Specialist Veterinary Arthroscopy equipment
Stryker 3 chip camera
and console
Dynonics 1.9mm, 2.4mm & 2.7mm arthroscopes
Stryker xenon light source
Styker TPS & Shaver
Arthrocare bipolar / RF coblation
3M arthroscopy pump
Shutt arthroscopic forceps
Stryker SDC 2 image recorder
Elbow Arthroscopy- fragmented coronoid process FCP
Greenmount Veterinary Clinic 72 Gilford Road Portadown Co Armagh Northern Ireland
© GVC
Digital vision
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A Fragmented coronoid process FCP lesion seen as a continuous roughened line across the cartilage surface on arthroscopic examination in this 9 month old chocolate labrador ,
In situ Fragmented coronoid process
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A 2.5mm currette is used to demonstrate the edges of the fragmented coronoid process which can be seen to be loose when elevated slightly with the currette.
The surgical instruments used arthroscopically are very small- approx 2-3 mm in size and the detail of magnification is seen in the videos- during the surgery this view is displayed in HD resolution on a 19” stryker monitor to allow accurate diagnosis and surgery.
This loose fragmented coronoid process which moves on weight bearing is a cause of persistent
pain and will lead to significant DJD if not treated. Both the diseased cartilage and the underlying yellowish coloured avascular subchondral bone must be removed arthroscopically to allow the lesion to heal and the lameness to resolve.
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The fragmented coronoid lesion is now elevated using the 2.5mm currette to enable removal in 1 or 2 large pieces. The yellowish coloured avascular bone can be seen on the underside of the lesion. Avascular bone is bone which has lost it’s blood supply.
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The main fragmented coronoid process lesion (approx 7mm x 7mm) has now been freed and is ready to be grasped using a 2.75mm punch or grasping arthroscopic forceps and removed.
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After removal of the main fragments, the subchondral bone bed is now curretted until healthly bleeding bone is reached, ensuring all avascular bone is removed. This now allows the lesion to heal with replacement of the diseased cartilage with a new fibrocartilage surface.
The fragmented coronoid lesion on the ulnar bone is now fully removed. The view indicates the region where the lesion had been sitting in the foreground and in the background we can see the normal cartilage covering the radial head- which is moving as we rotated the leg.
The edges of the lesion will now be freshened to leave a smooth edge using either a hand burr or a motorised shaver, and the joint is then thoroughly flushed to remove any loose cartilage fragments.
Because arthroscopy is a minimally invasive surgery, both elbows can be examined and treated arthroscopically at one surgery. Due to the small surgical sites of 3mm diameter there is greatly reduced post operative pain compared to open joint surgery so most dogs are walking on the operated legs immediately after surgery, and recover more quickly that after open surgery.
Arthroscopic surgery allows detailed visualisation and surgical treatment of lesions which cannot be seen clearly at open joint surgery with the benefit of less post operative pain, faster recover and very small 3mm operative sites.
Effective pain medications are given intra-articularly immediately post op and followed up with injectable and oral medications for several days
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grasping arthroscopic forceps removing the freed fragment