Veterinary Surgeon Performs Arthroscopy

Part of our mission at NorthStar VETS is to educate our clients about what a veterinary specialty center does. I also said I would take you behind the scenes into our surgical suite for an insiders peek …well today is your lucky day!

Our state-of-the-art technology allows us to create videos of the really neat stuff that occurs in the OR.  In the past, we have shared clips of feline brain surgery featuring Dr. Culbert and Dr. Stobie,  sexing turtles by Dr. Doolen, and even the miracle of life with Dr. Tamassia.

Today I am sharing a 2:30 min video of an Arthroscopy done on a young Bernese Mountain Dog by NorthStar’s creator:  Dr. Dan Stobie himelf!

A couple of quick things for you to know about Fragmented Medial Cornoid Process: fragments are another word for (bone chips), and Elbow dysplasia is an inherited disease that primarily affects intermediate and large breed dogs like Bernese Mountain Dog, German Shepherd, Rottweiler, Golden Retriever, and Labrador Retriever.   Other breeds affected are the Newfoundland, Saint Bernard, Mastiff, Springer Spaniel, Austrailian Shepherd, Chow Chow, Shar-Pei, Shetland Sheepdog, and some Terrier Breeds.

Dr. Stobie provided this commentary on the video below for you to understand what is happening:

Fragmented Medial Coronoid Process is one  form of elbow dysplasia that affects young, rapidly growing dogs of large or giant breeds.  Clinical signs usually start around 6mos of age and present as elbow pain, swelling and lameness.  The cause of the condition is multi-factorial and relates to genetics, breed, nutrition and asynchronous growth between the radius and ulna which are two of the 3 bones that make up the elbow joint.  While these 2 bones should grow together at exactly the same rate, in elbow dysplasia, they grow at slightly different rates, resulting in one bone being shorter or longer than the other.  This leads to a more ‘open’ elbow joint and causes the humeral condyles (the 3rd bone that makes up the elbow) to put abnormal pressure or wear on the Medial coronoid process of the ulna.  The excessive pressure causes the coronoid process to break off or fragment resulting in the pain and lameness seen in this form of elbow dysplasia. This fragment or bone chip present in the joint is very irritating to the dog similar to having a rock or stone in one’s shoe.

Previously, surgical removal of the fragment by surgically opening the joint was the only way to treat this condition.  Today arthroscopy is available and allows the veterinary surgeon to see into the joint through a tiny little puncture hole and retrieve the bone chip or fragment.  It also allows us to remove soft or dead cartilage and shave or resurface the joint.  Vascular access channels are then drilled in the subchondral (under cartilage) bone to allow blood vessels to reach the joint surface and promote healing with fibrocartilage.  Fibrocartilage is not as good as the hyaline cartilage we are all born with that normally lines the joint surface, but it is better than bone on  bone contact or no cartilage at all.  Whereas previous open surgical procedures were very painful for dogs and resulted in long recovery periods and lameness and arthritis, arthroscopy (minimally invasive technique for removing the fragment) results in minimal pain or lameness and fast recoveries and return to function.

The following arthroscopic video is from a young Bernese Mountain Dog with a Fragmented Medial Cornoid Process:

1)      Video one shows normal cartilage – white shiny areas – in the elbow and inflamed synovium – inflamed joint lining cells that look like red coral floating in the joint fluid
2)      And
3)      Videos 2 and 3 show us using instruments to isolate and remove the fragment or bone chip from the elbow joint
4)      Video 4 show us using an arthroscopic shaver to remove dead cartilage and resurface the joint
5)      Video 5 shows us using a bone pick to create vascular access channels to promote blood vessel growth to the joint surface so new cartilage can grow in.

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