Austin B, Montgomery R D, Wright J, Bellah J R, Tonks C
Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, Alabama, USA.
Vet Comp Orthop Traumatol. 2007;20(2):92-7. doi: 10.1160/vcot-06-04-0033.
Three approaches to medial meniscal release (MMR) were compared using 48 canine cadaver stifles. The approaches included a caudomedial arthrotomy approach, a blind stab incision based on anatomic landmarks, and an arthroscopic guided approach. The cranial cruciate ligament was intact in all specimens. The time required to perform the meniscal release and joint capsule closure was recorded, as well as completeness and location of the meniscal transection. Damage to the caudal cruciate ligament, femoral cartilage, and medial collateral ligament were recorded. The mini-arthrotomy was 81% successful in accomplishment of MMR with a 4% rate of iatrogenic damage. The blind technique was 56% successful in the accomplishment of MMR with a 4% rate of iatrogenic damage. The arthroscopic guided approach was 62.5% successful in accomplishment of MMR, with a 10% rate of iatrogenic damage. Accomplishment and iatrogenic damage rates were not significantly different among procedures (p > 0.05). Significantly less time was required to perform the blind technique, and significantly greater time was required to perform the arthroscopic guided technique (p > 0.05). Significant differences were not noted among the procedures regarding the ability to accomplish the meniscal release or damage surrounding structures. None of the evaluated approaches for meniscal release resulted in a complete and accurate meniscal release for over 81% of the time.
使用48个犬类尸体膝关节比较了三种内侧半月板松解术(MMR)的方法。这些方法包括后内侧关节切开术、基于解剖标志的盲目穿刺切口和关节镜引导下的方法。所有标本的前交叉韧带均完整。记录进行半月板松解和关节囊闭合所需的时间,以及半月板横断的完整性和位置。记录后交叉韧带、股骨软骨和内侧副韧带的损伤情况。小切口关节切开术完成MMR的成功率为81%,医源性损伤率为4%。盲目技术完成MMR的成功率为56%,医源性损伤率为4%。关节镜引导下的方法完成MMR的成功率为62.5%,医源性损伤率为10%。不同手术方法之间的完成率和医源性损伤率无显著差异(p>0.05)。盲目技术所需时间明显更少,关节镜引导技术所需时间明显更多(p>0.05)。在完成半月板松解或损伤周围结构的能力方面,不同手术方法之间未发现显著差异。所评估的半月板松解方法中,超过81%的时间内均未实现完全准确的半月板松解。