Minimally invasive technique for coxofemoral luxation stabilisation using transarticular toggle system: a cadaveric study

Segal, U.; Shani, Jonathan; Joseph, Rotem

doi:10.1111/jsap.12765

Cited by 7 publications

(18 citation statements)

References 21 publications

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“…16,19 In 1 study in which femoral bone tunnels were created based on fluoroscopic anteversion and inclination angles, 9 of 12 tunnels did not exit at the fovea capitis. 16 In another canine cadaveric study, 19 using a patient-specific 3D-printed drill guide, the femoral bone tunnel exited partially outside the fovea capitis in 12 of 19 joints and completely outside in 4 joints. Conversely, despite the overall high rate of deviations related to femoral bone tunnel creation in our study, 12 of 14 femoral head tunnel exit points were located at the fovea capitis, with 1 partially outside the fovea capitis and the other completely outside the fovea capitis.…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2023

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ObjectiveTo 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 designEx vivo study.AnimalsSkeletally mature cat cadavers (n = 7).MethodsPreoperative 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.ResultsDiagnostic 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.ConclusionIn feline cadavers AA‐HTS was feasible but was associated with a high rate of minor cartilage injury, intraoperative complications, and technique deviations.Clinical significanceHip toggle stabilization using an arthroscopic‐assisted approach may be an effective technique for management of coxofemoral luxation in cats.

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Section: Discussionmentioning

confidence: 99%

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

et al. 2023

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“…Segal and colleagues reported deviation of the drill hole from the target area in 75% of cases placed with fluoroscopic guidance. 14 Using a three-dimensional printed drill guide, Darrow and colleagues described complete placement of a 4 mm tunnel within the fovea in three of nineteen cases, partial placement in twelve of nineteen cases and complete misplacement outside the fovea in four of nineteen cases. 16 The deviation of the drill tunnel has not been reported in the open technique, but it is the authors' opinion that there is sometimes placement outside of the fovea capitis even when drilled in open fashion.…”

Section: Discussionmentioning

confidence: 99%

“…14 Their results describe drill aperture deviation into the cartilage of the femoral head; however, they achieved accurate entry into the acetabular fossa in all 12 joints examined. 14 Rocheleau described a completely arthroscopic approach in a single case report that was aided by fluoroscopy. 15 While this technique was minimally invasive, some limitations were present and it is a technically challenging procedure.…”

Section: Introductionmentioning

confidence: 96%

“…13 An additional cadaveric study by Segal and colleagues used fluoroscopic guidance to create the femoral tunnel. 14 An arthroscope was then inserted through the femoral tunnel to verify alignment with the acetabular fossa, the scope was removed, and the tunnel was drilled blindly. 14 Their results describe drill aperture deviation into the cartilage of the femoral head; however, they achieved accurate entry into the acetabular fossa in all 12 joints examined.…”

Section: Introductionmentioning

confidence: 99%

“…14 An arthroscope was then inserted through the femoral tunnel to verify alignment with the acetabular fossa, the scope was removed, and the tunnel was drilled blindly. 14 Their results describe drill aperture deviation into the cartilage of the femoral head; however, they achieved accurate entry into the acetabular fossa in all 12 joints examined. 14 Rocheleau described a completely arthroscopic approach in a single case report that was aided by fluoroscopy.…”

Section: Introductionmentioning

confidence: 99%

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Arthroscopic-Assisted Toggle Rod Stabilization in Canine Coxofemoral Luxation: A Cadaveric Study

Rivenburg

Murphy²,

Jones³

et al. 2022

Vet Comp Orthop Traumatol

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Objective The aim of this study was to describe an arthroscopic-assisted technique for coxofemoral toggle rod placement, and to report on the feasibility, drill tunnel trajectory and accuracy of tunnel aperture location using this method. Study Design Cadaveric pilot study. Sample Population Eight coxofemoral joints. Methods Craniodorsal coxofemoral joint luxations were artificially created. A simulated open hip reduction and stabilization with a toggle rod were performed through a limited arthrotomy under arthroscopic guidance. Computed tomography scans were performed to evaluate drill hole trajectory across the femoral neck, and joints were disarticulated and photographed. Digital imaging software was used to determine the percent overlap of the drill hole apertures relative to the origin and insertion of the round ligament on the acetabulum and fovea. Results The exit point of the tunnel was entirely within the fovea capitis in five of eight femurs, three of eight femoral drill apertures were only partially within the target area. Of the eight acetabular bone tunnels examined, all were centred occupying the acetabular fossa. Conclusions Coxofemoral toggle rod placement can be performed under arthroscopic guidance through a limited arthrotomy. Comparable femoral tunnel accuracy with the standard open technique should be achieved with the current method prior to its clinical use.

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Hip Joint

2021

Veterinary Arthroscopy for the Small Animal Practitioner

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Minimally invasive technique for coxofemoral luxation stabilisation using transarticular toggle system: a cadaveric study

Abstract: Closed reduction and stabilisation of coxofemoral luxations can be achieved using this minimally invasive technique. Refinements to the technique may be needed for its application in clinical cases due to relative high incidence of femoral head cartilage damage.

Cited by 7 publications

References 21 publications

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

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

Arthroscopic-Assisted Toggle Rod Stabilization in Canine Coxofemoral Luxation: A Cadaveric Study

Hip Joint

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