Arthroscopy in Cattleby Hélène Lardé, Sylvain Nichols

Veterinary Clinics of North America: Food Animal Practice

About

Year
2014
DOI
10.1016/j.cvfa.2013.11.004
Subject
Food Animals

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Text

Arthroscopy in Cattle

Technique and Normal Anatomy

Hélène Lardé, Dr Med Vet, DESa,*, Sylvain Nichols, DMV, MSb

Studies have recently highlighted the differences between the two species and have shown that cattle articulations need to be approached differently those of the horse.5

This article serves as a guide to bovine arthroscopy. Emphasis is placed on equipment, technique, and normal anatomy. Different disorders that can benefit from arthroscopy are discussed elsewhere in this issue.

ARTHROSCOPY VERSUS ARTHROTOMY

Arthroscopy has all the advantages of minimally invasive surgery. It improves evaluation of the articular cartilage, it allows evaluation of intra-articular structures (meniscus, ligaments, and bones) and pouches, it decreases hospitalization time, and it speeds up recovery.6 It is a complement to other diagnostic imaging techniques (radiography and ultrasonography) and helps determine the prognosis of joint disease.

Hospital), Univerb Department of

Clinical Sciences, Faculty of Veterinary Medicine, Universite´ de Montre´al, 3200 Rue Sicotte,

St-Hyacinthe, Quebec J2S 2M2, Canada * Corresponding author.

E-mail address: helene.larde@umontreal.ca

Vet Clin Food Anim 30 (2014) 225–245a Centre Hospitalier Universitaire Ve´te´rinaire (Veterinary Medicine Teaching site´ de Montre´al, 3200 Rue Sicotte, St-Hyacinthe, Quebec J2S 2M2, Canada;popular among food animal surgeons because of the prohibitive cost of the equipmentINTRODUCTION

Arthroscopy in cattle was first described many years ago.1–3 However, it remains unneeded and the necessity to do the procedure under general anesthesia. The arthroscopic approach to the bovine joints is described to be similar to that in the horse.4

KEYWORDS  Cattle  Arthroscopy  Surgery  Anatomy

KEY POINTS  Arthroscopy has all the advantages of minimally invasive surgery in cattle.  Specialized equipment and knowledge of normal joint anatomy of cattle are mandatory for successful arthroscopy.  The surgical technique is different in cattle compared with the horse. Thick skin and joint capsules complicate movement of the arthroscope within the joints.  In cattle, septic arthritis and osteochondrosis are the most frequent disorders suitable for arthroscopic treatment.http://dx.doi.org/10.1016/j.cvfa.2013.11.004 vetfood.theclinics.com 0749-0720/14/$ – see front matter  2014 Elsevier Inc. All rights reserved.

Despite these advantages, arthroscopy is not routinely performed on cattle for reasons related to the species and to the practice. First, specialized and expensive equipment is needed to perform arthroscopy and there is a steep learning curve to become familiar with the procedure. In adult cattle, thick joint capsules and thick skin make it difficult to manipulate the scope. Artiodactyl species have smaller distal joints (interphalangeal joints) and range of movement is limited in the metacarpophalangeal joint.5 Adding to this, abnormal findings like proliferative synovium and fibrin formation make observation of joint structures even more difficult. General anesthesia is another drawback to performing arthroscopy in cattle. It is essential for a thorough and safe arthroscopic examination, which increases the cost of the procedure. All these factors have contributed to make arthroscopy in cattle a procedure exclusive to valuable cows in referral hospitals. However, with the value of purebred cattle continuing to increase, arthroscopic procedures for both septic and nonseptic joint disease should become more popular because the advantages compared with arthrotomy are substantial.

EQUIPMENT AND SURGERY SUITE

The equipment needed for bovine arthroscopy is similar to the equipment used in horses.

Arthroscope

A 4-mm diameter arthroscope, 160 to 180 mm in length, with a 30 viewing angle creating a field of view of 115 is usually used (Fig. 1). In narrow joints, a scope with 

Larde´ & Nichols226a 70 viewing angle can be used to increase the field of view.

Fig. 1. Instruments needed to perform an arthroscopy. A, light cable and camera; B, 4-mm arthroscope; C, arthroscopic sleeves; D, graduate probe; E, various size and type of

Ferris-Smith rongeurs; F, various types and sizes of bone curettes.

Arthroscopy in Cattle 227Cannula with Adapted Sharp and Blunt Trocars

Blunt or sharp trocars are placed inside the arthroscopic stainless steel sleeve (outer diameter, 5.5 mm; see Fig. 1). The skin is sharply incised (1 cm) with a number 10 scalpel blade. The subcutaneous tissue and the joint capsule are incised with a number 11 scalpel blade. The trocar/sleeve unit is inserted through the joint capsule and synovial membrane with a twisting motion until its tip moves freely in the joint.

In mature cattle, if the joint capsule is not incised before penetration of the joint, the sharp trocar must be used.

The trocar is then replacedby the arthroscope. The arthroscopic sleeve is essential to protect the scope from bending. Because of the thick joint capsule, stress is often placed on the scope/sleeve unit to seeparticular areas of the joints. The sleeve also protects the lens from scratches and allows continuous flow of fluids during the procedure.

Light Source

A cold light source is required. It is directly connected to the arthroscope by a fiber light cable. Several light sources are available (xenon, halogen, tungsten, mercury, and so forth), with xenon considered to be the best.

Video Camera

Direct visualization through the eyepiece of the scope is possible, but pictures and videos cannot be recorded and saved this way. The proximity of the surgeon’s head also increases the risk of contaminating the surgical field. A video camera is ideally connected directly to the arthroscope and to a processor that projects the images on a monitor. The monitor is on the arthroscopic tower, which can be positioned according to the surgeon’s preference.

Video Capture Unit

Theprocedure canbe recorded at lowcost on aDVD recorder. Thedisadvantage of this technology is that the videos are not readily available for computer editing, but it is adequate to keep in the medical record. More expensive medical recording units are available. With this technology, the surgeon can take pictures and control the video recording. The videos are available in many formats that are readily available for computer editing.