Comparison of Arthroscopy and Arthrotomy for Diagnosis of Medial Meniscal Pathology: An Ex Vivo Study
Version of Record online: 3 DEC 2008
© Copyright 2008 by The American College of Veterinary Surgeons
Volume 37, Issue 8, pages 749–755, December 2008
How to Cite
POZZI, A., HILDRETH, B. E. and RAJALA-SCHULTZ, P. J. (2008), Comparison of Arthroscopy and Arthrotomy for Diagnosis of Medial Meniscal Pathology: An Ex Vivo Study. Veterinary Surgery, 37: 749–755. doi: 10.1111/j.1532-950X.2008.00442.x
- Issue online: 3 DEC 2008
- Version of Record online: 3 DEC 2008
- Submitted April 2008; Accepted July 2008
Objective— To evaluate the sensitivity and specificity of arthroscopy and arthrotomy for diagnosis of medial meniscal pathology and to evaluate the diagnostic value of medial meniscal probing.
Study Design— Ex vivo study.
Animals— Cadaveric canine stifle joints (n=30).
Methods— Stifle joints were assigned to either a cranial cruciate ligament (CrCL) deficient or intact group. Within each stifle joint, no medial meniscal tear, a peripheral detachment, or 1 of 3 variants of vertical longitudinal tears of the medial meniscus were created. Each stifle joint had arthroscopy, craniomedial (CrMed), and caudomedial (CdMed) arthrotomy. Diagnoses were made by both observation and probing. Sensitivity, specificity, and correct classification rate (CCR) for diagnosing the state of the medial meniscus using both observation and probing with all diagnostic methods were calculated. Odds ratios were calculated to determine if probing increased diagnostic accuracy.
Results— Arthroscopy with probing was the most sensitive and specific diagnostic method and had the highest CCR. For arthrotomy, CrMed was the most sensitive in CrCL-deficient and CdMed the most sensitive in stable, CrCL-intact stifle joints. For all methods, probing increased their diagnostic accuracy.
Conclusions— Arthroscopy is the most accurate diagnostic method; however, probing the medial meniscus enhances the diagnostic accuracy of all methods.
Clinical Relevance— Accurate diagnosis of medial meniscal pathology is ideally achieved by means of arthroscopy; however, if arthrotomy is chosen, CrMed should be selected in unstable and CdMed in stable stifle joints. Regardless, medial meniscal probing should be performed to increase diagnostic accuracy.