Götzens Bruno, Medl Susanne C, Medl Nikola S
AniCura Kleintierklinik Babenhausen, Babenhausen, Germany.
Vet Surg. 2019 Jun;48(S1):O25-O33. doi: 10.1111/vsu.13119. Epub 2018 Nov 8.
To evaluate safety and accuracy of lateral pin placement for the use of a Leipzig stifle distractor (LSD) and to assess improvements in visualization and treatment of the lateral meniscus in the canine stifle.
Ex vivo cadaveric study.
Paired canine cadaveric hind limbs (n = 10).
Pins for the LSD were placed from lateral to medial in the distal femur and proximal tibia. Safety and accuracy of lateral pin placement were evaluated via anatomical dissection, computed tomography (CT), and arthroscopy. In every case, distraction of the lateral compartment of the femorotibial joint space was evaluated arthroscopically, and the meniscus was probed. Afterward, the limbs were assigned to 1 of 2 groups, and a partial meniscectomy was attempted with or without distraction. Stifles were disarticulated to evaluate the meniscectomy and iatrogenic cartilage damage.
Computed tomography revealed some variation in pin placement, although sufficient distraction was achieved for all stifle joints. No damage to the surrounding structures was observed during anatomical dissection, CT, or arthroscopy. Disarticulation provided evidence that using an LSD allowed for complete caudal horn meniscectomies and less articular cartilage damage than when meniscectomy was attempted with manual distraction.
Lateral placement of an LSD proved to be safe and effective for the distraction of the lateral femorotibial joint space and the examination and treatment of the lateral meniscus in dogs weighing 18-42 kg.
Canine lateral meniscus pathology, although rare, leads to severe pain. A laterally placed LSD improves arthroscopic evaluation and treatment of this pathology.
评估使用莱比锡膝关节撑开器(LSD)时外侧钢针置入的安全性和准确性,并评估犬膝关节外侧半月板可视化及治疗效果的改善情况。
离体尸体研究。
成对的犬尸体后肢(n = 10)。
将LSD的钢针从股骨远端外侧向内侧置入,胫骨近端同样操作。通过解剖、计算机断层扫描(CT)和关节镜检查评估外侧钢针置入的安全性和准确性。在每种情况下,通过关节镜评估股骨胫关节外侧间隙的撑开情况,并探查半月板。之后,将肢体分为2组中的1组,尝试在有或无撑开的情况下进行部分半月板切除术。将膝关节离断以评估半月板切除术及医源性软骨损伤情况。
CT显示钢针置入存在一定差异,尽管所有膝关节均实现了充分撑开。在解剖、CT或关节镜检查过程中均未观察到周围结构受损。膝关节离断结果表明,与手动撑开进行半月板切除术相比,使用LSD可实现更完整的半月板后角切除术,且关节软骨损伤更少。
对于体重18 - 42 kg的犬,LSD外侧置入在撑开股骨胫关节外侧间隙以及检查和治疗外侧半月板方面被证明是安全有效的。
犬外侧半月板病变虽罕见,但会导致严重疼痛。外侧放置LSD可改善这种病变的关节镜评估和治疗。