Evaluation of a small-bore needle arthroscope for diagnosis and treatment of medial coronoid disease in dogs: a pilot study with short-term assessment

• Published in: New Zealand veterinary journal 2023-05, Vol.71 (3), p.152-158
• Main Authors: Garnier, P, Dekerle, B, Vial, J, Maurice, E, Manassero, M, Viateau, V
• Format: Article
• Language: English
• Subjects: Animals; Arthroscopes; developmental elbow disease; Dog; Dog Diseases - diagnosis; Dog Diseases - surgery; Dogs; elbow; Forelimb - surgery; Hospitals, Animal; Hospitals, Teaching; Joint Diseases - diagnosis; Joint Diseases - surgery; Joint Diseases - veterinary; Lameness, Animal - diagnosis; Lameness, Animal - surgery; medial coronoid process; needle arthroscopy; Pilot Projects; standard arthroscopy
• ISSN: 0048-0169; 1176-0710
• DOI: 10.1080/00480169.2023.2181239

Dogs (n = 15) that were presented to a single veterinary teaching hospital with elbow dysplasia-associated lameness between September 2021 and May 2022, and were determined to require arthroscopy based on imaging results, were prospectively recruited into the study. The median duration of lameness was 4 (min 1, max 24) months. Various breeds were represented with a median body weight of 31.6 (min 15, max 46.4) kg and median age at presentation of 14 (min 8, max 83) months. Results of imaging modalities (CT) were consistent with medial coronoid disease with fissured or fragmented medial coronoid process in all dogs. Feasibility of the needle arthroscopy (NA) procedure was firstly assessed in a preliminary cadaveric study in forelimbs (n = 10) collected from 10 adult dogs euthanised for reasons unrelated to the study. Elbow exploration was performed through a medial approach beginning with NA (1.9 mm 0° angle scope) followed by standard arthroscopy (SA; 2.4 mm 30° angle scope). The quality and extent of visualisation (scored through the number of anatomical structures visualised) were recorded and statistically compared. As the cadaver study indicated that NA allowed safe inspection of all structures in medial/caudal compartments, this procedure was then used in the dogs requiring treatment. In the clinical setting, elbow exploration was successful in all dogs and the treatment (removal of osteochondral fragments) was performed without requiring conversion into SA. One month after surgery, all dogs had an improvement in their lameness score (0-5) and 12/15 dogs were no longer lame. There was a reduction in Canine Orthopaedic Index scores measured a median of 99 (min 47, max 180) days after surgery (24 (IQR 19.5-31.5)) compared to the pre-operative period (49 (IQR 46.5-57); p