Evaluation of a distractor to increase joint space of the stifle joint in dogs: a cadaveric study

Rovesti, Gian Luca; Devesa-Garcia, V.; Urrutia, Paula; Román, Francisco; Rodríguez-Quiros, Jesus

doi:10.3415/vcot-14-04-0058

Cited by 5 publications

(8 citation statements)

References 37 publications

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“…However, the visualization of menisci can be difficult: stable joints or chronic cases may affect their evaluation. The use of a femoral distractor during arthroscopic procedures has been described in both human [ 11 , 12 ] and veterinary medicine [ 3 , 8 – 10 , 13 ]. It has been reported that stifle joint distraction facilitates joint access, visualization of intra-articular structures, as well as the diagnosis and treatment required.…”

Section: Discussionmentioning

confidence: 99%

“…The distractor device was applied as described previously [ 13 ]. A 1.5-mm diameter K-wire was placed through the femoral condyles, halfway between the patella and the fibular head in a latero-medial direction and connected to a traction stirrup (Ad Maiora s.r.l., Cavriago, Italy).…”

Section: Methodsmentioning

confidence: 99%

“…Then, the distractor (Titan distractor, Ad Maiora s.r.l., Cavriago, Italy) was connected to the stirrups (Fig. 1 ) [ 13 ].

Fig.…”

Section: Methodsmentioning

confidence: 99%

“…It has been reported to be necessary during meniscal transplantation since it facilitates suture placement [ 12 ]. In veterinary medicine, a few studies have been published regarding the use of a joint distractor in the stifle joint during arthroscopy [ 3 , 9 , 10 , 13 ]. Kim et al [ 8 ] described the use of a stifle distractor in cadaveric joints of toy breed dogs for performing medial meniscal release; Böttcher et al [ 3 ] described the use of a stifle distractor technique in a case series to improve visualization of the medial meniscus and to perform partial meniscectomy if needed; Gemmil and Farrell [ 10 ] evaluated a stifle distraction technique in cadaveric stifles and client-owned dogs and performed partial meniscectomy in five cases.…”

Section: Introductionmentioning

confidence: 99%

“…In veterinary medicine, intra-articular pin placement while using an invasive pin distractor in the stifle of two dogs has been described [ 3 ]. However, other studies report no complications, tissue damage or fractures when using an invasive joint distractor in different cadaveric joints [ 13 , 16 – 18 ]. Complications were also not observed in a recent clinical study [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Facilitation of arthroscopic visualization and treatment of meniscal tears using a stifle joint distractor in the dog

Rovesti¹,

Devesa²,

Bertorelli³

et al. 2018

BMC Vet Res

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BackgroundStifle arthroscopy has been described to have high sensitivity and specificity in the evaluation of menisci in dogs, particularly for the medial meniscus. However, the visualization of menisci can be difficult. The use of femoral distractors in human medicine has been described to simplify demanding surgical procedures, such as meniscus transplantation. In veterinary medicine, stifle distraction has been reported to facilitate access to the joint and visualization of intra-articular structures, but there are no studies reporting the use of a stifle distraction technique while performing challenging surgical procedures, such as meniscal suture, in clinical patients.The objective of this study was to evaluate the feasibility, effectiveness and safety of stifle distraction to achieve consistent visualization of menisci and to facilitate performing arthroscopic procedures in clinical patients with stifle disease. Initial arthroscopic evaluation of the stifle joint was performed without distraction in the study population consisting of 13 dogs with naturally occurring stifle disease. The criteria for inclusion was prospectively set as the observation of a frank disease or anomaly of the menisci that could not be further treated or clarified without the risk of damaging the joint cartilage due to the requested manoeuvres. After the first examination, distraction was applied in order to complete the assessment of menisci. After achieving an accurate diagnosis, partial meniscectomy or meniscal repair was performed as needed while maintaining the distraction.ResultsComplete visualization and assessment of menisci were achieved thanks to the use of distraction. This manoeuvre facilitated access to the required area of the involved meniscus, and meniscal treatment could be successfully performed without damaging the articular cartilage. During the follow-up period, no postoperative complication related to the distraction or to the arthroscopic procedure was observed.ConclusionsStifle joint distraction during arthroscopy in dogs improves visualization of both menisci, and particularly the caudal horn of the medial meniscus. Despite being a subjective assessment, it is the authors’ opinion that this procedure also increases the ease of performing challenging procedures like meniscal suture, as it enlarges the space available to reach the correct working angulations.

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