HUGE CAPABILITIES IN AN ULTRA-COMPACT SYSTEM

SMALL ANIMAL: Elbow — Hip — Knee — Shoulder
LARGE ANIMAL: Carpus — Coffin — Fetlock — Hock — Navicular Bursa — Shoulder — Stifle

 

The Biovision 1.2mm NeedleView™ system is a breakthrough technology that offers a visualization tool the size of an 18-gauge needle! You can perform diagnostic and therapeutic arthroscopic procedures that bring a “value added element” to your equine/large animal or small/companion animal practice. The system combines several essential surgical and diagnostic features into a single compact and portable all-digital visualization platform.

When Biovision introduced the NeedleView Arthroscope Suite in 2010, it was the only system that allowed veterinarians to perform conscious/standing micro-arthroscopy. That’s still true in 2016 — but updates have made our next-generation suite more remarkable. In this issue, we review the suite in depth, pointing out not just what it can do, but what it can now do even better.

 


Key Benefits

Easy to Learn – You don’t necessarily need to be a surgeon to be able to use the NeedleView Arthroscope Suite effectively. You do need to be comfortable with joint anatomy and know how to be in a joint without damaging cartilage; this can be taught in a wetlab or weekend workshop. But the actual technique is easily taught if you’re in joints frequently (for example, using PRP, stem cells, IRAP, or other therapeutic agents).

Minimally Invasive – At 1.2mm, the NeedleView scope is the size of an 18-gauge needle. You can scope with just a local block and sedation. If you don’t have a surgery room or ventilator, NeedleView opens up a way to diagnose cases in a treatment room, trailer, or wash rack.

Meaningful Information – NeedleView helps you give clients the information they need to make good decisions about how to proceed with their animal. It helps you know what paths to consider. For example, if the animal has been treated with biologic agents or regenerative therapies and doesn’t seem to be responding, NeedleView lets you easily take a look to see what’s going on. NeedleView can also help you give the owner the information and options – for example, to proceed with surgery, debride to speed healing, or – if the injury is too severe, particularly with working or sport horses – to choose the right next step.

 


It’s Better Medicine: Capabilities Proven by Both Research and Practice

In a seminal peer-reviewed study¹ published in 2014, researchers confirmed:

  • The 18-gauge NeedleView arthroscope can be used to perform complete diagnostic examination of the three compartments of the stifle joint in standing horses.
  • In areas of the joint where space was limited, the small diameter of the scope was an advantage despite the smaller field of view.

One of the study’s lead authors (David Frisbie, DVM, PhD, MS, DACVS, DACVSMR, Professor of Equine Surgery, Colorado State University, Fort Collins, CO) has successfully used the NeedleView arthroscope to diagnose injuries in more than 100 stifles, including:

  • Meniscal tears and lesions
  • Cartilage damage
  • Cruciate ligament tears and lesions
  • Floating joint fragments
  • Subchondral bone cysts

Needle arthroscopy can also be used to confirm the presence of a lesion identified by either x-rays or ultrasound and confirm that no additional lesions are present.

Another study² concluded:

  • “When combined, arthroscopy and ultrasound can provide a more global assessment of pathological changes within the equine stifle.”

And it’s not limited to the stifle. A 2015 study³ explored direct and transthecal approaches to the navicular bursa using Biovision’s NeedleView scope. Among its conclusions:

  • “Needle endoscopy offers a reliable technique to evaluate the navicular bursa and may complement or replace other diagnostic modalities in horses with lameness localized to the navicular region.”

Leading veterinary schools and forward-thinking practices across the United States and around the world are beginning to perform and teach standing equine diagnostics using the NeedleView Arthroscope suite.

