Arthroscopy or keyhole surgery involves placing a fibre optic camera into a joint. It has been performed in people since the 1940s but only recently has it become available for animals.
What does the procedure involve?
The actual arthroscopy procedure itself is quite straight forward, it involves the patient (usually a dog) being anaethetised. Once anaesthetised xrays of the suspect joint are taken. The joint is then aseptically prepared and the joint is distended with sterile saline.The arthroscope is then placed via small stab incisions. The camera can then be attached and a detailed picture of the inside of the joint is established.
Once any surgical procedures have been performed the scope is taken out and the incisions are generally so small that they do not even need stitching.
The dog then wakes up from anaesthesia and depending on the case usually goes home that evening.
What are the uses?
Because the image is viewed on a television screen and the arthroscope greatly magnifies the image we can see things that cannot be seen any other way such as cartilage damage, ligament tears and meniscal damage. Some surgical procedures can also be performed such as removal of fragments of bone, cutting of diseased tendons and treatment of meniscal tears in large dogs. If these procedures are performed arthroscopically the pain suffered after the surgery is minimal in comparison with traditional methods where the whole joint had to be opened up, meaning dogs can return to normal use more quickly.
The majority of cases seen are either stifles (or knees), elbows or shoulders but hips, hocks and carpi (wrist area) are also frequently scoped. The great thing is the low morbidity associated with arthroscopy, in other words it causes very little problems and yet so much important information can be yielded and beneficial surgical procedures performed. On the whole the dogs are no more lame 48 hours after the surgery than they were before, but this does not mean the post operative rehab is not important.
What are the risks?
The problems associated with arthroscopy seem very low. In human knee arthroscopy a complication rate of 1 in 200 is quoted but in surveys in the veterinary world this figure is much lower (1:2000)
