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

 

 Buy Article Permissions and Reprints

Summary

Objective: To evaluate the technical feasibility and efficacy of a joint distraction technique to increase the stifle joint space and assess potential soft tissue damage due to the distraction.

Methods: Twenty stifle joints of twelve canine cadavers without evidence of disease were radiographically evaluated by medio-lateral, cranio-caudal and varus-valgus stressed projections. Joint distraction was applied with loads from 40 N up to 200 N, and the joint space achieved was measured on radiographic images. Distraction plus distension with saline was subsequently applied and measured. Varus-valgus stressed projections were repeated after distraction to evaluate a potential increase in joint laxity.

Results: Distraction produced a significant increase of the joint space for most of the evaluated loads. Distraction plus distension produced a significant increase for most of the loads compared to the distraction alone. No ensuing joint laxity could be inferred from the post-distraction radiographic evaluation.

Clinical significance: Stifle distraction produces an increase of the joint space, which is wider when intra-articular saline is injected. This may be potentially useful for improving joint structure visualization and facilitating arthroscopic procedures, thus reducing the potential for iatrogenic damage to intra articular structures. No soft tissue damage could be inferred by radiographic pre- and post-procedure comparison. Further clinical studies are required to evaluate potential neurovascular complications.

• References

• 1 Beale BS, Hulse DA, Schulz KS. et al. History of arthroscopy. In: Small Animal Arthroscopy. Philadelphia, PA: WB Saunders; 2003: 1-3.
  Google Scholar
• 2 Ridge PA. A retrospective study of the rate of postoperative septic arthritis following 353 elective arthroscopies. J Small Anim Pract 2011; 52: 200-202.
  CrossrefPubMedGoogle Scholar
• 3 Hoelzler MG, Millis DL, Francis DA. et al. Results of arthroscopic versus open arthrotomy for surgical management of cranial cruciate ligament deficiency in dogs. Vet Surg 2004; 33: 146-153.
  CrossrefPubMedGoogle Scholar
• 4 Bright SR. Arthroscopic-assisted management of osteochondritis dissecans in the stifle of a cat. J Small Anim Pract 2010; 51: 219-223.
  CrossrefPubMedGoogle Scholar
• 5 Bright SR, May C. Arthroscopic partial patellectomy in a dog. J Small Anim Pract 2011; 52: 168-171.
  CrossrefPubMedGoogle Scholar
• 6 Smith TJ, Baltzer WI, Löhr C. et al. Primary synovial osteochondromatosis of the stifle in an English Mastiff. Vet Comp Orthop Traumatol 2012; 25: 160-166.
  Article in Thieme ConnectPubMedGoogle Scholar
• 7 Bertrand SG, Lewis DD, Madison JB. et al. Arthroscopic examination and treatment of osteochondritis dissecans of the femoral condyle of six dogs. J Am Anim Hosp Assoc 1997; 33: 451-455.
  CrossrefPubMedGoogle Scholar
• 8 Böttcher P, Winkels P, Oechtering G. A novel pin distraction device for arthroscopic assessment of the medial meniscus in dogs. Vet Surg 2009; 38: 595-600.
  CrossrefPubMedGoogle Scholar
• 9 Pozzi A, Hildreth BE, Rajala-Schultz PJ. Comparison of arthroscopy and arthrotomy for diagnosis of medial meniscal pathology: an ex vivo study. Vet Surg 2008; 37: 749-755.
  CrossrefPubMedGoogle Scholar
• 10 Ridge PA. Isolated medial meniscal tear in a Border Collie. Vet Comp Orthop Traumatol 2006; 19: 110-112.
  Article in Thieme ConnectPubMedGoogle Scholar
• 11 Jakob RP, Stäubli HU, Zuber K. et al. The arthroscopic meniscal repair. Techniques and clinical experience. Am J Sports Med 1988; 16: 137-142.
  CrossrefPubMedGoogle Scholar
• 12 Kurtz CA, Bonner KF, Sekiya JK. Meniscus transplantation using the femoral distractor. Arthroscopy 2006; 22: 568.e1-e3.
  PubMedGoogle Scholar
• 13 Gemmill TJ, Farrell M. Evaluation of a joint distractor to facilitate arthroscopy of the canine stifle. Vet Surg 2009; 38: 588-594.
  CrossrefPubMedGoogle Scholar
• 14 Austin B, Montgomery RD, Wright J. et al. Evaluation of three approaches to meniscal release. Vet Comp Orthop Traumatol 2007; 20: 92-97.
  Article in Thieme ConnectPubMedGoogle Scholar
• 15 Theken R, Reiman P, Njus G. et al. Ligament strain and ankle joint opening during ankle distraction. Arthroscopy 1992; 8: 469-473.
  CrossrefPubMedGoogle Scholar
• 16 Dienst M, Seil R, Godde S. et al. Effects of traction, distension, and joint position on distraction of the hip joint: an experimental study in cadavers. Arthroscopy 2002; 18: 865-871.
  CrossrefPubMedGoogle Scholar
