首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献，搜索用时 15 毫秒
1.
REASON FOR PERFORMING STUDY: The traditional techniques for injection of the sacroiliac (SI) region are based on external landmarks. Because of the depth of the SI joint and pathological modifications, SI injections are sometimes challenging in horses. HYPOTHESIS: An ultrasound-guided techniques would allow placement of the needle without depending on external landmarks. METHODS: Fourteen pelvic specimens were isolated from mature horses. A 20 cm bent spinal needle was positioned with ultrasonographic guidance under both iliac wings aiming for SI joints using 5 approaches: cranial, craniomedial, medial and 2 caudal approaches. The length of needle inserted was recorded and 2 ml of latex injected. The distance from latex to the closest sacral articular margin, the contact between latex and the SI interosseous ligament or the contact with the neurovascular structures emerging from the greater sciatic foramen were recorded at the time of dissection. RESULTS: Latex was identified under the iliac wing in all injections but one. The distance from the latex to the closest sacral articular margin was significantly shorter (P = 0.02) for the 2 caudal approaches compared to the cranial, craniomedial and medial approaches. Contact between latex and the SI interosseous ligament was significantly more frequent (P = 0.01) with the cranial, craniomedial and medial approaches (38/73) compared to the caudal approaches (1/24). Contact between latex and the neurovascular structures was significantly less frequent (P = 0.005) for the cranial and craniomedial approaches (0/47) compared to the medial and caudal approaches (8/60). Four erratic injections were encountered. CONCLUSIONS: Ultrasonographic guidance allowed the needle to engage under the iliac wing without being dependent on external landmarks. The caudal approaches allowed deposition of liquid extremely close to the SI joint although retroperitoneal injections occurred. CLINICAL RELEVANCE: Each approach has advantages/drawbacks that could be favoured for selected purposes, but additional work is required to evaluate them on clinical cases.  相似文献   

2.
REASON FOR PERFORMING STUDY: Coxofemoral joint pain is probably underestimated due to difficulties in identifying hip pain. The deep location of the joint and proximity of the sciatic nerve make arthrocentesis based on external landmarks a difficult and potentially risky procedure in mature horses. OBJECTIVES: To describe an ultrasound-guided injection technique of the coxofemoral joint in standing horses and to evaluate its accuracy and potential difficulties/complications. METHODS: Nine mature horses had both pelvic areas prepared for sterile ultrasound examination (3.5 MHz curvilinear probe). Coxofemoral joints were located and penetrated at their craniodorsolateral aspect under ultrasonographic guidance and injected with sterile contrast medium. A standing ventrodorsal radiographic view of each hemipelvis centred on the hip was obtained for each horse to assess the injection site. Horses were evaluated for 10 days following injection for possible complications. RESULTS: Intra-articular injection was successful in all 18 joints. The procedure was well tolerated by horses under minimal restraint. Mean +/- s.d. needle repositionings required before accurate placement was 1.5 +/- 1.3 per joint. Once the needle was in the joint, synovial fluid was obtained in 7/18 joints. Minimal periarticular contrast medium was detected in 2/18 joints. Mean +/- s.d. ultrasonographic examination time required for coxofemoral localisation, accurate needle positioning and injection was 4.3 +/- 2.1 min. No complications were observed in the 10 days following injection. CONCLUSION: The ultrasound-guided coxofemoral arthrocentesis is an accurate, reliable and safe technique that offers a real time evaluation of needle introduction into the deep and narrow coxofemoral joint space. POTENTIAL RELEVANCE: Although this technique remains to be tested on clinical cases, it is a promising tool to facilitate diagnosis of coxofemoral pain, septic arthritis or administration of intra-articular medication.  相似文献   

3.
ObjectivesTo develop an ultrasound-guided cervical perineural injection technique for horses and to evaluate and compare the distribution of contrast agent among perineural, intra-articular and periarticular injections.Study designProspective, experimental cadaveric study.AnimalsA total of 14 equine cadaveric necks.MethodsBilateral ultrasound-guided perineural injection technique for the caudal cervical spinal nerve roots (CSNRs 5–7) was developed. Paramagnetic or iodinated contrast was injected and the distribution of contrast was evaluated using magnetic resonance (MR) or computed tomography (CT) imaging, respectively. The presence of contrast in the CSNR region was determined by an observer unaware of the technique used for each injection performed. The ability of the perineural injection technique to distribute contrast agent to the CSNR region was compared with intra-articular and periarticular injection techniques.ResultsPerineural injection delivered contrast agent to the CSNR region 100% of the time and was significantly different when compared with intra-articular injection (p = 0.008). There was no difference in ability to deliver contrast agent to the CSNR region between the perineural and periarticular injection techniques or between the intra-articular and periarticular injection techniques.Conclusion and clinical relevanceThe ultrasound-guided perineural injection technique developed in this study accurately delivered contrast agent to the CSNR region in equine cadavers. This technique could potentially be used for the diagnosis and treatment of cervical pain in horses, particularly in cases where intra-articular cervical articular process joint injections have not been beneficial. Further studies are necessary to assess the effectiveness of the ultrasound-guided perineural injection technique in live horses.  相似文献   

