Rovesti Gian Luca, Böhme Beatrice
Clinica Veterinaria M.E. Miller, Via della Costituzione, 10, 42025 Cavriago, Italy.
Kleintierzentrum Hirschberg, Landstr. 15, 69493 Hirschberg, Germany.
Animals (Basel). 2024 Sep 19;14(18):2717. doi: 10.3390/ani14182717.
Current treatments for medial meniscus lesions in association with CCL ruptures have shown disappointing long-term outcomes. Meniscal suturing may improve the outcome, but their clinical application remains limited. This study aims to assess the practicability of a minimally invasive DNT to facilitate meniscal suturing in dogs. Ten stifles of eight client-owned dogs with arthroscopically confirmed CCL disease and medial meniscal tears in the abaxial third of the meniscus were included. The described suture technique was applied under joint distraction using the Titan joint distractor. Surgical stabilization of all stifles was then accomplished via an X-Porous TTA procedure. The DNT allowed for the precise placement of meniscal sutures. Minor intraoperative complications included reduced arthroscopic visibility ( = 2) and suture breakage during its passage through the meniscus ( = 3). No complications related to the meniscal sutures were noted throughout the six-month follow-up period. The described DNT proved to be a viable and effective method for suturing lesions of the caudal horn of the medial meniscus, provided there is adequate visualization during the procedure. Appropriate stifle stabilization postoperatively is mandatory for protecting the suture and avoiding concomitant meniscal lesions due to joint instability.
目前针对内侧半月板损伤合并十字韧带断裂的治疗方法,长期疗效令人失望。半月板缝合术或许能改善治疗效果,但其临床应用仍受限。本研究旨在评估一种微创双针技术(DNT)在犬类中辅助半月板缝合的可行性。纳入了8只客户拥有的犬的10个膝关节,这些膝关节经关节镜证实患有十字韧带疾病且半月板内侧撕裂位于半月板背侧三分之一处。所描述的缝合技术在使用泰坦关节撑开器进行关节牵张的情况下应用。然后通过X型多孔胫骨结节前移术(X-Porous TTA)对所有膝关节进行手术稳定。双针技术(DNT)能够精确放置半月板缝线。术中轻微并发症包括关节镜视野受限(2例)以及缝线穿过半月板时断裂(3例)。在六个月的随访期内未发现与半月板缝线相关的并发症。所描述的双针技术(DNT)被证明是一种可行且有效的缝合内侧半月板后角损伤的方法,前提是手术过程中有足够的视野。术后进行适当的膝关节稳定处理对于保护缝线以及避免因关节不稳定导致的半月板伴随损伤是必不可少的。