Ventura Stifle Thrust Lever
User Guide
by IMEX Veterinary
A versatile stifle distraction device, the Ventura Stifle Thrust Lever (VSTL) is designed for use during open arthrotomy or arthroscopic stifle exploration to provide unimpeded, stable visualization of the medial stifle compartment.
Patient Size » Standard VSTL - 20 kg to 60 kg | Mini VSTL - <20 kg
FIGURE 1 | Overall view of Ventura Stifle Thrust Lever in position during open arthrotomy. Note that minimal force is necessary as evidenced by open hand and fingertip control.
FIGURE 2 | A close up VSTL during open arthrotomy demonstrating excellent visualization of the medial stifle compartment.
STEP 1 Placement | The Ventura Stifle Thrust Lever (VSTL) is placed in a lateral arthroscopy portal which is created slightly proximal to the standard camera portal. The lever portal is at the disto-lateral margin of the distal patella. During placement the arthroscope is placed through the pre-established medial instrument portal to allow lever tip visualization intra-articularly.
STEP 2 – Introduction | Once introduced into the joint, the lever tip is well visualized directly cranial to the debrided origin of the cranial cruciate ligament and directly lateral to the course of the caudal cruciate ligament. The tip of the lever is then advanced into the lateral aspect of the intercondylar notch between the lateral femoral condyle and lateral tibial plateau.
STEP 3 – Advancement | Once advanced into the notch, the lever tip is placed under the axial aspect of the caudal portion of the lateral meniscus body and rotated so that the tip engages distal and behind the caudo-axial aspect of the lateral tibial plateau.
STEP 4 – Seated | Once well seated, mild distraction pressure can be applied to the handle to ensure lever is secure but the joint is NOT placed into distraction at this time.
STEP 5 – Visualization | Once the VSTL is securely seated, the arthroscope is removed from the medial portal and is replaced in the original lateral arthroscope portal. As the arthroscope barrel must pass distally by the lever shaft, it is important a good lateral camera portal is present and the joint is NOT distracted until the scope is well situated and the medial joint space can be visualized.
STEP 6 – Medial Compartment | Once the medial joint space is well visualized, the joint can be distracted by placing moderate pressure on the lever handle moving the tibial plateau cranially in relation to the femoral condyle. This brings the medial compartment into visualization including the medial meniscus. At this stage the medial instrument port can be utilized to palpate and manipulate the medial meniscus.
Caution should be exercised when both placing and distracting the stifle joint with the VSTL that gentle tissue handling, respect for the intra-articular structures, and use of only mild to moderate force on the lever handle is utilized. Inappropriate use, poor placement, and excessive force can irreversibly damage joint structures and MUST be avoided.