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出于关节镜检查目的,对马股胫关节尾侧囊的解剖学和影像学特征的考量。

Consideration of anatomic and radiographic features of the caudal pouches of the femorotibial joints of horses for the purpose of arthroscopy.

作者信息

Trumble T N, Stick J A, Arnoczky S P, Rosenstein D

机构信息

Department of Large Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing 48824.

出版信息

Am J Vet Res. 1994 Dec;55(12):1682-9.

PMID:7887511
Abstract

Development of an arthroscopic approach to the caudal pouches of the equine stifle has been necessary because cranial approaches do not allow access to articular lesions in the caudal aspect of the joint. Therefore, the anatomy of the caudal region was examined in 52 cadaver limbs by use of gross dissection (29), x-ray-computed tomography (6), fluoroscopy (8), or arthroscopy (9). Additionally, using arthroscopic techniques developed in equine cadaver limbs, 3 stifles from 2 anesthetized horses were arthroscopically explored. Fluoroscopy was used to verify needle placement for joint injection and filling patterns of each femorotibial joint. The medial femorotibial joint sac (n = 4) held a mean +/- SD 41.67 +/- 5.77 ml of injection fluid, and the lateral femorotibial joint sac (n = 4) held a mean 61.67 +/- 2.89 ml of injection fluid. Vital structures that inadvertently could be damaged during arthroscopy of the caudal pouches of the stifle included the peroneal nerve (located approx 7 cm caudal to the lateral collateral ligament), the popliteal artery and vein (situated directly between the medial and lateral femoral condyles), and the lateral femoral condyle (most often traumatized during arthroscopy). The tendon of the popliteus muscle, which is contiguous with the joint capsule of the caudal pouch of the lateral femorotibial joint, made arthroscopic exploration of this pouch particularly difficult.

摘要

由于经颅入路无法触及马膝关节尾侧关节面的病变,因此有必要开发一种关节镜入路来处理马膝关节的尾侧囊。为此,我们通过大体解剖(29例)、X线计算机断层扫描(6例)、荧光透视(8例)或关节镜检查(9例),对52具尸体肢体的尾侧区域进行了解剖学研究。此外,利用在马尸体肢体上开发的关节镜技术,对2匹麻醉马的3个膝关节进行了关节镜探查。荧光透视用于验证关节注射时的进针位置以及每个股胫关节的充盈模式。内侧股胫关节囊(n = 4)平均可容纳41.67 +/- 5.77 ml注射液,外侧股胫关节囊(n = 4)平均可容纳61.67 +/- 2.89 ml注射液。在对膝关节尾侧囊进行关节镜检查时可能意外受损的重要结构包括腓总神经(位于外侧副韧带尾侧约7 cm处)、腘动脉和静脉(位于股骨内外侧髁之间)以及外侧股骨髁(在关节镜检查时最常受到损伤)。与外侧股胫关节尾侧囊的关节囊相连的腘肌肌腱,使得对该囊进行关节镜探查特别困难。

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