Effects of traction, distension, and joint position on distraction of the hip joint: An experimental study in cadavers

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

“…Some joint distraction techniques have been widely used in human surgery to facilitate arthroscopic procedures, eliminate the need for an assistant and to reduce the potential for iatrogenic damage in several different joints (Correa et al, 2008;de Leeuw et al, 2010;Dienst et al, 2000;Flecher et al, 2011;Hoenecke et al, 2004;O'Brien et al, 1997;Qin-wei et al, 2010;Theken et al, 1992;Yates and Grana, 2010). In veterinary medicine, the use of distractors has been previously reported to reduce diaphyseal fractures (Rovesti et al, 2006a(Rovesti et al, , 2006b.…”

“…Alternatively, however, a hanging limb technique with the dog in dorsal recumbency has also been described to allow for bilateral arthroscopy (Cook and Cook, 2009). Joint distraction has been used in human medicine to enhance arthroscopic visualization in several joints; with studies reporting the use of distraction in the shoulder (Correa et al, 2008;Hoenecke et al, 2004;O'Brien et al, 1997), ankle (de Leeuw et al, 2010;Qin-wei et al, 2010;Theken et al, 1992;Yates and Grana, 2010), elbow (Takahashi et al, 2000), hip (Dienst et al, 2000;Flecher et al, 2011), wrist (Davies et al, 2008) and knee (Hagemeister et al, 2002;Harfe et al, 1998). The role of distraction during arthroscopy is aimed at improvement in the visualization and manipulation of joint structures.…”

“…The increase in the joint space makes use of instruments in the joint easier and safer for the patient, reducing the likelihood of cartilage damage as a consequence of intra-articular surgical maneuvres. However, distraction does have potential complications, such as fractures, ligamentous injury or neurovascular damage (Dienst et al, 2000;Theken et al, 1992). In small animals, there are few reports concerning the development of distractors to help perform arthroscopy (Böttcher et al, 2009;Gemmill and Farrell, 2009;Schulz et al, 2004), and data on the amount of distraction that can be achieved, or concerning the evaluation of potential soft tissue injuries due to the distraction, are completely missing.…”

Basic Hip Arthroscopy: Supine Patient Positioning and Dynamic Fluoroscopic Evaluation

“…16,17 Venting the joint or injecting normal saline solution with joint distention can aid in breaking the suction seal and facilitate distraction across the hip joint; in some instances these forces are reduced to 50 lb (23 kg). 18,19 The complications related to excessive traction force or the duration of the applied traction are well documented and include, but are not limited to, pudendal neurapraxia, sciatic nerve injury, lower-extremity skin compromise, and genital injury.…”

Operative Arthroskopie des Hüftgelenks

“…Bei der Anlage der Portale zur Arthroskopie des Hüftgelenks muss insbesondere die Anatomie des Labrum acetabulare berücksichtigt werden. Es dichtet den "tiefen" Gelenkanteil ab, sodass sogar unter vollständiger Muskelrelaxation eine Vakuumkraft zwischen 120 und 200 N aufrechterhalten wird [21,54]. Zur Separation von Femurkopf und Gelenkpfanne und damit Überwindung des Vakuums und Dehnung der Gelenk über-brückenden Weichteile bedarf es der Anlage von nicht unerheblichen Zugkräften, die nicht selten über 400-500 N liegen.…”