Nixon A J
Department of Clinical Sciences, College of Veterinary Medicine, Cornell University, Ithaca, NY 14853.
Vet Surg. 1994 Sep-Oct;23(5):377-85. doi: 10.1111/j.1532-950x.1994.tb00498.x.
Arthroscopic examination of the hip joint was performed in mature and juvenile horses, using a lateral approach and standard or long instruments depending on body weight. Nine hip joints were examined in three cadavers and four anesthetized horses. The lateral, cranial, and caudal regions of the femoral head and acetabulum were accessible, and, after distraction of the limb, the ligament of the head of the femur and the acetabular notch were also visible. In small horses, the medial regions of the hip joint were visible but were inaccessible in larger horses. Iatrogenic injury to the sciatic nerve or periarticular vasculature was not evident at necropsy examination. Six horses with lameness localized to the hip joint were examined arthroscopically. At surgery, two horses had tearing of the ligament of the head of the femur, two horses had osteochondrosis of the femoral head or acetabulum, and two horses had degenerative joint disease, one associated with a rim fracture of the caudal aspect of the acetabulum and the other of indeterminant origin. Improvement after debridement occurred in one of the horses with partial disruption of the ligament of the head of the femur and in both horses with osteochondrosis. Diagnostic and surgical arthroscopy of the hip can be accomplished in foals and weanlings using standard equipment, but, in adults weighing more than 300 kg, longer instruments are required and the ease of access and the visible extent of the hip joint is considerably reduced.
采用外侧入路,根据体重使用标准器械或长器械,对成年马和幼年马进行髋关节镜检查。在3具尸体和4匹麻醉马身上检查了9个髋关节。股骨头和髋臼的外侧、头侧和尾侧区域均可观察到,肢体牵引后,股骨头韧带和髋臼切迹也可见。在小型马中,髋关节的内侧区域可见,但在大型马中无法触及。尸检时未发现坐骨神经或关节周围血管的医源性损伤。对6匹跛行局限于髋关节的马进行了关节镜检查。手术中,2匹马的股骨头韧带撕裂,2匹马有股骨头或髋臼骨软骨病,2匹马有退行性关节病,其中1例与髋臼尾侧缘骨折有关,另1例病因不明。清创术后,1例股骨头韧带部分断裂的马和2例骨软骨病马均有改善。使用标准设备可对幼驹和断奶幼畜进行髋关节诊断性和手术性关节镜检查,但对于体重超过300 kg的成年马,需要更长的器械,并且髋关节的易接近性和可视范围会大大降低。