Endoscopy Brief: Treating osteochondritis dissecans of the stifle with arthroscopic surgery

Mar 01, 2005

A 7-month-old intact male Labrador retriever was presented for evaluation of a two-week history of left hindlimb lameness. The results of the physical examination confirmed left hindlimb lameness and revealed mild joint capsule distention with no joint pain, crepitus, or drawer instability. A radiographic examination of the left stifle revealed an osseous defect in the medial femoral condyle (Figures 1 & 2). The results of the physical and radiographic examinations of the right stifle were normal.

Arthroscopy was performed on the left stifle with a craniolateral telescope portal, craniomedial operative portal, and a suprapatellar egress portal. A large loose flap of cartilage was found on the medial femoral condyle (Figure 3). The diagnosis was osteochondritis dissecans. The free cartilage flap was removed with curved mosquito hemostats, and the cartilage defect was d├ębrided by using a 5-0 curette with an arthroscope (Figure 4). The patient's recovery was uneventful. NSAIDS were administered for seven days after surgery. Minimal residual lameness was seen at a recheck examination two weeks later.

At an examination four years later, when the patient was presented for an unrelated problem, no left hindlimb lameness was noted. And the owner reported no recurrence of the lameness in the four years since the arthroscopic surgery. The left stifle was normal on palpation with no pain, crepitus, swelling, thickening, or instability. The joint had a normal range of motion. Radiography of the left stifle showed mild degenerative changes (Figures 5 & 6).

"Endoscopy Brief" was contributed by Timothy C. McCarthy, DVM, PhD, DACVS, Surgical Specialty Clinic for Animals, 4525 S.W. 109th Ave., Beaverton, OR 97005.