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Espinel Rupérez et al: Arthroscopic-assisted hip toggle stabilization in cats: An ex vivo feasibility study
Veterinary Surgery 6, 2023

🔍 Key Findings

  • Arthroscopic-assisted hip toggle stabilization (AA-HTS) was successfully completed in all 14 feline cadaver joints.
  • Femoral and acetabular tunnel creation was feasible in all cases, though femoral tunnel placement had a higher rate of deviations.
  • Intraoperative complications occurred in 5/14 joints, mostly related to femoral tunnel creation and toggle lodging.
  • Minor articular cartilage injury (<10% total cartilage area) occurred in 10/14 joints, but no injury to neurovascular or intrapelvic structures.
  • Thirteen surgical technique deviations (8 major, 5 minor) were identified in 7 joints, all involving the femoral tunnel.
  • Toggle passage through the femoral tunnel was the most challenging step, being mildly difficult in 6 joints.
  • Postoperative CT and gross dissection confirmed all toggles and buttons were in correct position, without damage to major surrounding structures.
  • No deviations, complications, or cartilage injuries occurred in the last 4 joints, suggesting a learning curve effect.

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← Articles

Espinel Rupérez et al: Arthroscopic-assisted hip toggle stabilization in cats: An ex vivo feasibility study
Veterinary Surgery 6, 2023

🔍 Key Findings

  • Arthroscopic-assisted hip toggle stabilization (AA-HTS) was successfully completed in all 14 feline cadaver joints.
  • Femoral and acetabular tunnel creation was feasible in all cases, though femoral tunnel placement had a higher rate of deviations.
  • Intraoperative complications occurred in 5/14 joints, mostly related to femoral tunnel creation and toggle lodging.
  • Minor articular cartilage injury (<10% total cartilage area) occurred in 10/14 joints, but no injury to neurovascular or intrapelvic structures.
  • Thirteen surgical technique deviations (8 major, 5 minor) were identified in 7 joints, all involving the femoral tunnel.
  • Toggle passage through the femoral tunnel was the most challenging step, being mildly difficult in 6 joints.
  • Postoperative CT and gross dissection confirmed all toggles and buttons were in correct position, without damage to major surrounding structures.
  • No deviations, complications, or cartilage injuries occurred in the last 4 joints, suggesting a learning curve effect.

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Multiple Choice Questions on this study

In Espinel Rupérez 2023 et al., on feline hip stabilization, which of the following structures was most at risk of impingement due to excessively ventral toggle placement?

A. Femoral artery
B. Sciatic nerve
C. Obturator nerve
D. Femoral vein
E. Urethra

Answer: Obturator nerve

Explanation: The toggle was placed just dorsal to the obturator nerve in all joints, and excessively ventral placement may cause impingement.
In Espinel Rupérez 2023 et al., on hip toggle stabilization, what was the most challenging step reported during the procedure?

A. Femoral tunnel drilling
B. Positioning the arthroscopic guide
C. Toggle passage through femoral tunnel
D. Toggle tying on lateral cortex
E. Removal of ligament of the head of femur

Answer: Toggle passage through femoral tunnel

Explanation: This was rated mildly difficult in 6 joints and was the step most frequently noted as challenging.
In Espinel Rupérez 2023 et al., on hip toggle stabilization, which intraoperative complication occurred most frequently?

A. Toggle disengagement within the acetabulum
B. Tunnel malposition in the acetabulum
C. K-wire misplacement or loss during drilling
D. Toggle failure after knot tying
E. Neurovascular injury to obturator nerve

Answer: K-wire misplacement or loss during drilling

Explanation: K-wire complications (loss or misplacement) occurred in multiple joints, highlighting it as the most frequent issue.
In Espinel Rupérez 2023 et al., on hip toggle stabilization, what was a major cause of technique deviation?

A. Improper toggle knot tension
B. Improper acetabular tunnel depth
C. Femoral tunnel exit outside fovea capitis
D. Femoral tunnel entry too cranial
E. Use of flexible k-wire

Answer: Femoral tunnel exit outside fovea capitis

Explanation: This was a common deviation; though implant positions were ideal, 8 major deviations were noted—all in the femoral tunnel.

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