Arthroscopic-assisted hip toggle stabilization in cats: An ex vivo feasibility study.

Abstract

To describe arthroscopic-assisted hip toggle stabilization (AA-HTS) in cats, evaluate its feasibility and associated rate of iatrogenic injury, and assess deviations from planned surgical technique. Ex vivo study. Skeletally mature cat cadavers (n=7). Preoperative pelvic computed tomography (CT) was performed for surgical planning and to identify the ideal femoral bone tunnel projection. Ultrasound-guided transection of ligament of head of femur was performed. Following exploratory arthroscopy, AA-HTS was performed using a commercially available aiming device. Surgical time, intraoperative complications, and feasibility of technique were recorded. Iatrogenic injury and technique deviations were assessed by postoperative CT and gross dissection. Diagnostic arthroscopy and AA-HTS were successfully performed in all 14joints. Median (range) surgical time was 46.5 (29-144) min, including 7 (3-12) min for diagnostic arthroscopy and 40 (26-134) min for AA-HTS. Intraoperative complications occurred in 5 hips, related to bone tunnel creation (4) and toggle dislodgment (1). Toggle passage through the femoral tunnel was the most challenging component of technique, recorded as mildly difficult in 6 joints. No damage to periarticular/intrapelvic structures was identified. Minor articular cartilage damage (<10% total cartilage area) was identified in 10 joints. Thirteen deviations (8 major, 5 minor) in surgical technique from preoperative planning were identified in 7 joints. In feline cadavers AA-HTS was feasible but was associated with a high rate of minor cartilage injury, intraoperative complications, and technique deviations. Hip toggle stabilization using an arthroscopic-assisted approach may be an effective technique for management of coxofemoral luxation in cats.