Fitch R B, Montgomery R D, Kincaid S A, Hatchcock J T, Milton J L, Garrett P D, Wright J C, Terry G C
Department of Small Animal Surgery and Medicine, College of Veterinary Medicine, Auburn University, AL 36849-5523, USA.
Vet Surg. 1995 Mar-Apr;24(2):156-64. doi: 10.1111/j.1532-950x.1995.tb01310.x.
This study evaluated the effect of notchplasty (enlargement of the intercondylar fossa) in stable and unstable canine stifles. Bilateral notchplasty and unilateral cranial cruciate ligament (CrCL) transection were performed in 6 dogs. Exercise, consisting of walking 1.5 miles three times a week, began 1 month after surgery and continued until euthanasia 6 months after surgery. Evaluation methods included orthopedic examination, serial radiographs, thin section radiography, histopathology, and gross pathology. Notchplasty in the stable stifle did not cause lameness beyond 3 weeks, joint instability, or degenerative joint disease. In the stable stifle, smooth resurfacing of the notchplasty site with fibrous and osseous tissue occurred. Stifles with notchplasty and CrCL transection exhibited persistent lameness, instability, and degenerative joint disease. In CrCL deficient stifles osteophytes formed within the notchplasty site, resulting in a rough surface. Our observations indicated significant refilling in notchplasties of both stable and unstable stifles (P < .05). However, the intercondylar fossa (ICF) width 6 months after notchplasty was significantly smaller in unstable stifles compared with stable stifles (P < .05) indicating that greater refilling of the notchplasties occurred in the unstable stifles. In clinical cases, notchplasty should be larger than the desired final result to accomodate the partial refilling that occurs even in stable stifles.
本研究评估了髁间切迹成形术(髁间窝扩大术)对稳定型和不稳定型犬膝关节的影响。对6只犬实施了双侧髁间切迹成形术和单侧颅侧交叉韧带(CrCL)切断术。术后1个月开始运动,每周三次,每次行走1.5英里,持续至术后6个月实施安乐死。评估方法包括骨科检查、系列X线片、断层X线摄影、组织病理学和大体病理学。稳定型膝关节的髁间切迹成形术在3周后未导致跛行、关节不稳定或退行性关节病。在稳定型膝关节中,髁间切迹成形术部位出现纤维组织和骨组织的光滑重塑。实施髁间切迹成形术和CrCL切断术的膝关节表现出持续性跛行、不稳定和退行性关节病。在CrCL缺失的膝关节中,髁间切迹成形术部位形成骨赘,导致表面粗糙。我们的观察结果表明,稳定型和不稳定型膝关节的髁间切迹成形术均有显著的再填充(P < 0.05)。然而,与稳定型膝关节相比,不稳定型膝关节在髁间切迹成形术后6个月时髁间窝(ICF)宽度显著更小(P < 0.05),表明不稳定型膝关节的髁间切迹成形术再填充更多。在临床病例中,髁间切迹成形术的尺寸应大于预期的最终结果,以适应即使在稳定型膝关节中也会发生的部分再填充。