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1.
A caudal approach to the scapulohumeral joint for treatment of osteochondritis dissecans of the humeral head was performed in seven dogs. By 14 days after surgery, three of the seven dogs were walking normally. At 6 weeks after surgery, all dogs were considered sound. Visualization was adequate for curettage of the osteochondritis dissecans lesions. Access to the medial joint compartment also was afforded.  相似文献   

2.
Luxation of the humeral head by internal rotation of theforelimb with the shoulder joint in flexion will maximize exposure of the humeral head for treatment of osteochondritis dissecans of the canine shoulder. The procedure was performed on 51 normal dogs and on 13 shoulders of 11 dogs with osteochondritis dissecans. Postoperative evaluation was obtained in all 51 normal dogs and 8 clinical patients. Postoperative seromas were seen in two dogs; one was presumed to be due to reaction to the suture material used, and the other to unrestricted exercise during the immediate postoperative period. There were no other complications. The time for recovery to normal ambulation was similar to those reported for other approaches.  相似文献   

3.
Two scapulohumeral arthrotomy techniques were evaluated and compared in 10 normal, young adult greyhounds. A caudolateral approach with craniodorsal retraction of the teres minor muscle (no-tenotomy) and a craniolateral approach with tenotomy of the infraspinatus tendon were each performed unilaterally in 5 dogs. The dogs were evaluated using force plate gait analysis, lameness evaluation, radiography, and goniometry for 5 weeks and then euthanatized. Tenotomy sites and sections of the humeral articular cartilage were collected from shoulder joints that had been operated on and examined microscopically. The same surgical approach was then performed on the contralateral shoulder in the cadavers and exposure of the humeral articular cartilage was measured using planimetry. Peak vertical force applied to the operated limbs in the tenotomy group was significantly less than preoperative levels on day 3 and significantly less than the no-tenotomy group on days 21 and 28. The peak vertical force applied to the operated limbs in the no-tenotomy group was not significantly different from preoperative levels during the study. Scapulohumeral arthrotomy by tenotomy of the infraspinatus resulted in decreased range-of-motion and joint extension compared with joints operated on without tenotomies, but provided significantly greater exposure to the articular surface. Scapulohumeral arthrotomy with craniodorsal retraction of the teres minor muscle did not significantly alter goniometric measurements compared with unoperated joints. Both techniques resulted in similar subjective lameness scores and caused no gross microscopic or radiographic evidence of articular cartilage damage.  相似文献   

4.
In fourteen dogs with osteochondritis dissecans of the stifle joint the lesion was found in the articular cartilage of the medial condyle of the femur in six and the lateral condyle in eight. Both stifle joints were affected in eight dogs and in two of these, both Wolfhounds, the shoulder joints were also affected. Ten dogs were treated surgically and three by conservative means. The results of treatment are discussed.  相似文献   

5.
Specimens of cartilage removed from the shoulder joint of dogs with osteochondritis dissecans were compared with the articular-epiphyseal cartilage from the same location of healthy dogs. The pathologic cartilage lost the lamination pattern of articular-epiphyseal cartilage from healthy dogs. Chondrocytes of healthy and pathologic cartilage contained lipid inclusions. However, in pathologic samples, the lipid inclusions were more prominent, particularly in the superficial region of the presumptive articular cartilage. Lipids in the interterritorial matrix of the pathologic cartilage were observed. The pathologic cartilage contained large groups of chondrocytes and areas of mineralization of variable magnitude. Although lipid inclusions were found in the chondrocytes of cartilage of healthy dogs, the increase in magnitude of lipids in the cartilage from dogs with osteochondritis dissecans was considered to result from a metabolic response of the chondrocyte to an altered microenvironment. The loss of sudanophilic lipids in areas of chondrolysis may be used to explain the retardation of osteogenesis of chondrolytic cartilage.  相似文献   

6.
Objective: To establish whether osteochondral autograft transfer (OAT) procedures for osteochondritis dissecans (OCD) of the canine caudocentral humeral head would restore articular contour, resurface osteochondral defects, and resolve lameness in dogs with OCD. Study Design: Case series. Animals: Dogs (n=14) with caudocentral humeral head OCD (16 shoulders). Methods: After arthroscopic assessment, the humeral head was exposed by arthrotomy. The OCD lesion was debrided and OATS? instrumentation used for resurfacing the defect with osteochondral core grafts collected from the stifle. Recipient sockets were created to maximally resurface articular lesions. Outcomes measures included clinical, radiographic, and arthroscopic examination at 12–18 weeks and clinical examination at 12–46 months (mean, 30.8 months) postoperatively. Results: Resurfacing of the humeral head was achieved in all dogs. Subjectively, lameness resolved in 9 of 16 limbs by 5–6 weeks postoperatively, and in 13 limbs by 12–18 weeks. Radiographically, all autografts were maintained. On second‐look arthroscopy, the grafted section was intact, resilient on probing, satisfactorily conformed to the adjacent articular contour, and grossly appeared consistent with hyaline or fibrocartilage depending on the graft source. Of 12 limbs available for 12–46 months reevaluation, none were considered lame and mild discomfort on shoulder manipulation was recorded for only 1 joint. Conclusions: OAT procedures are technically feasible in the caudocentral aspect of the canine humeral head. Articular contour reconstruction, resurfacing of osteochondral defects, and amelioration or resolution of short‐term lameness may be achieved.  相似文献   

