Silicone Cannula Guards for Canine Stifle Arthroscopy Reduce Iatrogenic Cartilage Injury

 

Introduction: Iatrogenic cartilage injury (IACI) is the most common complication of canine stifle arthroscopy. The objective of this study was to devise a method to decrease IACI during canine stifle arthroscopy using a silicone arthroscope cannula guard. We hypothesized that there would be fewer and smaller IACI in stifles receiving silicone guarded arthroscopy versus unguarded arthroscopy.

Materials and Methods: A 3.0 mm silicone endotracheal tube was trimmed and placed over the 2.7 mm arthroscope cannula, insuring that 2–3 mm of silicone extended beyond the cannula tip. Stifle arthroscopy was performed by a second-year surgery resident on fourteen canine cadavers alternating left and right stifles for guarded versus unguarded arthroscopy. Following arthroscopy, stifles were dissected and the India ink assay performed to identify IACI. Total IACI number, lesion length, and area were recorded for each stifle.

Results: Unguarded arthroscopy resulted in longer IACI (p = 0.02), larger IACI area (p = 0.02), and total IACI number per joint (p = 0.03).

Discussion/Conclusion: These data support our alternative hypothesis: silicone guarded arthroscope cannulas decreased IACI number and size during canine cadaveric stifle arthroscopy. Silicone guarded arthroscopy resulted in significant reduction in cartilage damage. While this may decrease IACI for arthroscopy in general, it may also improve the training process for canine stifle arthroscopy, where there is a steep learning curve, by reducing IACI created by novice arthroscopic surgeons.

Acknowledgment: The authors declare no conflicts of interest and funding acquired from Department of Clinical Sciences, Oregon State University.