A modified approach to portal placement for arthroscopic management of osteochondritis dissecans lesions of the tarsocrural joint in 15 dogs (19 tarsi)

Authors
Benoît Cruciani, Lucile Gros, Guillaume Ragetly
Journal
Vet Surg. 2024 Oct 30. doi: 10.1111/vsu.14177.

Objective: To describe the surgical technique and outcomes of arthroscopic treatment for talar osteochondritis dissecans (OCD) in dogs, using scope and instrument portals placed on the same side of the joint as the lesion.

Study design: Retrospective case series.

Animals: Fifteen client-owned dogs (19 tarsi).

Methods: The records of dogs with talar OCD lesions managed by arthroscopy using this modified approach to portal placement were reviewed. Signalment, owner-completed questionnaires-the Canine Brief Pain Inventory (CBPI) and a visual analog scale (VAS)-together with clinical and imaging data, surgical techniques, and postoperative complications were recorded. Mid- to long-term outcomes (over 6 months) were assessed using orthopedic examinations, osteoarthritis radiographic scores, and owner-completed questionnaires.

Results: Visualization of the affected articular structures was adequate in all cases. The multiple OCD fragments identified on CT scans were removed without intraoperative complication in 17 tarsi. Mini-arthrotomy was performed in one dog and mini-tenotomy of the deep digital flexor sheath was performed in another. Minor postoperative complications (synovial cysts) were reported in four cases. Mid- to long-term outcomes were good to excellent in 11 of the 14 dogs with substantial improvement in lameness, CBPI, and VAS scores compared with preoperative results. Degenerative joint disease progression was observed in 10 of the 14 cases.

Conclusion: The modified arthroscopic technique resulted in few complications, rapid clinical improvement, and full or acceptable function in most cases.

Clinical significance: This modified approach to portal placement is an appealing and suitable alternative to the approach described previously for managing tarsal OCD lesions.

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