Objective: To determine the accuracy and safety of two established landmark-based techniques and two novel techniques for stifle arthrocentesis in dogs.
Study design: Ex vivo prospective study.
Animals: A total of 32 paired canine cadaver pelvic limbs.
Methods: An electronic survey assessed technique prevalence among surgeons. Pelvic limbs (n = 32) were randomized to one of four techniques; lateral intercondylar notch (LINC), infrapatellar (INFRA), suprapatellar (SUPRA), or proximal lateral parapatellar pouch (POUCH) technique, with n = 8 per group. Repositions, attempts, and synovial fluid presence were recorded. Stifle arthrography assessed accuracy. India ink assay assessed iatrogenic articular cartilage injury (IACI). Omnibus tests were used (p < .05), with post hoc Bonferroni-correction (p < .0083).
Results: A total of 40 surgeons responded, with LINC most commonly used (35/40, 87.5%). All tested techniques were accurate (8/8, 100%, p > .9). INFRA and SUPRA required more needle repositions (median 3 and 2, respectively) than LINC and POUCH (median 1 for both), (p = .001). LINC and SUPRA produced no IACI, INFRA (6/8, 75%) and POUCH (3/8, 37.5%) (p = .007). Over half of IACI produced with INFRA exceeded 10 mm2 in area, all on weightbearing cartilage (p = .041). POUCH injuries occurred exclusively on non-weightbearing cartilage (p = .041).
Conclusion: LINC and INFRA are currently used clinically and were accurate; however, INFRA required increased repositions and had high IACI rates on weightbearing cartilage. Two novel techniques were feasible and accurate; SUPRA was safe with no IACI, while POUCH had high IACI risk on non-weightbearing cartilage.
Clinical significance: SUPRA may be a safer alternative than current established techniques and warrants further clinical investigation. INFRA carries high IACI rates.