Institutions adopting the technology include:

  • Colorado State University College of Veterinary Medicine and Biosciences
  • University of Florida College of Veterinary Medicine
  • Oklahoma State University Veterinary Teaching Hospital
  • VetSuisse Faculty (University of Bern and University of Zurich)
  • University of Montreal
  • University of Melbourne Veterinary Clinic

Practices adopting NeedleView can be found from coast to coast in the United States and around the world:

  • Veterinary Specialists of the Southeast (Savannah, GA)
  • Premier Equine Veterinary Services (Whitesboro, TX)
  • Pferdeklinik Burg Müggenhausen (Müggenhausen, Germany)
  • Comstock Equine Hospital (Reno, NV)
  • Littleton Equine Medical Center (Littleton, CO)
  • Veterinary Specialty Center (Buffalo Grove, IL)
  • VRCC Veterinary Specialty & Emergency Hospital (Englewood, CO)

References

1 Frisbie DD, Barrett MF, McIlwraith CW, and Ullmer J. Diagnostic stifle joint arthroscopy using a needle arthroscope in standing horses. Vet Surg. 2014 Jan;43(1):12-8. doi: 10.1111/j.1532-950X.2013.12068.x. Epub 2013 Oct 31.

2 Adrian AM, Barrett MF, Werpy NM, et al. A comparison of arthroscopy to ultrasonography for identification of pathology of the equine stifle. Equine Vet J. 2015 Nov 18. doi: 10.1111/evj.12541. [Epub ahead of print]

3 Mahlmann K, Koch C, and Bodo G. Diagnostic endoscopy of the navicular bursa using a needle endoscope by direct or transthecal approach: a comparative cadaver study. Vet Surg. 2015;44:816-824.


It’s Profitable: Equine/Large Animal

ESTIMATING CONSERVATIVELY


  • 2 procedures per month
  • $1,000-$1,200/procedure from diagnostic first looks
  • Additional $500-$850/procedure from post-treatment, confirmatory second looks
  • Income from therapy and/or surgery from your own clients or referrals

CASE SCENARIOS


  • Case 1 — Diagnostic
    • Acute 4/5 lameness
    • 3/4+ MFT effusion, with >80% response to anesthesia
    • Radiographs within normal limits
    • Ultrasound — suspect meniscal involvement
  • Case 2 — Lack of Response
    • 2 previous MFT arthroscopies
    • Unable to return to work
    • Known meniscal damage
    • No other diagnostic changes

ROI EXAMPLE


  • 247% Year One cash-on-cash return
  • Assumptions:
    • 5-year loan
    • 6% simple interest
    • 35% marginal U.S. tax rate
    • Use of Section 179 deduction (U.S. only)

Click on the image for full size spreadsheet.

CALCULATE THE ROI FOR YOURSELF



It’s Profitable: Small/Companion Animal

ESTIMATING CONSERVATIVELY


  • 2 procedures per month
  • $300-$500/procedure from diagnostic first looks
  • Additional $250-$300/procedure from post-treatment, confirmatory second looks
  • Income from therapy and/or surgery from your own clients or referrals

CASE SCENARIOS


  • Case 1 — Diagnostic
    • 5 year-old female canine presents with stiffness and other symptoms of arthritis
    • X-ray and CT inconclusive — suspect fragmented medial coronoid process
  • Case 2 — Therapeutic
    • 9 year-old male canine presents with lameness, periarticular enlargement, joint effusion, loss of range of motion, and pain, laxity, and crepitus upon joint manipulation
    • X-ray and arthrocentesis reveal loss of and degraded quality of synovial fluid

ROI Example


  • 99% Year One cash-on-cash return
  • Assumptions:
    • 5-year loan
    • 6% simple interest
    • 35% marginal U.S. tax rate
    • Use of Section 179 deduction (U.S. only)

Click on the image for full size spreadsheet.

CALCULATE THE ROI FOR YOURSELF



Included Equipment

Click the image below for a printable PDF overview of Biovision Veterinary Endoscopy’s NeedleView Arthroscope Suite, including a list of all suite components.


You Can Do It: See for Yourself

Check out the videos below demonstrating the use and discussing the learning curve of the NeedleView™ 1.2mm O.D. arthroscope for diagnostic and therapeutic use in both large animals and small animals.

A Recent Equine Example