Hoelzler Michael G, Millis Darryl L, Francis David A, Weigel Joseph P
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37901-1071, USA.
Vet Surg. 2004 Mar-Apr;33(2):146-53. doi: 10.1111/j.1532-950X.2004.04022.x.
To evaluate postoperative morbidity in dogs after experimental cranial cruciate ligament transection and immediate stifle stabilization using an arthroscopically assisted or open arthrotomy technique.
Experimental, prospective study.
Thirteen mature, healthy dogs.
Dogs were randomly assigned to 1 of 2 groups. Seven underwent open arthrotomy while 6 underwent arthroscopy of 1 stifle joint. Cranial cruciate ligaments were transected and debrided and all stifles were stabilized using 2 lateral extracapsular fabellar-tibial sutures. Minimally invasive suture placement was employed in the arthroscopy group. All animals were evaluated for 9 weeks using kinetic gait assessments, comfortable stifle range of motion measurements, thigh girth measurements, differential cell counts of synovial fluid, and subjective scores of behavior, limb use, and lameness.
Significant differences in postoperative morbidity were observed during the 9-week postoperative period. Greater peak vertical force for 8 weeks (P=.015), vertical impulse for 6 weeks (P=.044), comfortable stifle range of motion for 9 weeks (P=.017), comfortable stifle flexion for 4 weeks (P=.005), and operative limb thigh circumference (P=.020) for 9 weeks were observed for the arthroscopy group. A trend towards a lower differential mean synovial polymorphonuclear cell count in the arthroscopy group was seen at 4 and 8 weeks postoperatively. No differences in subjective evaluation scores were noted.
In this study population, significant differences were seen between the arthroscopy and arthrotomy groups for peak vertical force, vertical impulse, comfortable stifle range of motion, comfortable stifle flexion, and thigh circumference data.
The results of this study suggest that short-term postoperative morbidity may be reduced in dogs receiving arthroscopic joint surgery with a limited approach for stifle stabilization as compared with a traditional open arthrotomy technique.
评估实验性颅交叉韧带切断术后，采用关节镜辅助或切开手术技术对犬进行即时 stifle 关节稳定术后的术后发病率。
实验性前瞻性研究。
13 只成熟健康犬。
将犬随机分为两组。7 只接受切开手术，6 只接受一侧 stifle 关节镜检查。切断并清理颅交叉韧带，所有 stifle 关节均使用 2 根外侧囊外腓骨 - 胫骨缝线进行稳定。关节镜检查组采用微创缝线置入。使用动态步态评估、舒适的 stifle 关节活动范围测量、大腿围测量、滑液细胞分类计数以及行为、肢体使用和跛行的主观评分对所有动物进行 9 周评估。
术后 9 周观察到术后发病率存在显著差异。关节镜检查组在术后 8 周的最大垂直力（P = 0.015）、术后 6 周的垂直冲量（P = 0.044）、术后 9 周的舒适 stifle 关节活动范围（P = 0.017）、术后 4 周的舒适 stifle 关节屈曲（P = 0.005）以及术后 9 周的手术肢体大腿周长（P = 0.020）方面均有差异。术后 4 周和 8 周时，关节镜检查组的滑液多形核细胞分类平均计数有降低趋势。主观评估评分无差异。
在本研究群体中，关节镜检查组和切开手术组在最大垂直力、垂直冲量、舒适 stifle 关节活动范围、舒适 stifle 关节屈曲和大腿周长数据方面存在显著差异。
本研究结果表明，与传统切开手术技术相比，采用有限入路进行 stifle 关节稳定的关节镜手术的犬，其术后短期发病率可能降低。
