Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: A cadaveric study.

Objective: To (1) Describe the proximal lateral insertion portal for the placement of an intra-articular distraction lever. (2) Assess for associated damage with the insertion of the lever and (3) evaluate the impact of duration of lever use on articular cartilage damage.

Study design: Ex vivo canine cadaveric experimental study.

Animals: Paired canine stifles from seven cadavers (14 stifles from dogs weighing >20 kg).

Methods: A separate 0.5 cm proximal lateral portal was established adjacent to the lateral scope portal. A standard Ventura stifle thrust lever (VSTL) was inserted without removing the arthroscope. In Group A, the VSTL was placed in distraction for 5 min while in Group B the VSTL was placed for 10 min. The stifle joints were disarticulated and evaluated for associated damage to the long digital extensor tendon and iatrogenic articular cartilage injury (IACI) via India ink assay.

Results: No damage to the long digital extensor tendon was noted in any of the specimens during dissection. Superficial IACI was present in all specimens. There were no differences between groups when assessing for overall IACI.

Conclusion: A proximal lateral portal and insertion of a standard VSTL can be performed without removing the arthroscope.

Clinical significance: The use of a proximal lateral lever portal without repositioning the arthroscope was repeatable without damaging the long digital extensor tendon. A duration of up to 10 min in which the thrust lever was engaged did not result in increased visual cartilage damage.