Kennedy S C, Dunning D, Bischoff M G, Kuriashkin I V, Pijanowski G J, Schaeffer D J
Department of Veterinary Clinical Medicine and Veterinary Biosciences, College of Veterinary Medicine, University of Illinois, Urbana, Illinois, USA.
Vet Comp Orthop Traumatol. 2005;18(4):227-34.
The meniscal release (MR) is used to minimize meniscal pathology after Tibial Plateau Leveling Osteotomy (TPLO) surgery. The purposes of this study were: (i) to describe meniscal orientation in a unaltered cadaveric canine stifle, a cruciate deficient stifle, TPLO repaired stifle with and without the MR using magnetic resonance imaging; (ii) to determine if the abaxial release is equivalent to the axial release in its ability to affect caudal pole displacement in a TPLO repaired stifle and (iii) to evaluate with MRI the effect of MR on the femorotibiol articular cartilage contact area in a TPLO repaired stifle. Briefly, cadaver limbs were placed into a jig designed to mimic a weight-bearing stance at 140 degrees and 90 degrees at the stifle. The limbs were sequentially evaluated from the unaltered state; after cranial cruciate ligament transection; after TPLO stabilization; and finally after a meniscal release. No significant difference was found between the intrameniscal area (IMA) of the abaxial and axial meniscal releases although there was an increase in the IMA after the meniscal release compared to the IMA in the normal, cranial cruciate ligament deficient stifle, and TPLO stabilized stifle. In the abaxial release, a meniscal remnant remained in situ and provided a space effect between the femur and the tibial plateau. This is in contrast to the axial meniscal release, where the entire caudal pole of the medial meniscus relocated caudolaterally and consequently permitted more direct femorotibial contact. Overall, however, there was evidence of caudal pole compression of the medial meniscus throughout the MRI series which was ameliorated by either of the MR procedures.
半月板松解术(MR)用于在胫骨平台水平截骨术(TPLO)手术后将半月板病变降至最低。本研究的目的是:(i)使用磁共振成像描述未改变的尸体犬膝关节、十字韧带缺损膝关节、进行和未进行MR的TPLO修复膝关节中的半月板方向;(ii)确定在TPLO修复的膝关节中,外侧松解在影响后极移位方面是否等同于内侧松解;(iii)通过MRI评估MR对TPLO修复膝关节中股骨-胫骨关节软骨接触面积的影响。简要地说,将尸体肢体放入一个夹具中,该夹具设计用于模拟膝关节在140度和90度时的负重姿势。对肢体从未改变的状态开始依次进行评估;在切断前交叉韧带后;在TPLO稳定后;最后在半月板松解后。外侧和内侧半月板松解的半月板内面积(IMA)之间未发现显著差异,尽管与正常、前交叉韧带缺损膝关节和TPLO稳定膝关节中的IMA相比,半月板松解后的IMA有所增加。在外侧松解中,半月板残余物留在原位,并在股骨和胫骨平台之间提供了空间效应。这与内侧半月板松解相反,在内侧半月板松解中,内侧半月板的整个后极向尾外侧重新定位,从而允许更直接的股骨-胫骨接触。然而,总体而言,在整个MRI系列中都有内侧半月板后极受压的证据,而两种MR手术均可改善这种情况。