Iatrogenic cartilage injury associated with the use of stainless‐steel cannulas and silicone‐guarded cannulas for canine stifle arthroscopy

• Published in: Veterinary surgery 2019-11, Vol.48 (8), p.1456-1465
• Main Authors: Cortés, Isaac, Warnock, Jennifer J., Ranganathan, Bharadhwaj, Bobe, Gerd
• Format: Article
• Language: English
• Subjects: Animals; Arthroscopy; Arthroscopy - veterinary; Cadaver; Cadavers; Cannula - adverse effects; Cannulae; Cartilage; Cartilage, Articular - injuries; Dogs - surgery; Exploration; Iatrogenesis; Iatrogenic Disease - veterinary; Injury prevention; Medical materials; Menisci, Tibial - surgery; Meniscus; Silicones; Stainless Steel; Stifle - pathology; Stifle - surgery; Surgery; Veterinary surgeons
• ISSN: 0161-3499; 1532-950X
• DOI: 10.1111/vsu.13288

Objective To determine the ability to reduce iatrogenic cartilage injury (IACI) during canine stifle arthroscopy by using a silicone arthroscope cannula guard. Study design Ex vivo canine cadaver experimental study. Animals Paired canine stifles from 14 cadavers (≥20 kg). Methods Stifles (N = 28) were assigned to unguarded traditional or silicone‐guarded arthroscopy. Stifle arthroscopy and full joint exploration with meniscal probing was performed by a second‐year surgery resident (I.C.) in fourteen canine cadavers, alternating between left and right stifles for guarded vs unguarded arthroscopy. After arthroscopy, stifles were disarticulated, and india ink assay was performed to identify IACI. Total IACI number, lesion length and area, duration of procedure, and procedure difficulty score were recorded for each stifle. Results Unguarded arthroscopy resulted in more total IACI per joint (unguarded 5.2 ± 3.0, guarded 2.4 ± 1.4; P = .02), larger IACI area (unguarded 5.2 ± 4.2 mm2, guarded 2.3 ± 1.5 mm2; P = .02), and IACI length (unguarded 13.6 ± 6.9 mm, guarded 8.6 ± 5.9 mm; P = .03). No difference was identified in duration of procedure (unguarded 11.8 ± 5.2 minutes, guarded 13.8 ± 4.3 minutes; P = .79) or procedure difficulty score (unguarded 1.7 ± 0.6, guarded 1.6 ± 0.6 P = .73). Conclusion Silicone‐guarded arthroscope cannulas decreased IACI number and size during canine cadaveric stifle arthroscopy without increasing duration of procedure or surgical difficulty. Clinical significance Silicone‐guarded arthroscope cannulas may be safer than traditional cannulas for novice veterinary surgeons performing stifle arthroscopy.