 21.0 ± 21.97 months (range 6-57 months) after primary hip replacement. RESULTS: Pathological findings were prosthetic joint infection (two cases), impingement between acetabular component and psoas tendon (two cases), adhesions of the periprosthetic tissue (one case). The patients achieved a significant improvement of the Hip Outcome Score (HOS), from an average of 45.6 ± 22.5 (range 14.0-63.1) to 76.5 ± 3.8 (range 41.0-89.4, P = 0.016). Evaluation of the VAS showed a significant improvement from a preoperative value of 8.8 ± 0.5 to a postoperative value of 3.4 ± 1.0 (P = 0.001). CONCLUSION: Hip arthroscopy provides a minimal-invasive tool for diagnosis and therapy. In cases of persistent pain after THA, standard diagnostic procedures should be utilised. Arthroscopy of a hip post-THA would be highly specialised. As a next step, arthroscopy helps the diagnosis and therapy of persistent pain after THA.
“…During the arthroscopic surgical procedure, the surgeon inserts the ultrasound catheter into the hip joint using an arthroscopic portal ( Fig 1 ), sliding it into the joint through a slotted cannula. 16 The ultrasound probe is maneuvered into the areas of interest under arthroscopic control with the help of an arthroscopic hook probe by use of the same portal or another applicable portal to guide the probe. Fig 1 (A) Plain radiographic image of right proximal femur (posterior-anterior direction).…”
An ultrasound arthroscopy (UA) technique is a promising tool for the evaluation of the articular cartilage during arthroscopic examination. However, the applicability of UA for the evaluation of the hip joint is unknown. We describe a UA assessment of a patient with osteochondritis dissecans at the femoral head. An ultrasound catheter designed for intravascular imaging was inserted into the hip joint by use of conventional arthroscopic portals, and the cartilage surfaces of the femoral head and acetabulum were investigated with ultrasound. UA provided essential quantitative information on the integrity of the articular cartilage and the condition of the subchondral plate not assessable with conventional arthroscopy. Furthermore, the UA technique provided the possibility to monitor arthroscopy-assisted retrograde drilling and bone transplantation in the hip joint.
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