Page 63 - Clinical Manual of Small Animal Endosurgery

Diagnostic Arthroscopy 51

Fig. 2.22 The arthroscope is inserted into the cannula, and the fluid
ingress is transferred to the arthroscope sleeve.

where the needle will not be visible through the arthroscope. Care
should be taken to insert the needle sufficiently far from the scope
such that when the needle is replaced with an instrument the sur-
geon’s instrument hand does not interfere with handling of the scope.
Once a suitable location and direction of needle is obtained, a stab
incision is made along the path of the needle to the joint capsule and
the instrument cannula with trocar is inserted along the needle path.
The needle and trocar are removed and arthroscopic surgery com-
mences through the instrument cannula.

Diagnostic arthroscopic investigations

Arthroscopic evaluation enables direct visualisation of intra-articular
structures, generally giving a markedly superior assessment of the
anatomy and any pathophysiological changes within the joint compared
with the findings achieved from imaging techniques and traditional open
arthrotomy. Using a systematic arthroscopic investigative approach, the
majority of the articular space is directly visualised and the appearance
of articular cartilage, synovium and intra-articular structures (e.g. intra-
articular ligaments, tendons, menisci, etc.) can be accurately assessed.
The detailed and magnified view obtained from a systematic examination
of the joint enables the creation of a map or chart of the joint on which
the integrity of articular structures, or pathological changes thereof, and
their degree can be recorded. In addition, the functional integrity of
intra-articular structures can be assessed by manipulation and by probing,