7.
Arthroscopic approaches to the scapulohumeral joint were developed in four clinically normal, live horses (5 limbs) to determine their usefulness for evaluation and potential surgical treatment of intraarticular lesions. The articular surface of the entire glenoid, cranial humeral head (medial and lateral) and caudolateral humeral head, as well as the synovial membrane, could be closely examined from an arthroscopic portal cranial to the infraspinatus tendon. The caudomedial humeral head could be examined partially. Cranial and caudal instrument portals allowed good surgical access to the entire glenoid and the majority of the humeral head (except caudomedial in adult, heavily muscled horses). The described arthroscopic and instrument portals allowed access to the areas frequently affected with osteochondritis dissecans (OCD). Potential difficulties with this technique include problems establishing triangulation, extravasation of fluids, and inability to reach potential lesions on the caudomedial humeral head with conventional equipment in heavily muscled horses.  相似文献   

8.
A craniomedial approach to the scapulohumeral joint of the dog is described for the removal of large, intraarticular cartilaginous bodies from the medial aspect of the joint. This technique was used successfully in 4 dogs with chronic osteochondritis dissecans in which the medial aspect of the joint was inaccessible through a standard lateral approach.  相似文献   

9.
Eight 4 month old crossbred puppies underwent surgery simulating treatment of osteochondritis dissecans. Both humeral heads were exposed by a caudal approach to the shoulder joint. In one, an 8 mm circular, full-thickness cartilage defect was created so that the remnant cartilage margin was perpendicular to the joint surface. In the other, a similar 8 mm defect was created with the chondral margins beveled at approximately 45 degrees. There was no clinical lameness in any of the dogs. At necropsy after 16 weeks, the cartilage defects with beveled edges were significantly larger (11.0 +/- 0.6 mm SD) than those with perpendicular edges (8.0 +/- 0.1 mm SD), because of the beveling (p = 0.0039). Fibrocartilage was present but did not always completely fill the defects. Articular surfaces of the glenoid cavities suffered erosion and fibrillation more frequently opposite beveled defects than opposite defects with vertical walls (p = 0.0312). This was presumably due to the larger apposing defect. It was concluded that the cartilage margins surrounding a chondral defect should not be beveled.  相似文献   

10.
A one-year-neutered male cat was presented for veterinary examination because of a left forlimb lameness. A painful left shoulder joint was found on examination and radiology of this joint revealed an erosive lesion of the humeral head and a detached flap of articular cartilage. The detached cartilage was surgically removed after which the lameness resolved. The lesion in this cat resembled osteochondritis dessicans of other species but whether the pathogenesis of the condition in this cat was 115 similar also was not determined.  相似文献   

11.
A surgical procedure for medial arthrotomy in the elbow joint is described. Surgery was performed in an endeavour to remove an ununited coronoid process and/or a loose piece of cartilage from the humeral condyle. A long term follow up investigation of 58 operated and 20 unoperated dogs was undertaken. The prognosis of dogs operated upon because of osteochondritis dissecans of the humeral condyle, was fairly good; 11 of 15 dogs (73.3%) being reported as showing no signs of lameness. When dogs with the both diagnoses were judged together, the percentage of dogs reported not to be lame was 48.3 among operated dogs and 45 among unoperated dogs. However, dogs operated upon, recovered somewhat sooner than unoperated dogs. Of 38 dogs (58 joints) which were clinically and radiographically re-examined by the author, it was found that severe arthrosis (degree 3) developed in about 60% of the joints, no matter whether surgical treatment was carried out or not. However, 19 of these dogs were not lame, or only revealed lameness occasionally.  相似文献   

12.
SUMMARY The diagnosis, aetiology, pathogenesis and treatment of osteochondritis dissecana in the shoulder, elbow, stifle and hock joints of the dog is reviewed. A technique of surgically exploring the shoulder joint with minimal exposure is described. Recommendations for preventing the development of osteochondritis dissecans are made.  相似文献   

