Cadaveric Feasibility Study Describing Transarticular Drilling of the Canine Anconeal Process through a Cranial Arthroscopic Portal.

Cranial arthroscopic portal enables feasible, accurate anconeal process drilling in cadavers, but clinical validation is required.

This cadaveric feasibility study describes a novel cranial arthroscopic portal approach for retrograde transarticular drilling of the anconeal process in dogs, targeting a minimally invasive treatment option for ununited anconeal process (UAP). Using eight canine cadaveric elbows, a NanoScope was introduced through a cranial portal in the distal humerus and navigated through the supratrochlear foramen to visualize the anconeal process. A 2.0-mm drill tunnel, simulating the pilot hole used in UAP repair, was created using a C-guide and cannulated drill bits under arthroscopic guidance. The first two elbows served as technique development specimens; outcomes were reported for the remaining six. Mean surgical time was 16.6 minutes (SD 3.0). CT imaging and gross dissection confirmed acceptable tunnel trajectories in all six elbows, with no major damage to critical neurovascular structures. However, drill tunnels were noted to be in close proximity to transcubital vessels and a musculocutaneous nerve branch, highlighting potential risks that warrant careful consideration. The technique successfully allowed arthroscopic identification of the anconeal process and accurate drill placement in this cadaveric model. Limitations include the small sample size and the cadaveric nature of the study, which may not fully replicate in vivo conditions such as tissue tension, hemorrhage, or patient movement. The authors conclude that while the technique is feasible and accurate in cadavers, clinical validation is necessary before adoption in live patients.

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