4.
OBJECTIVE: To (1) describe a caudal approach to equine medial and lateral femorotibial (FT) joints and (2) illustrate the complex anatomic detail of the caudal compartments of the lateral FT joint. STUDY DESIGN: Prospective experimental study. ANIMALS: Cadaveric equine hindlimbs (n = 36; 26 horses) and 6 horses (11 hind limbs). METHODS: Stifles (n = 8) were dissected and 10 FT joints were injected with silicone. Arthroscopic exploration (n = 29) was performed, followed by dissection to determine sites and structures penetrated during entry. RESULTS: A more caudal approach to the caudal pouch of the medial FT improved anatomic observation. A more caudal approach to the caudal pouch of the lateral FT joint occasionally caused damage to the common peroneal nerve; however, after reverting to the previously described approach, damage was avoided. CONCLUSION: Arthroscopy of the caudal pouch of the medial FT joint was facilitated using a more caudomedial approach, which improved observation of intrasynovial structures, most importantly, the caudal cruciate ligament and caudal horn of the medial meniscus. A more caudal approach to the caudal pouch of the lateral FT joint cannot be safely performed without risk to the common peroneal nerve and therefore the standard caudal approach is described in detail. CLINICAL RELEVANCE: A caudomedial arthroscopic approach allows improved surgical assessment of meniscal or caudal cruciate ligament injury. Care should be exercised when exploring the caudal pouch of the lateral FT joint because the common peroneal nerve is variably located and could easily be damaged during arthroscope or instrument insertion, especially if the limb is minimally flexed.  相似文献   

5.
Sacroiliac lesions are commonly suspected in sport‐ and racehorses. Injection of the sacroiliac (SI) area can be performed for diagnostic purposes and/or for treatment of SI pain. Because of the deep location of the SI joint, blind injections may be unsafe. The purpose of this paper is to present how to perform ultrasonographic guided injection of the SI area using cranial and caudal approaches. With this technique drugs can be injected close to the SI joint and technical errors (needle implantation in the sciatic nerve, injection in the vertebral canal or in the rectum) can be avoided.  相似文献   

6.
Objective: To compare ultrasound‐guided lateral and medial approaches for periarticular injections of the thoracolumbar intervertebral facet joints (IFJ). Study Design: Experimental cadaveric study. Sample Population: Adult equine cadavers (n=4). Methods: IFJ (T12–T13 to L5–L6) were identified by ultrasound (transducer perpendicular to the spine axis) and insertion of a 13 cm, 18 g spinal needle monitored until bone contact using medial (right side) and lateral (left side) approaches. Number of needle insertions at each site, needle repositioning, and insertion depth were recorded. On bone contact 2 mL latex was injected. Intraarticular deposition, distance of latex from the closest articular margin, and presence of latex in the multifidus muscle were established by dissection. Results: Of 96 attempts, only 1 site require reinsertion of the needle; however, 46% of the injections required needle repositioning. Mean ± SD insertion depth was 8.5 ± 1.1 cm. Most injections (86%) were intraarticular and 96% were at or within 0.5 cm of the closest articular margin. Needle insertion relative to the transducer (lateral, medial) had no effect on the distance from the latex to the closest articular margin and all injections were performed into the multifidus muscle. Conclusions: Ultrasound‐guidance facilitated accurate periarticular injection of thoracolumbar IFJ irrespective of using a medial or lateral approach.  相似文献   

7.
OBJECTIVE: To develop a dorsolateral approach to the centrodistal (distal intertarsal) joint in horses and compare its success rate with that of the traditional medial approach in that joint. SAMPLE POPULATION: 25 cadaveric equine hind limbs, ultrasonographic images, and radiographic views of the tarsal region of 5 and 59 healthy horses, respectively, and 22 horses with a clinical indication for centrodistal joint centesis. PROCEDURES: The dorsolateral approach was established anatomically (3 cadaveric limbs), ultrasonographically (5 horses), and radiographically (59 horses). Centrodistal joint arthrocentesis was performed in 22 cadaveric hind limbs and 22 horses; the number of needle repositionings required for procedure completion via the medial (in vitro) and the dorsolateral approach (in vitro and in vivo) was determined. RESULTS: For the dorsolateral approach to the centrodistal joint, the injection site was 2 to 3 mm lateral to the long digital extensor tendon and 6 to 8 mm proximal to a line drawn perpendicular to the axis of the third metatarsal bone through the proximal end of the fourth metatarsal bone. The needle was directed plantaromedially (angle of approx 70 degrees from the sagittal plane). The number of needle repositionings required to complete centrodistal joint centesis via the dorsolateral and medial approaches was not significantly different. CONCLUSION AND CLINICAL RELEVANCE: In a clinical setting, the dorsolateral approach to the centrodistal joint in horses appears to have some advantages over the traditional medial approach. The success rate of arthrocentesis was similar via either approach, and palpation of the anatomic landmarks was easy.  相似文献   

