Modification of the triangulation technique for arthroscopy of the canine shoulder joint using a new target device

nal is determined by puncturing the caudal pouch of the shoulder joint with a 5 cm long, 0.6-mm cannula. This cannula is inserted in the direction of the arthroscope tip.The working cannula with trocar is then inserted along the puncture canal into the shoulder joint. This triangulation technique has successfully been used for arthroscopic surgery in the shoulder joint, in particular for the treatment of OCD (11). Fewer postoperative complications have been observed with this technique when compared to other methods which have been described (6). The advantages of this technique to conventional arthrotomy include less soft tissue trauma, faster healing, better cosmetic results and shorter operating time. However, determining the optimal point to puncture and the correct angle of the cannula to the optic, which are necessary in order to successfully puncture the caudal pouch of the shoulder joint, sometimes proved to be very difficult (10). In some cases the trauma to the joint capsule led to leakage of the irrigation fluid from the joint into the surrounding tissue. This peri-articular irrigation fluid caused joint collapse and made insertion of the working cannula difficult because it obscured the field. Also it often proved to be very difficult to locate the instrument tips via arthroscopic view. Furthermore, in some instances joint cartilage was damaged during insertion of the cannula and trocar. These problems did not improve until the experience of the surgeon subscribed to the operations. Only with intensive training was it possible to acquire the skills necessary for the triangulation and depth perception. Approximately one year and 30 cases were required to acquire sufficient skills (10). Modification of the triangulation technique for arthroscopy of the canine shoulder joint using a new target device