13.
The femoropatellar joints of four mature, clinically normal horses were surgically entered by a craniolateral or a lateral approach. Visualization of intra-articular structures was documented for each approach. Horses were euthanized 21, 42, and 63 days after surgery. Joint healing was evaluated clinically, and the joints were subjected to gross pathological and histopathological examination. Healing was by first intention following arthrotomy in six limbs. Skin dehiscence occurred in two limbs with healing by second intention. Subcutaneous seromas developed which resulted in peri-incisional swelling in seven limbs. The lateral approach to the femoropatellar joint provided greater exposure of the lateral femoral trochlear ridge and articular surface of the patella.
Surgery was performed on nine joints of seven clinical patients with osteochondritis dissecans. The craniolateral approach was used on four joints, and the lateral approach was used on five joints. Skin dehiscence occurred following four arthrotomies. Location of the lesion was concluded to be the main criterion for selection of the surgical approach.  相似文献   

14.
A condition of the stifle joints of a young Alsatian bitch, resembling osteochondritis dissecans of the humeral head of the dog, is described. This case is compared with osteochondritis dissecans of the canine humeral head and with osteochondritis dissecans of the human knee.
Résumé. On décrit une atteinte du grasset d'une jeune chienne alsacienne ressemblant à l'ostéo-chondrite disséquante de la tête humérale du chien; on fait un parallèle entre la présente observation, et l'ostéochondrite disséquante de l'articulation du genou humain.
Zusammenfassung. Es wird ein Zustand der Kniegelenke einer jungen Schäferhündin beschrieben, die der Osteochondritis dissecans des Humeruskopfes beirn Hund gleicht. Dieser Fall wird mit Osteochondritis dissecans des Humeruskopfes des Hundes und mit Osteochondritis dissecans des menschlichen Knies verglichen.  相似文献   

15.
A 6-year-old, male Labrador retriever was presented for lameness of the right forelimb. The lameness occurred 5 years after the dog was surgically treated for osteochondritis dissecans (OCD) of the caudal right humeral head. Radiographs revealed an expansile, osteolytic lesion occupying the entire caudal half of the right humeral head, and biopsy confirmed the diagnosis of osteosarcoma. Forelimb amputation was performed. Histopathology of the lesion and associated articular cartilage revealed neoplastic osteoblasts extensively infiltrating the marrow space adjacent to scar tissue associated with the previous OCD lesion. This is the first report of an epiphyseal osteosarcoma in the area of a previous OCD lesion in a dog.  相似文献   

16.
Techniques and normal radiographic anatomy for positive and double contrast shoulder arthrography in horses were evaluated. General anaesthesia was used for most radiographic projections of the shoulder. The mediolateral projection provided the most information during arthrography, although the supinated mediolateral view occasionally allowed better definition of the cartilage surfaces on the medial aspects of the humeral head. The craniocaudal mediolateral oblique and caudocranial projections provided limited additional information. Water soluble non-ionic contrast agents, such as metrizamide and iohexol, were suitable for shoulder arthrography; iohexol resulted in less synovitis and lameness. Arthrography in cases of osteochondrosis and osteochondritis dissecans allowed better evaluation of cartilage attachment to subchondral bone, better evaluation of the length and depth of cartilage lesions and more accurately defined the site and shape of osteocartilaginous free bodies. Cartilage thickening without detachment from the subchondral bone could only be determined by arthrography. Although these thick cartilage regions may later dissect from the subchondral bone, most cases where the cartilage was firmly adherent were not candidates for surgical debridement and carried a favourable prognosis. The determination of a free flap by arthrography indicated the need for surgery. Extensive humeral and glenoid cavity lesions were better defined by arthrography, allowing a rational decision between surgical debridement or euthanasia. Using arthrography, evaluation of the size and patency of the communicating canal to a subchondral cystic defect better separated cases with long, narrow and poorly patent canals for conservative rather than surgical therapy.  相似文献   

17.
OBJECTIVE: To determine clinical, scintigraphic, radiographic, and arthroscopic findings and results of treatment in horses with lameness attributable to subtle osteochondral lesions of the shoulder joint. DESIGN: Retrospective study. ANIMALS: 15 horses. PROCEDURE: Medical records were reviewed, and results of physical examination, scintigraphy, radiography, arthroscopy, and treatment were recorded. RESULTS: Severity of lameness ranged from grade 1 to 4. Response to shoulder flexion or extension was variable. Twelve horses had a narrow upright foot. Intra-articular anesthesia of the shoulder joint localized the cause of the lameness to the shoulder joint in 9 of 10 horses. Scintigraphic abnormalities were detected in 4 of 6 horses. Radiographic lesions were subtle and included glenoid sclerosis, focal glenoid lysis, small glenoid cysts, and alterations in the humeral head contour. Arthroscopic evaluation confirmed clefts in the glenoid cartilage, glenoid cysts, a humeral head cyst, fibrillation of the humeral head cartilage, cartilage fragmentation, or a nondisplaced fracture of the humeral head. After treatment, 12 horses returned to their previous level of performance, 1 was sound for light riding, 1 remained lame, and 1 was euthanatized because of chronic lameness. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that a combination of physical examination, scintigraphy, and radiography is necessary to diagnose subtle osteochondral lesions of the shoulder joint in horses. Arthroscopy can be used to confirm the diagnosis and treat cartilage and subchondral bone lesions. Young and middle-aged horses with subtle osteochondral lesions of the shoulder joints have a good prognosis for return to performance following arthroscopic treatment.  相似文献   

