Summary
Objectives: To describe the relationship of the major muscular, ligamentous and neurovascular
structures in relation to standard medial elbow arthroscopic portals used in dogs,
and to evaluate their potential iatrogenic lesions.
Design: Anatomical study using 20 canine cadaveric elbows.
Methods: Arthroscopic explorations were performed using medial portals. Three 4 mm orthopaedic
pins were introduced in place of the arthroscope, egress canula and instrumental portals.
Limbs were dissected. Distances between pins and neurovascular structures were measured.
Muscle, ligament and cartilage lesions were recorded.
Results: Minimal muscular lesions were observed. No ligament injury was evidenced. Superficial
iatrogenic cartilage lesions were observed in three joints. The arthroscopic portal
was 23.1 mm (range: 16 to 28.5 mm) caudal to the brachial artery, 21.0 mm (13–30.5
mm) caudal to the median nerve, and 4.0 mm (1–7 mm) cranial to the ulnar nerve. The
instrumental portal was 16.3 (9–24 mm) caudal to the brachial artery, 13.5 mm (7–24.5
mm) caudal to the median nerve, and 11.8 (8–18 mm) cranial to the ulnar nerve. The
egress portal was 21.4 mm (12–37 mm) caudal to the ulnar nerve.
Conclusions and clinical relevance: The study confirmed the safety of elbow medial arthroscopic portals. Care must be
taken when placing the camera portal so as to avoid injury of the ulnar nerve. Should
extensive intra-articular procedures be needed, manipulation of instruments should
be done cautiously in the cranio-medial compartment of the joint due to the proximity
of the median nerve to the capsule.
Keywords
Elbow - arthroscopy - anatomy - canine