Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado, USA.
Equine Vet J. 2012 Jul;44(4):412-5. doi: 10.1111/j.2042-3306.2011.00454.x. Epub 2011 Aug 18.
Annular ligament desmotomy is commonly performed in horses with chronic tenosynovitis. Previously reported tenoscopic techniques have limitations related to haemorrhage and awkward instrumentation. Radiofrequency (RF) energy affords precision and excellent haemostasis and may be a good alternative to sharp transection of the annular ligament in horses.
To describe a technique for using a RF probe for tenoscopic-guided annular ligament desmotomy and to report the clinical outcome of horses in which it was performed.
Cadaver specimens (n = 14) and live horses undergoing unrelated terminal procedures (n = 2) were used to optimise the tenoscopic-guided RF annular ligament desmotomy technique. Records were examined for all horses undergoing annular ligament desmotomy with an RF probe from 2003 to 2008 for which follow-up of >1 year post operatively was available.
The annular ligament was successfully transected in the cadaver and live horse model limbs using 2 different commercially available RF probes. Complete transection was achieved with practice and confirmed on gross dissection. Histopathology did not reveal any collateral damage to surrounding tissue. Follow-up of >1 year was available for 6 of 7 clinical cases. Four of 6 horses returned to work. Owners were satisfied with the outcome in all cases.
Desmotomy using a RF probe allows precise tissue transection under tenoscopic guidance without damage to surrounding structures or haemorrhage. With experience, it is an easily performed technique. In clinical patients, an acceptable outcome may be expected.
Tenoscopic-guided RF annular ligament desmotomy offers advantages, including reliable haemostasis and precise tissue transection, over previously reported techniques and is a viable surgical alternative for treating horses with annular ligament desmitis and other complex pathology within the tendon sheath.
环状韧带切开术常用于慢性腱鞘炎的马。以前报道的关节镜技术存在与出血和仪器操作不便相关的局限性。射频 (RF) 能量提供了精确性和出色的止血效果，并且可能是马中环状韧带锐性横断术的良好替代方法。
描述一种使用 RF 探头进行关节镜引导的环状韧带切开术的技术，并报告对接受该手术的马的临床结果。
使用尸体标本（n = 14）和进行无关终端手术的活马（n = 2）来优化关节镜引导的 RF 环状韧带切开术技术。检查了 2003 年至 2008 年间接受 RF 探头环状韧带切开术的所有马的记录，这些马在术后随访超过 1 年。
在尸体和活马模型肢体中，使用 2 种不同的市售 RF 探头成功地横切了环状韧带。通过实践可以实现完全横切，并在大体解剖时得到证实。组织病理学没有发现周围组织的任何附带损伤。6 例临床病例中有 4 例获得了 >1 年的随访。4 匹马中的 6 匹恢复工作。在所有情况下，主人对结果都很满意。
使用 RF 探头进行的切开术允许在关节镜引导下进行精确的组织横切，而不会对周围结构或出血造成损伤。有经验后，这是一种易于执行的技术。在临床患者中，可能会出现可接受的结果。
关节镜引导的 RF 环状韧带切开术提供了优于以前报道的技术的优势，包括可靠的止血和精确的组织横切，并且是治疗马环状韧带炎和肌腱鞘内其他复杂病理的可行手术替代方法。
