Page 54 - Clinical Manual of Small Animal Endosurgery

42 Clinical Manual of Small Animal Endosurgery

A right-angled blunt probe is useful for palpating articular cartilage to
assess its mechanical integrity, to identify osteochondral lesions, to
manipulate meniscal tears and to retract soft tissues. An arthroscopic
curette is useful to debride osteochondral and subchondral bone lesions.
A straight curette passes readily through the instrument cannula but an
angled curette can be preferable in some applications to work on surfaces
that are difficult to access. Knives are used to cut soft tissues such as the
soft-tissue attachments of loose osteochondral fragments. The meniscal
knife has a protected blade, making it useful for performing a combina-
tion of blunt and sharp dissection rather like the action of a periosteal
elevator in open surgery. The meniscal knife is very useful for freeing
osteochondral fragments of the coronoid process from its soft-tissue
attachments. Sometimes the unprotected banana knife and hooked knife
are necessary for cutting soft tissues and this is performed with care to
avoid cutting tissue beyond the field of view. A hand burr is an efficient
instrument for debriding and abrading lesions of bone and of cartilage.
Although slower than a powered burr or shaver, a hand burr is inexpen-
sive and its use does not require setting up of the additional equipment
required with power instruments. Grasping forceps are modified alligator
forceps that are fine and delicate in dimension (Fig. 2.12). Some models
are resistant to mechanical failure in use through an ‘overload protection’
mechanism. Grasping surfaces with fine serrations are recommended to
grip tissues with minimal risk of breaking the forceps through overzeal-
ous squeezing of the jaws. Some forceps have locking jaws which help
protect against such misuse. In addition to grasping forceps, a pair of
biting or biopsy forceps can be useful for taking biopsies of soft tissue
and for debriding soft-tissue or meniscal lesions.

Fig. 2.12 Grasping forceps. The second pair from the bottom has a ratchet
that allows the instrument jaws to be locked, preventing overzealous
squeezing.