Arthroscopy

Arthroscopy is a specialised surgical procedure used quite commonly in humans and now more frequently in dogs and even cats. Of course arthroscopy has been used for a long time in horses due to the large joint spaces.

Before arthroscopy became available the investigation and surgical treatment of joint diseases or injuries was by open surgical technique. Open surgical technique or arthrotomy involves complete opening up of the joint by making a surgical incision through the skin, muscles, joint capsule and synovial membrane, with closure by many stitches.

The degree of trauma to the joint is significant with arthrotomy. Surprisingly even with arthrotomy the visualisation of all joint compartments was still difficult due to the tight spaces and inaccessible spaces of some joints. Because arthroscopy involves inserting a very small rigid camera (scope) with very bright light emitting from the end the whole joints could be inspected more easily in some joints that could be achieved by arthrotomy.

The image is enlarged and put up on a monitor in real time to allow for closer examination. The scope is inserted through a stab incision and only takes one stitch to close up afterwards, so the surgical trauma is minimal. Furthermore through other stab incisions some instruments could be inserted as well to allow for surgical treatment. One such instrument is the shaver which is a motorised cutting tool that can be only 2 mm wide at its tip.

The degree of advancement in human arthroscopic surgery allows for practically all types of operations to be done. The commonest joints that can have arthroscopy in the dog are the shoulder, elbow, stifle (knee) and the hip. It would be considered the gold standard for diagnostic procedures of the shoulder and elbow being used to diagnose soft tissue injuries such as biceps tenosynovitis, elbow incongruenty, OCD, and other soft tissue or cartilage pathology.

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