Effects of shoulder distraction on canine shoulder arthroscopy

Koji Aoki, Jun-Yan Sek, Fernando de Paula Freitas, Miriam Bates, Hugues Beaufrere
Vet Surg. 2021 Jan 5. doi: 10.1111/vsu.13562.

Objective: To evaluate the use of the Leipzig distractor during canine shoulder arthroscopy.

Study design: Experimental, ex vivo.

Sample population: Paired shoulder joints from 15 large breed canine cadavers.

Methods: Standard lateral shoulder arthroscopy was performed with or without the use of the Leipzig distractor (n = 15 each). Joint space width, procedure time, and visibility and palpability of the intra-articular structures were assessed during the arthroscopy. After the arthroscopic evaluation, each shoulder joint was disarticulated to assess the area and number of iatrogenic articular cartilage injury (IACI) lesions. Sites around the distraction device were assessed for the presence of iatrogenic injury.

Results: With shoulder distraction, median joint space width was 4 mm larger (P = .01), IACI area was 9.5 mm2 lower (P = .003), and there were two fewer total number of IACI lesions (P = .004) compared with nondistracted shoulders. The mean total surgery time was 93 seconds shorter (P = .01) in distracted shoulders. Although distraction was associated with increased visibility of the supraglenoid tubercle (P = .015), no significant differences were found for other intra-articular structures for their visibility and palpability. Unexpected lesions at the sites around the distraction device were not encountered.

Conclusion: Use of the distraction device decreased the area and incidence of IACI lesions and shortened the arthroscopy time. However, no improvement was found in the visibility or palpability of the intra-articular structures.

Clinical significance: Although additional clinical studies are required to evaluate the effect of the distraction device on pathologic articular conditions and intraoperative manipulation, the use of a shoulder distraction device might improve the outcomes of shoulder arthroscopy by decreasing IACI and arthroscopy time.