The Impact of Joint Capsule Closure on Retention of Intra-Articular Injectable Biologics in Poststifle Arthroscopy: A Comparative and Cadaveric Study

Introduction: Cranial cruciate ligament (CrCL) rupture is a common orthopaedic issue in dogs, often resulting in pain and degenerative changes like synovitis and osteoarthritis (OA) even after surgical stabilization. Arthroscopy improves joint evaluation but can remove vital components of synovial fluid, such as hyaluronic acid. Postarthroscopic intra-articular (IA) injections of hyaluronic acid and platelet-rich plasma show promise for OA management. However, capsulotomy closure is not routinely practiced, despite its role in maintaining joint stability and function. This study investigates the effect of capsulotomy closure on the retention of IA injectables during stifle arthroscopy, aiming to identify the optimal injection volume for maximizing retention and minimizing extravasation. We hypothesize that capsular closure will improve retention, especially with smaller volumes.

Materials and Methods: This ex vivo study involved 40 pelvic limbs from cadavers over 15 kg, with no prior stifle pathology or OA. Baseline imaging included radiographs and CT scans, followed by random assignment into four groups: (1) 2 mL with closure, (2) 2 mL without closure, (3) 4 mL with closure, and (4) 4 mL without closure. Standard arthroscopy was performed, and portals were repaired, with joint capsules closed in groups 1 and 2. Contrast was injected, and images were evaluated for extravasation by a radiologist.

Results: We hypothesize that 2 mL IA injection postclosure will demonstrate the lowest extravasation and highest retention scores compared with the 4 mL injection without closure.

Discussion/Conclusion: If our hypothesis is accepted, smaller volumes of postcapsular closure retain more biologics, enhancing therapeutic retention and warranting further research into optimal closure techniques for clinical application.

Acknowledgment

None.

 

MissingLinkText

Publikationsverlauf

Artikel online veröffentlicht:
15. Juli 2025