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对站立镇静的马匹进行桡腕关节和腕中关节的关节镜检查。

Needle arthroscopy of the radiocarpal and middle carpal joints in standing sedated horses.

作者信息

Kadic Dimitri T N, Miagkoff Ludovic, Bonilla Alvaro G

机构信息

Department of Clinical Sciences, College of Veterinary Medicine, University of Montreal, Saint Hyacinthe, Quebec, Canada.

出版信息

Vet Surg. 2020 Jul;49(5):894-904. doi: 10.1111/vsu.13430. Epub 2020 Apr 25.

Abstract

OBJECTIVE

To develop a technique for standing diagnostic needle arthroscopy of the radiocarpal and middle carpal joints in standing sedated horses.

STUDY DESIGN

Experimental study.

ANIMALS

Six cadaveric forelimbs (phase 1) and six healthy horses (phase 2).

METHODS

In phase 1, six cadaveric forelimbs were used to assess needle arthroscopic evaluation of both joints. Six healthy horses were subsequently enrolled in phase 2 to validate the procedure in live animals. The joint was maintained in flexion with a custom-made splint and base.

RESULTS

In phase 1, needle arthroscopy allowed thorough evaluation of the dorsal and palmar recesses of both joints with traditional arthroscopic portals. In phase 2, joint evaluation was also thorough but only dorsal approaches were performed. All horses underwent radiocarpal joint arthroscopy, whereas the middle carpal joint was evaluated in only three of six horses because of limb movement. The technique was quickly performed and well tolerated by all horses. Complications included moderate movement, mild iatrogenic cartilage damage, and mild hemarthrosis.

CONCLUSION

Standing needle arthroscopy allowed thorough evaluation of the dorsal aspect of both joints, although only three of six middle carpal joints were assessed because of movement limitations.

CLINICAL SIGNIFICANCE

The proposed technique offers an alternative diagnostic tool for radiographically silent intra-articular lesions of the carpus while initially avoiding the cost and risks associated with general anesthesia. Arthroscopy of a single joint is recommended to minimize risks associated with movement during the procedure.

摘要

目的

开发一种用于对站立镇静马匹的桡腕关节和腕中关节进行站立诊断性针式关节镜检查的技术。

研究设计

实验性研究。

动物

6个尸体前肢(第1阶段)和6匹健康马匹(第2阶段)。

方法

在第1阶段,使用6个尸体前肢评估两个关节的针式关节镜检查。随后6匹健康马匹进入第2阶段,以在活体动物中验证该程序。使用定制夹板和底座将关节保持在屈曲状态。

结果

在第1阶段,针式关节镜检查能够通过传统关节镜入口对两个关节的背侧和掌侧隐窝进行全面评估。在第2阶段,关节评估也很全面,但仅进行了背侧入路。所有马匹均接受了桡腕关节镜检查,而由于肢体移动,6匹马中只有3匹对腕中关节进行了评估。该技术操作迅速,所有马匹耐受性良好。并发症包括中度移动、轻度医源性软骨损伤和轻度关节积血。

结论

站立针式关节镜检查能够对两个关节的背侧进行全面评估,尽管由于移动限制,6个腕中关节中只有3个进行了评估。

临床意义

所提出的技术为腕关节影像学无异常的关节内病变提供了一种替代诊断工具,同时初步避免了与全身麻醉相关的成本和风险。建议对单个关节进行关节镜检查,以尽量减少手术过程中与移动相关的风险。

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