182 Surgical Treatment
(A) (B) (C)MFC MFC MFCMM MMBHTTPTPFigure 23.17 The meniscus should be carefully probed to assess for meniscal tears. The meniscus of this patient was
examined using an arthroscopy-assisted arthrotomy technique. (A) The meniscus appears normal. (B) A probe is
introduced to palpate and assess the meniscus for damage. (C) A bucket-handle tear of the medial meniscus is found and
displaced cranially using the probe. MFC,-medial femoral condyle; MM, medial meniscus; TP, tibial plateau; BHT,
bucket-handle tear.
femur and proximal tibia. The design of this
distractor allows the surgeon to use a com-
bination of cranial tibial thrust together with
distraction to optimize viewing of the femoro-
tibial joint (Figures 23.3 and 23.4). Distrac-
tion can be maintained by the instrument after
placement.
Use of joint distraction is an important con-
sideration in surgical evaluation of the stifle
joint. Diagnosis of medial meniscal tearing is
improved (Kimet al. 2017; Winkelset al. 2016)
(Figures 23.5 and 23.8). Improved access to the
caudal portion of the medial meniscus also facil-
itates meniscectomy or medial meniscal release
(A) (B) (C)MFC MFCGMMMMHKBHT
BHT
TPTPFigure 23.18 Bucket-handle tears should be removed by partial meniscectomy. Arthroscopy-assisted arthrotomy allows
the surgeon to perform a partial meniscectomy with great precision. (A) A hook knife is used to cut the abaxial
attachment to the bucket-handle tear of the medial meniscus. (B) The torn portion of the meniscus is grasped and tension
is applied before cutting the axial attachment of the torn fragment. (C) Appearance of the periphery of the medial
meniscus and articular surfaces after partial meniscectomy. MFC, medial femoral condyle; MM, medial meniscus; TP,
tibial plateau; BHT, bucket-handle tear; HK, hook knife; G, grasper.
in both large and small dogs (Kimet al. 2016;
Winkelset al. 2016; Kimet al. 2017). Joint distrac-
tion appears a safe procedure that is unlikely to
induce collateral ligament injury or joint injury
from inadvertent pin penetration (Bottcher ̈ et al.
2009; Winkelset al. 2016).Patient morbidity
Postoperative pain
Stifle surgery is a painful procedure. Pain is
generated locally by cellular mechanisms and