Veterinary Arthroscopy for the Small Animal Practitioner

Timothy C. McCarthy

• Publisher: Wiley-Blackwell
• Year: 2021
• Print ISBN:
  9781119548973
• eBook ISBN:
  9781119549024
• Edition: 1
• Topic: Medicine
• Subtopic: Veterinary Medicine

Veterinary Arthroscopy for the Small Animal Practitioner delivers a practical guide to all aspects of veterinary arthroscopy for small mammals. The book covers the anatomy, techniques, joint pathology, and operative procedures of arthroscopy.

The book includes a foundational introduction to basic tenets for veterinarians just beginning to use arthroscopy in their work as well as reference images for joint pathology useful to experienced practitioners. Nearly 1000 images are included in the reference, each of which illustrate one or more aspects of specific arthroscopic findings.

Veterinary Arthroscopy for the Small Animal Practitioner draws on the author's 35 years of clinical arthroscopic experience and offers a thorough examination of small animal arthroscopy. The book serves as a powerful demonstration of the centrality, practicality, utility, and necessity of arthroscopic veterinary procedures. Readers will also benefit from topics like:

• A comprehensive introduction to, and discussion of, instrumentation, including arthroscopes, sheaths and cannulas, hand instruments, power equipment, video systems, and fluid management systems
• An exploration of general technique, including anesthesia, patient support, pain management, and postoperative care
• Multiple chapters cover the six most commonly examined joints, including shoulders, elbows, radiocarpal joints, hips, stifles, and the tibiotarsal joints
• Treatment of common conditions diagnosed with arthroscopy
• Discussion of common problems and complications seen with arthroscopy in small animal practice

Ideal for veterinary orthopedic surgeons and general veterinary practitioners, Veterinary Arthroscopy for the Small Animal Practitioner also belongs on the bookshelves of veterinary surgery residents and veterinary students seeking to improve their understanding of small animal arthroscopic surgery, pathology, anatomy, and techniques.

1
Introduction and Instrumentation

1.1 Introduction

Arthroscopy is the most significant advance in small animal orthopedics that has occurred during my 50 years of professional lifetime.

Arthroscopy provides more information about intra‐articular pathology than any other diagnostic technique. The most important advantages of arthroscopy are visual access to more joint area, magnification produced by the telescopes and video systems, excellent illumination, and a clear visual field when continuous irrigation is employed. Arthroscopy is also minimally invasive, reduces trauma, shortens operative times, and decreases recovery times. The small sizes of telescopes available today allow placement into the deepest parts of joints and combined with angulation of the field of view, 30° for most arthroscopes, provide visual access to more area of joints than can be achieved with open surgery. Arthroscopes magnify intra‐articular structures allowing visualization of anatomical details and pathologic changes that are beyond the resolution of radiographs, CT, MRI, or what can be seen with open surgery (Video 1.1). Submacroscopic lesions that elude us with open surgical exploration can be easily seen with arthroscopy. High‐intensity lighting is passed directly through the arthroscope providing perfect illumination of everything in the field of view of the telescope. Irrigation employed with arthroscopy maintains a clear field of view by continuously flushing blood and debris away from the end of the telescope. This is all done with minimally invasive technique and far less tissue trauma than with an arthrotomy. Speed is not the most important criteria or the most important advantage of arthroscopy over open arthrotomy, but for the experienced arthroscopic surgeon, anesthesia and procedure times are significantly shorter than with conventional open surgery. Postoperative recovery after arthroscopy is also much faster than following an open arthrotomy. This time comparison is an important advantage of arthroscopy. Most dogs recover to their preoperative status of lameness and pain within a few hours after arthroscopy. Many dogs are better than their preoperative level of function by the time they are released from the hospital on the day after arthroscopy. Arthroscopy is commonly performed as an outpatient procedure with a release on the same day as surgery. Activity restriction is not needed for portal site healing. The time required for healing of intra‐articular structures after arthroscopy for conditions such as OCD and medial coronoid process disease (MCPD) has not been studied or effectively compared with healing after open surgery.

There are few disadvantages of arthroscopy. The most significant disadvantage is that arthroscopy is the most difficult of all endoscopies to learn. Arthroscopy's technical difficulty with its long slow learning process for both diagnostic applications and for performing corrective surgical procedures makes it a challenge to gain proficiency. Arthroscopy requires considerable practice, patience, and persistence to master. Reasons for arthroscopy's difficulty are related to the small space involved, confinement by rigid bony structures, and the anatomic complexity of some joints such as the stifle. Even with its difficulties, developing proficiency with arthroscopy is within the grasp of most who are willing to make the effort and put in the time to learn. Expense of instrumentation is a relative disadvantage as the cost of the equipment and instrumentation for arthroscopy is significant but is no more than other sophisticated instrumentation used in small animal practice today. The limitation of small patient size is shrinking as instrument size decreases and as our skill level and experience increase.

Arthroscopy is indicated whenever there is a history, physical findings, imaging changes, or laboratory result suggestive of joint disease. A history of lameness, stiffness, difficulty or reluctance to get up, reluctance to go up or downstairs, reluctance to get up and down off the couch or the favorite chair, and inability to get in and out of the car or truck; ...

Table of contents

• Cover
• Table of Contents
• Title Page
• Copyright Page
• Dedication Page
• Preface
• Acknowledgments
• About the Companion Website
• 1 Introduction and Instrumentation
• 2 General Technique
• 3 Shoulder Joint
• 4 Arthroscopy of the Elbow Joint
• 5 Radiocarpal Joint
• 6 Hip Joint
• 7 Stifle Joint
• 8 Tibiotarsal Joint
• 9 Problems and Complications
• Index
• End User License Agreement