Feasibility and cartilage injury of an all-inside arthroscopic meniscal repair application in a canine cadaveric study

Abstract

Meniscal injury is the most common comorbidity in canine stifles with cranial cruciate ligament (CCL) pathology. Arthroscopic repair for acute tears can be technically challenging and is rarely described. This study evaluates the feasibility of using an all-inside arthroscopic meniscal repair device, Arthrex Meniscal Cinch II™ (MCII) in canine cadaveric stifles and the associated risks of iatrogenic vascular injury (IVI) and cartilage injury (ICI). 20 healthy paired canine cadaveric stifles (25 – 45 kg BW) were divided randomly into two groups of 10. Both groups received transection of the CCL via mini arthrotomy, joint distraction and diagnostic arthroscopy with meniscal probing. No further procedures were performed in the control group whereas the implant group underwent placement of the MCII-implants in the caudal horn of the medial meniscus. Angiography of the femoral artery was performed for each limb before and after operation and vascular trauma was assessed on radiographs. After disarticulation, the cartilage was stained via Indian ink assay and underwent blinded scoring for ICI. Implants were evaluated for desired position. Correct position of the MCII-implants was achieved in all stifles. No IVI was detected. Implant placement created more ICI on the medial femoral condyle (1.33 mm²) than arthroscopy alone (0.15 mm²) (p = 0.03). Implant associated complications occurred in 30 %. Arthroscopic use of MCII is feasible and carries minimal risk for vascular damage. Despite joint distraction, implant placement using the MCII is associated with significant cartilage damage. Although technically challenging, all-inside meniscal repair appears to carry limited risk in canine patients over 25 kg bodyweight.