Panizzi Luca, Barber Spencer M, Lang Hayley M, Allen Andrew L, Woodbury Murray R
Department of Large Animal Clinical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK, Canada.
Vet Surg. 2011 Jun;40(4):464-72. doi: 10.1111/j.1532-950X.2011.00810.x. Epub 2011 Mar 11.
To evaluate a minimally invasive technique for arthrodesis of the carpometacarpal (CMC) joint in horses.
Experimental study.
Healthy horses (n=6).
A 5.5 mm, 3-drill tract arthrodesis technique was evaluated in 1 randomly selected CMC joint in each of 6 normal horses. Peak vertical ground reaction force (GRF) values were recorded before surgery and at 6, 8, and 12 months thereafter. Radiographic and clinical lameness scores were assigned at regular intervals until 12 months after surgery when the horses were euthanatized. Gross and histologic examinations were performed on the treated CMC joints.
After surgery, all horses were lame. Clinical resolution of lameness occurred in 2 by 12 months. Mean peak vertical GRF values significantly differed between treated and nontreated limbs at all recorded time points after surgery. Radiographic scores significantly differed from day 0 at all times after surgery, but did not change significantly after 4 months. Intraarticular bony ankylosis only occurred in 2 horses, based on gross, histologic, and microradiographic examination of sagittal sections of the operated CMC joints.
The 5.5 mm, 3-drill tract arthrodesis technique was considered successful in only 2 of 6 normal CMC joints treated. Greater articular damage may be necessary to achieve arthrodesis in normal horses. Better results may be achieved by technique modification or in horses affected by CMC osteoarthritis.
评估一种用于马掌指关节(CMC)关节融合的微创技术。
实验研究。
健康马匹(n = 6)。
对6匹正常马中的每匹马随机选取1个CMC关节,评估一种5.5毫米、3钻孔道关节融合技术。在手术前以及术后6个月、8个月和12个月记录垂直地面反作用力(GRF)峰值。定期进行放射学和临床跛行评分,直至术后12个月对马匹实施安乐死。对治疗后的CMC关节进行大体和组织学检查。
术后所有马匹均出现跛行。到12个月时,2匹马的跛行症状临床缓解。术后所有记录时间点,治疗肢体与未治疗肢体的平均垂直GRF峰值均存在显著差异。术后所有时间点的放射学评分与术后第0天相比均有显著差异,但4个月后未出现显著变化。根据对手术CMC关节矢状切面的大体、组织学和微放射学检查,仅2匹马出现关节内骨性融合。
在接受治疗的6个正常CMC关节中,只有2个关节采用5.5毫米、3钻孔道关节融合技术被认为是成功的。在正常马匹中可能需要更大程度的关节损伤才能实现关节融合。通过技术改良或在患有CMC骨关节炎的马匹中可能会取得更好的效果。