Page 74 - Clinical Manual of Small Animal Endosurgery

62 Clinical Manual of Small Animal Endosurgery

Table 2.4 (Continued)

Gross characteristics Score
Normal: opal white, semi-translucent, smooth, with sparse, well-defined blood vessels 0
Slight: focal involvement, slight discoloration, visible proliferation/fimbriation/ 1
thickening, notable increase in vascularity
Mild: diffuse involvement, slight discoloration, visible proliferation/fimbriation/ 2
thickening, notable increase in vascularity
Moderate: diffuse involvement, severe discoloration, consistent notable proliferation/ 3
fimbriation/thickening, moderate vascularity
Marked: diffuse involvement, severe discoloration, consistent and marked 4
proliferation/fimbriation/thickening, diffuse hypervascularity
Severe: diffuse involvement, severe discoloration, consistent and severe proliferation/ 5
fimbriation/thickening, thickening to the point of fibrosis, and severe
hypervascularity
L, lateral; M, medial.

the surgical assistant in combination with ideal placement of the arthro-
scopic portal. Alternatively, a stifle distraction device (Fig. 2.14) can be
used to obtain a good view of the meniscus and to increase the working
space for instruments. Meniscal inspection is more readily achieved when
the cranial cruciate ligament is ruptured and debrided prior to attempting
to view the menisci. A blunt probe is useful to manipulate the meniscus
at the same time as the cranial thrust manoeuvre is performed to identify
non-displaced tears.

Investigative arthroscopy of the hip

Current indications for arthroscopic evaluation of the hip include the
investigation of some forms of hip pain and the assessment of the hip
joint prior to performing pelvic osteotomy surgery for hip dysplasia.
With the patient in lateral recumbency, the arthroscope portal is created
following the routine of first placing the locator needle to identify the
joint space, followed by joint distension, and then placing the arthro-
scope portal at 12 o’clock with reference to the femoral head. An assist-
ant applies traction to the limb to distract the joint space and facilitate
insertion of the arthroscope. When the arthroscope is fully inserted, the
soft tissues of the acetabular fossa and the round ligament of the head
of the femur are initially viewed. Controlled retraction on the scope
brings the acetabular cartilage into view and systematic tilting of the
arthroscope with directed rotation of the light post, combined with
manipulation of the limb by the assistant enables inspection of the articu-
lar surfaces of the femoral head and the acetabulum, the acetabular
labrum and the joint capsule. Cartilage and soft-tissue health or disease
should be recorded using a hip-joint-specific chart.