Clinic for Ruminants, Department of Clinical Veterinary Medicine, Vetsuisse-Faculty, University of Berne, CH-3001, Bern, Switzerland.
Department of Surgery and Anesthesia, Faculty of Veterinary Medicine, University of Khartoum, P.O. Box 32, Khartoum North, Khartoum, Sudan.
BMC Vet Res. 2020 May 24;16(1):150. doi: 10.1186/s12917-020-02337-z.
Arthroscopic surgery is described as a minimally invasive technique for diagnosis, exploration and treatment of joint disorders. It allows intraarticular structures to be assessed accurately, thereby improving the diagnostic capabilities, and it broadens the spectrum of surgical techniques feasible for treatment of articular pathologies in cattle. This study aimed to assess for cattle the described arthroscopic approaches to the shoulder joint of horses, and to describe the appearance of the corresponding intraarticular structures of the shoulder joint. Additionally, to perform histological examination where tissues were identified and assessed arthroscopically, but the tissue type was uncertain using cadaveric limbs from cattle of different age categories without any signs of orthopedic diseases of the front limbs.
An anatomic and arthroscopic investigation with 34-cadaveric forelimbs from 20-cattle was performed. The arthroscope was inserted either immediately cranial or 1-cm caudal to the tendon of the infraspinatus muscle for the cranial and caudal approaches, respectively. The shoulder joints were examined with the limbs in either horizontal non-pulled position, abducted non-pulled position using a three-pod limb holder adjustable in height, or horizontal manually pulled position. Arthroscopy was performed using a rigid 30°arthroscope (18-cm length, 4-mm outer diameter) to view the synovial pouches with their synovial villi and the following structures: cranial rim of the glenoid, cranial portion of the humeral head, incisura-glenoidalis, caudal rim of the glenoid, caudal portion of the humeral head, and cranial and caudal cul-de-sac. Abduction of the limb allowed improved visualization of the lateral portion of the joint. Pulling the limb facilitated investigation of the medial portion of the joint. Generally, the distention range was higher in younger as compared to adult cattle, and visualization of the medial portion of the joint was, therefore, facilitated in younger animals. The main complications observed were subcutaneous fluid extravasations and partial-thickness articular cartilages wear-lines.
The described arthroscopic techniques allowed good overall visualization of the most relevant anatomical structures within the healthy cadaveric joint. Further investigations are warranted to evaluate the diagnostic and therapeutic applications of these techniques and the prognosis of arthroscopic surgery as a tool for the treatment of joint lesions.
关节镜手术被描述为一种用于诊断、探查和治疗关节疾病的微创技术。它可以准确评估关节内结构，从而提高诊断能力，并拓宽了用于治疗牛关节病变的手术技术范围。本研究旨在评估牛肩关节的描述性关节镜入路，并描述肩关节的相应关节内结构的外观。此外，对尸体四肢进行组织学检查，这些组织在关节镜下被识别和评估，但使用来自不同年龄组的无前肢骨科疾病迹象的牛的尸体四肢，组织类型不确定。
对 34 具来自 20 头牛的尸体前肢进行了解剖和关节镜检查。关节镜分别通过冈下肌腱的头侧或 1cm 尾侧插入进行头侧和尾侧入路。关节在水平非牵拉位置、使用可调节高度的三足肢架外展非牵拉位置或水平手动牵拉位置下进行检查。使用刚性 30°关节镜（18cm 长，4mm 外径）进行关节镜检查，以观察滑膜囊及其滑膜绒毛和以下结构：关节盂的头侧缘、肱骨头的头侧部分、关节盂切迹、关节盂的尾侧缘、肱骨头的尾侧部分以及头侧和尾侧隐窝。肢体外展可改善关节外侧部分的可视化效果。牵拉肢体可方便地探查关节的内侧部分。一般来说，与成年牛相比，年轻牛的扩张范围更高，因此更容易在年轻动物中观察到关节的内侧部分。观察到的主要并发症是皮下液渗出和部分厚度关节软骨磨损线。
所描述的关节镜技术允许对健康尸体关节内的大多数相关解剖结构进行良好的整体可视化。需要进一步研究以评估这些技术的诊断和治疗应用以及关节镜手术作为治疗关节病变的工具的预后。
