Evaluation of a joint distractor to facilitate arthroscopy of the hip joint in dogs

Abstract

OBJECTIVE To evaluate the technical feasibility and efficacy of a hip joint distraction technique, any potential ligamentous damage linked to the procedure, and the effect of joint venting on the maximum distraction achieved. METHODS Twenty hip joints from 11 canine cadavers were evaluated radiographically by standard and stressed projections. Joint distraction was applied with loads from 40 up to 200 N, in 40 N increments, and fluoroscopic images were obtained at each load. At 200 N, a needle was inserted into the joint to achieve a venting effect, and the space was measured again. Standard and stressed radiographs were performed to evaluate potential laxity changes. RESULTS Distraction caused a significant increase in joint space at each load of distraction, although there were some variations. Joint venting produced a significant increase in joint space. A statistically significant difference in joint laxity evaluated radiographically before and after the procedure was recorded. CLINICAL SIGNIFICANCE Use of the distraction apparatus resulted in an increase in joint space. This could be useful for clinical situations where a larger joint space is required such as for arthroscopic procedures. However, loads in excess of 200 N may induce significant increases in joint laxity.

Evaluation of a self-retaining distractor for hip joint arthroscopy in toy breed dogs

“…In a previous report, the feasibility of using a distractor device was evaluated based on joint space distraction length using a special device to accurately load a specific force, but these studies did not perform additional arthroscopic examination [3]. Unlike previous studies, our study was performed in a situation similar to that in a clinic, where surgeons applied a distractor device during hip arthroscopy without assistants, and the increased joint space length, arthroscopic visualization and surgeon’s ease in performing the procedure were assessed.…”

“…However, complications such as distraction-related pain, bone fracture, nerve and soft tissue injuries may occur [3, 10, 14, 16, 17]. According to a human medicine report, pain scores were increased due to traction.…”

“…Hip arthroscopy has become a viable option over the last few years for small animal orthopedic diseases, including hip dysplasia, osteoarthritis, joint evaluation, fracture repair, and bone fragment removal. The procedure offers the advantages of decreased postoperative pain, increased visualization, low morbidity rates, and increased precision [1–3].…”

“…Similarly, the use of distractors to perform arthroscopy in animals was studied in several joints to evaluate the technical feasibility and efficacy [3, 7, 11]; however, to the author’s knowledge, most of these reports were associated with medium to large breed dogs, and they did not perform arthroscopic examinations of hip joint with distractors in toy breed dogs.…”

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

“…No peer‐reviewed studies describe feline hip arthroscopy. In dogs, coxofemoral arthroscopy offers numerous advantages over traditional open surgical techniques, including decreased postoperative pain and morbidity, increased visibility, and increased precision 9–12 . In cats with coxofemoral luxation, arthroscopy offers the potential to assess damage to intra‐articular structures and debride the ligament of the head of the femur (LHF) 13 …”