Cortés Isaac, Warnock Jennifer J, Ranganathan Bharadhwaj, Bobe Gerd
Department of Clinical Sciences, Carlson College of Veterinary Medicine, Oregon State University, Corvallis, Oregon.
Department of Animal and Rangeland Sciences, Oregon State University, Corvallis, Oregon.
Vet Surg. 2019 Nov;48(8):1456-1465. doi: 10.1111/vsu.13288. Epub 2019 Jul 26.
To determine the ability to reduce iatrogenic cartilage injury (IACI) during canine stifle arthroscopy by using a silicone arthroscope cannula guard.
Ex vivo canine cadaver experimental study.
Paired canine stifles from 14 cadavers (≥20 kg).
Stifles (N = 28) were assigned to unguarded traditional or silicone-guarded arthroscopy. Stifle arthroscopy and full joint exploration with meniscal probing was performed by a second-year surgery resident (I.C.) in fourteen canine cadavers, alternating between left and right stifles for guarded vs unguarded arthroscopy. After arthroscopy, stifles were disarticulated, and india ink assay was performed to identify IACI. Total IACI number, lesion length and area, duration of procedure, and procedure difficulty score were recorded for each stifle.
Unguarded arthroscopy resulted in more total IACI per joint (unguarded 5.2 ± 3.0, guarded 2.4 ± 1.4; P = .02), larger IACI area (unguarded 5.2 ± 4.2 mm , guarded 2.3 ± 1.5 mm ; P = .02), and IACI length (unguarded 13.6 ± 6.9 mm, guarded 8.6 ± 5.9 mm; P = .03). No difference was identified in duration of procedure (unguarded 11.8 ± 5.2 minutes, guarded 13.8 ± 4.3 minutes; P = .79) or procedure difficulty score (unguarded 1.7 ± 0.6, guarded 1.6 ± 0.6 P = .73).
Silicone-guarded arthroscope cannulas decreased IACI number and size during canine cadaveric stifle arthroscopy without increasing duration of procedure or surgical difficulty.
Silicone-guarded arthroscope cannulas may be safer than traditional cannulas for novice veterinary surgeons performing stifle arthroscopy.
通过使用硅胶关节镜套管保护装置，确定其在犬膝关节镜检查过程中减少医源性软骨损伤（IACI）的能力。
离体犬尸体实验研究。
来自14具尸体（≥20千克）的配对犬膝关节。
将膝关节（N = 28）分为无保护的传统关节镜检查组或硅胶保护的关节镜检查组。由一名二年级外科住院医师（I.C.）对14具犬尸体进行膝关节镜检查及半月板探查的全关节探查，左右膝关节交替进行有保护和无保护的关节镜检查。关节镜检查后，将膝关节离断，并进行印度墨水试验以识别IACI。记录每个膝关节的IACI总数、损伤长度和面积、手术持续时间以及手术难度评分。
无保护的关节镜检查导致每个关节的IACI总数更多（无保护组5.2±3.0，有保护组2.4±1.4；P = 0.02），IACI面积更大（无保护组5.2±4.2平方毫米，有保护组2.3±1.5平方毫米；P = 0.02），IACI长度更长（无保护组13.6±6.9毫米，有保护组8.6±5.9毫米；P = 0.03）。手术持续时间（无保护组11.8±5.2分钟，有保护组13.8±4.3分钟；P = 0.79）或手术难度评分（无保护组1.7±0.6，有保护组1.6±0.6；P = 0.73）无差异。
硅胶保护的关节镜套管在犬尸体膝关节镜检查期间减少了IACI的数量和大小，而没有增加手术持续时间或手术难度。
对于进行膝关节镜检查的新手兽医外科医生，硅胶保护的关节镜套管可能比传统套管更安全。
