← Articles

Lotsikas et al: Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: A cadaveric study
Veterinary Surgery 3, 2025

🔍 Key Findings

Study type: Cadaveric stifle arthroscopy in large breed dogs (n=12 joints from 6 dogs)
Goal: Describe and assess the proximal lateral portal for insertion of a Ventura stifle thrust lever (VSTL)
Main results:

  • No damage to the long digital extensor tendon (LDE) with this portal
  • VSTL could be placed without removing the arthroscope
  • Portal creation time ~37 seconds (faster than previously reported)

Cartilage impact:

  • Superficial iatrogenic articular cartilage injury (IACI) present in all specimens
  • No difference in IACI between 5- and 10-minute lever durations
  • Zone 4 (lateral femoral condyle) had significantly more damage than zones 1–3 (p < .05)

Conclusion: Portal was safe, repeatable, minimally invasive, and did not increase cartilage damage with up to 10-minute lever use

Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: A cadaveric study
Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: A cadaveric study
Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: A cadaveric study
Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: A cadaveric study
Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: A cadaveric study
Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: A cadaveric study
Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: A cadaveric study
Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: A cadaveric study
Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: A cadaveric study
Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: A cadaveric study
Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: A cadaveric study
Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: A cadaveric study

Simini Surgery Review Podcast

How critical is this paper for crushing the Boards?

🚨 Must-know. I’d bet on seeing this.

📚 Useful background, not must-know.

💤 Skip it. Doubt it’ll ever show up.

Thanks for the feedback!
‍We'll keep fine-tuning the articles vault.
Oops — didn’t go through.
‍Mind trying that again?
← Articles

Lotsikas et al: Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: A cadaveric study
Veterinary Surgery 3, 2025

🔍 Key Findings

Study type: Cadaveric stifle arthroscopy in large breed dogs (n=12 joints from 6 dogs)
Goal: Describe and assess the proximal lateral portal for insertion of a Ventura stifle thrust lever (VSTL)
Main results:

  • No damage to the long digital extensor tendon (LDE) with this portal
  • VSTL could be placed without removing the arthroscope
  • Portal creation time ~37 seconds (faster than previously reported)

Cartilage impact:

  • Superficial iatrogenic articular cartilage injury (IACI) present in all specimens
  • No difference in IACI between 5- and 10-minute lever durations
  • Zone 4 (lateral femoral condyle) had significantly more damage than zones 1–3 (p < .05)

Conclusion: Portal was safe, repeatable, minimally invasive, and did not increase cartilage damage with up to 10-minute lever use

Simini Surgery Review Podcast

Know What Matters in the Literature - and Why

We distill peer-reviewed surgical studies into clinically relevant summaries and
exam-style questions, so you can make informed decisions with confidence.

Free Access. No Spam. Just Smarter Surgical Learning

Multiple Choice Questions on this study

In Lotsikas 2025 et al., on stifle distraction portal, what structure was specifically evaluated for risk of damage during portal placement?

A. Cranial cruciate ligament
B. Meniscal femoral ligament
C. Medial meniscus
D. Long digital extensor tendon
E. Lateral collateral ligament

Answer: Long digital extensor tendon

Explanation: The LDE was specifically assessed and found to be undamaged in all specimens.
In Lotsikas 2025 et al., on stifle distraction portal, what was the mean time required to place the thrust lever using the proximal lateral portal?

A. 17 seconds
B. 37 seconds
C. 55 seconds
D. 91 seconds
E. 122 seconds

Answer: 37 seconds

Explanation: Mean placement time for the lever was 37.25 seconds (range 17–122 s).
In Lotsikas 2025 et al., on stifle distraction portal, what was the effect of VSTL duration (5 vs. 10 minutes) on overall cartilage damage?

A. 10 minutes resulted in significantly more damage
B. 5 minutes showed reduced damage in all zones
C. Cartilage damage was significantly higher in medial zones
D. No significant difference in overall damage between durations
E. Cartilage was completely spared in 10-minute group

Answer: No significant difference in overall damage between durations

Explanation: There were no statistically significant differences in IACI between groups A (5-min) and B (10-min)【69†Veterinary Surgery†L1-L20】
In Lotsikas 2025 et al., on stifle distraction portal, what major procedural advantage did the new portal approach provide?

A. Avoided the need for stifle distraction
B. Allowed for bilateral arthroscopy simultaneously
C. Enabled cranial cruciate ligament debridement
D. Avoided fat pad shaving and scope removal
E. Allowed caudal cruciate ligament release

Answer: Avoided fat pad shaving and scope removal

Explanation: The new portal allowed safe insertion of the VSTL without needing to remove the arthroscope or shave the fat pad【69†Veterinary Surgery†L1-L20】
In Lotsikas 2025 et al., on stifle distraction portal, what was the most frequently affected cartilage zone in terms of iatrogenic damage?

A. Zone 1: Trochlear ridges
B. Zone 2: Weight-bearing surface of condyles
C. Zone 3: Medial femoral condyle
D. Zone 4: Lateral femoral condyle
E. All zones equally affected

Answer: Zone 4: Lateral femoral condyle

Explanation: Zone 4 had significantly more IACI compared to zones 1–3 in both groups (p < .05).

Access the full library of surgical summaries and exam-style questions.

Get Instant Access

Educational content developed independently and supported by Simini.

The maker of Simini Protect Lavage.

Review More Key Summaries from this Veterinary Surgery Journal Issue

Viljoen

 et al: 

Comparative antimicrobial efficacy of 4 surgical hand‐preparation procedures prior to application of an alcohol-based hand rub in veterinary students

Brincin

 et al: 

The value of routine radiographic follow up in the postoperative management of canine medial patellar luxation

Peycke

 et al: 

Center of rotation of angulation-based leveling osteotomy for stifle stabilization in skeletally immature dogs

Lemmon

 et al: 

Arthroscopic synovitis severity scoring in canine stifles with cranial cruciate ligament disease

Lotsikas

 et al: 

Proximal lateral insertion portal of an intra-articular arthroscopic stifle lever: A cadaveric study