Pennsylvania Veterinary Specialty and Emergency Associates at Hickory are proud to announce the addition of arthroscopy to our available services. Minimally invasive techniques such as arthroscopy can greatly increase comfort and speed recovery time for many orthopedic conditions. Common indications for arthroscopy include joint debridement and meniscal evaluation at the time of cruciate surgery, evaluation of the elbow joint and removal of fragmented coronoid processes in elbow dysplasia, removal of bone and cartilage abnormalities in osteochondritis dessicans, and evaluation and treatment of tenosynovitis in the shoulder.
"Pearl" a 2 year old female black Labrador Retriever presented for a second opinion after her referring vet had diagnosed her with right elbow dysplasia. She had a history of right front leg lameness and had been periodically treated with a COX 1 sparing canine NSAID. Radiographs were taken of her hips, shoulders, and elbows. The shoulders were normal. The hips showed early degenerative changes on the left side. The right elbow showed moderate degenerative joint disease with osteophytes present on the medial aspect of the elbow and head of the radius along with blunting of the medial coronoid process. There was sclerosis of the trochlear notch and humeral trochlea. A faint subchondral lucency could be seen in an area of flattening of the articular surface of the humeral trochlea. The left elbow showed milder changes than the right but still showed a blunted medial coronoid process with mild trochlear notch sclerosis.
Pearl's owner agreed to arthroscopy to further evaluate the elbow joints. The dog was placed under general anesthesia. Two portals were created on the medial side of the left elbow. A medial coronoid fragment was removed along with all of the abnormal cartilage. Overall there were mild degenerative changes to the cartilage. Each portal was closed with a single skin suture. Two portals were then used to explore the right elbow. As expected the right elbow showed more extensive damage than the left. The right medial coronoid process fragment was mostly degenerated but the remaining portion was removed. The osteophyte on the radial head was removed. The joint showed moderate cartilage degeneration overall. Two skin sutures were used to close each portal.
Following arthroscopy Pearl received one injection IV of buprenorphine and was then placed on her normal dose of NSAID along with one week of antibiotics. She appeared quite comfortable walking and was sound on all four limbs. At home her owner notes that she is doing well saying, "Well, she wants to be normal except for that stupid collar."
Generally patients recover more quickly following arthroscopic procedures compared to surgical arthrotomy. Abnormal joints may continue to have more degenerative changes over time, but arthroscopic removal of abnormal bone or cartilage may slow progression of the disease process. It also makes the joint more comfortable, similar to removing a stone from your shoe, and gives the pet a greater quality of life. Please call our referral office at (610)825-0402 if you would like to schedule one of your patients for an initial consultation for arthroscopy.