18.
Arthroscopic approaches to the femoropatellar joint were developed to determine their usefulness for evaluation and surgical treatment of osteochondritis dissecans. It was found that the articular cartilage of the lateral trochlear ridge, medial trochlear ridge, intertrochlear groove, patella, and the lateral and medial reflections of the joint capsule could be examined from an infrapatellar arthroscopic portal. The suprapatellar pouch could be examined partially. Lateral and medial instrument portals were evaluated to determine the accessibility of the lateral and medial trochlear ridges of the femur in the areas where osteochondritis dissecans lesions frequently occur. Sliding the arthroscope sleeve beneath the patella when entering the joint was associated with iatrogenic cartilage lesions. A new technique that directed the arthroscope lateral to the lateral trochlear ridge eliminated iatrogenic cartilage damage.  相似文献   

19.
Primary degenerative joint disease of the shoulder in a colony of beagles   总被引：1，自引：0，他引：1  
Shoulder joints of 149 Beagles over 8 years old at the time of death (mean age, 13.8 years +/- 3.21), were examined radiographically throughout their life-times for the frequency of degenerative joint disease (DJD). Clinical histories revealed no underlying cause for DJD. The shoulder joints of a subgroup of 18 dogs were examined at necropsy, and thin sections of the joints were evaluated radiographically and histologically. Serial clinical radiographic studies indicated that normal shoulder joint development during the first year of life was followed by the appearance of subchondral bone sclerosis and bony remodeling of normal joint contour, and by the formation of periarticular osteophytes and enthesiophytes. All changes were progressive with age and typical for DJD in dogs. Bilateral involvement was common. Evaluation of specimens obtained at necropsy revealed: articular cartilage change with roughening of the surface layer, degeneration and death of superficial chondrocytes, exposure of deeper layers of chondrocytes that had proliferated with fissuring of the damaged cartilage, total cartilage loss with polishing of the exposed subchondral bone, mixed patterns of subchondral bone sclerosis and osteoporosis, change in contour of the articular surfaces, and formation of periarticular osteophytes and enthesiophytes. Joint capsule thickening, synovitis, pannus formation, and synovial chondroma formation were observed. Because of the available clinical information, in addition to the typical changes of DJD, it was thought that the changes were primary. Instability appeared to play a role in the pathogenesis of the joint disease described; however, it was not clear whether the instability caused abnormal forces on healthy cartilage or whether the primary cartilage wear caused the instability.  相似文献   

20.
Osteochondrosis lesions in 29 shoulder joints (from 20 dogs) were evaluated with ultrasound (US) and the results were compared with survey radiography, arthrography, and arthroscopy. US was performed with a 7-12 MHz linear matrix transducer which was placed in cranio-caudal direction just distally to the acromion while the joint was adducted and maximally endorotated to visualize the caudal aspect of the humeral head. With US, the subchondral defect was completely visible in 21 joints and partially visible in 8 joints. The length of the subchondral defect measured on US was comparable with the length measured on survey radiographs. In two joints, the cartilage flap was mineralized and thus already visible on survey radiographs. The mineralized flap was visible on US as a straight hyperechoic line above the subchondral defect. In the other joints, survey radiographs could not assess the status of the articular cartilage. In 17 joints, the presence of a cartilage flap or cartilage fissuring was suspected based on the presence of a second hyperechoic line at the base of the subchondral defect, and this suspicion was confirmed by arthroscopic examination in 16 joints and also by arthrographic examination in 15 joints. One joint that was suspected of having a cartilage flap on US was normal on arthroscopy and arthrography. When US revealed only focal thickening of the anechoic cartilage layer (5 joints), the joints appeared normal on arthroscopic and arthrographic examination. Of the four joints where the subchondral defect was irregular and covered by heteroechogeneous material on US, arthroseopy revealed the presence of a lesion resembling chondromalacia in two joints, the presence of a small cartilage flap in one joint and the presence of scar tissue underneath the flap at the level of the subchondral defect in one joint. In conclusion, US is a helpful imaging modality in the identification of osteochondritic lesions in the canine shoulder joint. US also appears to be a satisfactory imaging tool for identifying lesions such as joint mice, joint effusion, and distinct new bone formation.  相似文献   

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