Page 79 - Clinical Manual of Small Animal Endosurgery

Chapter 3

Operative Arthroscopy

Martin R. Owen

Arthroscopically assisted surgery of the canine elbow

Indications for arthroscopic surgery of the elbow include:

• medial compartment disease,
• ununited anconeal process,
• septic arthritis.

Whereas arthroscopic procedures probably have reduced risk of infection
compared to open surgeries, perioperative antimicrobial therapy
is recommended following standard surgical protocols. Elbow arthros-
copy is routinely performed from the medial aspect of the elbow joint
since most lesions affecting the elbow can be investigated and treated
with access to the joint from the medial aspect. A 2.4 mm arthroscope
is recommended for elbow arthroscopy in large-breed dogs since this
scope gives a good field of view and the fluid flow rates are suitable to
maintain a clear view during surgical procedures. A 1.9 mm scope is
preferable in smaller elbow joints in order to access the joint without
risking iatrogenic damage to articular surfaces and to navigate the articu-
lar space without interfering with the surgical instruments in the limited
space. However, this small arthroscope yields a significantly reduced field
and depth of view hence greater arthroscopic skill is required to perform
procedures. The resistance to fluid flow rate of the standard 2.2 mm-
diameter cannula surrounding the 1.9 mm scope requires a pressure
pump and, even with pressurised fluid flow, achieving adequate fluid

Clinical Manual of Small Animal Endosurgery, First Edition. Edited by Alasdair Hotston Moore and
Rosa Angela Ragni.
© 2012 Blackwell Publishing Ltd. Published 2012 by Blackwell Publishing Ltd.