• 17 Bushnell BD, Hoover SA, Olcott CW. et al. Use of an independent skeletal distractor in hip arthroscopy. Arthroscopy 2007; 23: 106.e1-e4.
  PubMedGoogle Scholar
• 18 Schulz KS, Holsworth IG, Hornof WJ. Self-retaining braces for canine arthroscopy. Vet Surg 2004; 33: 77-82.
  CrossrefPubMedGoogle Scholar
• 19 Rodriguez-Quiros J, Rovesti GL, Devesa V. et al. Evaluation of a joint distractor to facilitate arthroscopy of the tibio-tarsal joint in dogs. J Small Anim Pract 2014; 55: 213-218.
  CrossrefPubMedGoogle Scholar
• 20 Mawby DI, Bartges JW, d' Avignon A. et al. Comparison of various methods for estimating body fat in dogs. J Am Anim Hosp Assoc 2004; 40: 109-114.
  CrossrefPubMedGoogle Scholar
• 21 Comerford EJ. The stifle joint. In Barr FJ, Kirberger RM. editors Manual of canine and feline musculoskeletal imaging. Gloucester, UK: BSAVA; 2006: 135-149.
  Google Scholar
• 22 Mostafa AA, Griffon DJ, Thomas MW. et al. Proximodistal alignment of the canine patella: radiographic evaluation and association with medial and lateral patellar luxation. Vet Surg 2008; 37: 201-211.
  CrossrefPubMedGoogle Scholar
• 23 Goddard AL, Millis D. Morphology of the Canine Stance. Honors Thesis Project. University of Tennessee 2005 Available from http://trace.tennessee.edu/utk_chanhonoproj/855
  PubMedGoogle Scholar
• 24 Apelt D, Kowaleski MP, Dyce J. Comparison of computed tomographic and standard radiographic determination of tibial torsion in the dog. Vet Surg 2005; 34: 457-462.
  PubMedGoogle Scholar
• 25 Whatmough C, Moores AP, Magalhaes RS. et al. Factors affecting width of the canine femorotibial joint space in nonweight-bearing radiographs. Vet Radiol Ultrasound 2008; 49: 129-134.
  CrossrefPubMedGoogle Scholar
• 26 Issa SN, Dunlop D, Chang A. et al. Full-limb and knee radiography assessments of varus-valgus alignment and their relationship to osteoarthritis disease features by magnetic resonance imaging. Arthritis Rheum 2007; 57: 398-406.
  CrossrefPubMedGoogle Scholar
• 27 Gottsauner-Wolf F, Grabowski JJ, Chao EY. et al. Effects of freeze/thaw conditioning on the tensile properties and failure mode of bone-muscle-bone units: a biomechanical and histological study in dogs. J Orthop Res 1995; 13: 90-95.
  CrossrefPubMedGoogle Scholar
• 28 Woo SL, Orlando CA, Camp JF. et al. Effects of postmortem storage by freezing on ligament tensile behavior. J Biomech 1986; 19: 399-404.
  CrossrefPubMedGoogle Scholar
• 29 Moon DK, Woo SL, Takakura Y. et al. The effects of refreezing on the viscoelastic and tensile properties of ligaments. J Biomech 2006; 39: 1153-1157.
  CrossrefPubMedGoogle Scholar
• 30 Huang H, Zhang J, Sun K. et al. Effects of repetitive multiple freeze-thaw cycles on the biomechanical properties of human flexor digitorum superficialis and flexor pollicis longus tendons. Clin Biomech 2011; 26: 419-423.
  CrossrefPubMedGoogle Scholar
• 31 Wolf RE, Scavelli TD, Hoelzer MG. et al. Surgical and postoperative complications associated with tibial tuberosity advancement for cranial cruciate ligament rupture in dogs: 458 cases (2007-2009). J Am Vet Med Assoc 2012; 240: 1481-1487.
  CrossrefPubMedGoogle Scholar
• 32 Hayes GM, Langley-Hobbs SJ, Jeffery ND. Risk factors for medial meniscal injury in association with cranial cruciate ligament rupture. J Small Anim Pract 2010; 51: 630-634.
  CrossrefPubMedGoogle Scholar
• 33 Simkin PA. Feeling the pressure. Ann Rheum Dis 1995; 54: 611-612.
  CrossrefPubMedGoogle Scholar
• 34 Byrd JW, Chern KY. Traction versus distension for distraction of the joint during hip arthroscopy. Arthroscopy 1997; 13: 346-349.
  CrossrefPubMedGoogle Scholar
• 35 Williams P, Simpson H, Kyberd P. et al. Effect of rate of distraction on loss of range of joint movement, muscle stiffness, and intramuscular connective tissue content during surgical limb-lengthening: a study in the rabbit. Anat Rec 1999; 255: 78-83.
  CrossrefPubMedGoogle Scholar
• 36 de Leeuw PAJ, van Dijk CN. Fixed distraction is not necessary for anterior ankle arthroscopy. Knee Surg Sports Traumatol Arthrosc 2009; 17: 1399-1400.
  CrossrefPubMedGoogle Scholar
• 37 Dismukes DI, Fox DB, Tomlinson JL. et al. Determination of pelvic limb alignment in the large-breed dog: a cadaveric radiographic study in the frontal plane. Vet Surg 2008; 37: 674-682.
  CrossrefPubMedGoogle Scholar
• 38 Voss K, Wiestner T, Galeandro L. et al. Effect of dog breed and body conformation on vertical ground reaction forces, impulses, and stance times. Vet Comp Orthop Traumatol 2011; 24: 106-112.
  Article in Thieme ConnectPubMedGoogle Scholar