8.
Radiologic findings are described in 20 horses with clinical signs of a caudal lumbar or hindlimb problem; the horses were subjected to linear tomography of the lumbosacral and pelvic regions. The cases could be divided into four groups: sacroiliac arthrosis (6 horses), lumbosacral abnormalities (3 horses), pelvic or lumbar fracture (6 horses), and no radiographic abnormalities (5 horses). Five of the six horses with sacroiliac arthrosis had spur formation, with localized arthrosis at the caudal aspect of the sacral wing and its articulation with the auricular surface of the ilium. In one horse these lesions were confirmed at postmortem examination. The sixth horse, a Standardbred trotter, had more even and widespread arthrosis of the sacroiliac joint. The three lumbosacral abnormalities were present in two horses with fusion of the L5-L6 articulation and one horse with a wider than normal sacrolumbar articulation. Linear tomography also proved to be of diagnostic and prognostic value in the evaluation of lumbar and pelvic fractures. Finally, tomography could be used to eliminate the presence of sacroiliac or lumbosacral damage in some horses that presented with clinical signs suggestive of disease of the lumbosacral or sacroiliac region.  相似文献   

9.
OBJECTIVE: To develop an arthroscopic approach to, and describe the arthroscopic anatomy of, the equine temporomandibular joint (TMJ). STUDY DESIGN: Cadaveric study, after which the technique was tested in horses. ANIMALS OR SAMPLE POPULATION: Ten cadaveric equine heads and 5 normal horses (age, 5-13 years; weight, 425-545 kg). METHODS: Specimens or horses were positioned in right lateral recumbency. After fluid distention of the TMJ, arthroscopic portals were made in the dorsal compartment over the most prominent portion of the joint outpouching (caudodorsal approach) and in rostral and intermediate locations. The joint was explored and photographed. Positional changes in the mandible were made to determine if observation of the joint could be improved. Instrument portals were created to assess the feasibility of surgical arthroscopy. Cadaveric heads were dissected to assess iatrogenic damage, whereas experimental horses were observed for postoperative complications for 30 days. RESULTS: A caudodorsal arthroscopic approach provided the best evaluation of the dorsal compartment of the TMJ. The approach allowed observation of the rostral and caudal synovial pouches and the lateral aspect of the joint including the articular disc. Examination of the medial aspect of the joint was limited to the most rostral and caudal aspects. Access to the lateral aspect of the ventral compartment of the TMJ was precluded by the position of the transverse facial artery and vein. In specimens, iatrogenic damage was minimal and limited to the articular fibrocartilage, articular disc, and penetration of the parotid salivary gland. If the latter also occurred in horses, no adverse effects were noted. In horses, mild fluid extravasation occurred and resolved within 1 day. All horses ate normally after surgery but had periarticular swelling and mild pain upon palpation of the TMJ for 2 days. CONCLUSIONS: A caudodorsal arthroscopic approach to the TMJ allowed adequate observation of the lateral aspect of the dorsal compartment of the joint. Access to the ventral compartment was precluded by the location of the transverse facial artery and vein. CLINICAL RELEVANCE: Conditions affecting the lateral and caudal aspects of the dorsal compartment of the TMJ should be visible by arthroscopy.  相似文献   

10.
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.  相似文献   

11.
Reasons for performing study: Arthrosis of the articular process joints (APJs) in the caudal thoracolumbar region of horses may cause back pain and subsequent reduced performance or lameness. Ultrasound‐guided injections of the APJs of the equine back have been described only briefly in the literature. Objectives: To evaluate factors affecting the accuracy of intra‐articular injections of the APJs in the caudal thoracolumbar region. Methods: One‐hundred‐and‐fifty‐four injections with blue dye were performed on APJs including the T14–L6 region in 12 horses subjected to euthanasia for reasons unrelated to back problems. The backs were subsequently dissected to verify the location of the injectate in relation to the APJs. Results: Twenty‐seven percent of the injections were found to be intra‐articular and a total of 77% found to be within 2 mm of the joint capsule including the intra‐articular deposits. Application of a medial approach and 18 gauge needle were significantly associated with an intra‐articular injection or deposition close to the joint capsule. Operator, APJ (location) and back number (chronological) did not significantly affect the accuracy of injection. Conclusions and potential relevance: Injection of the vertebral APJ in the thoracolumbar region using ultrasound guidance is a reliable method, as most of the injections were either in or within 2 mm of the joint. Based on the findings of this cadaver study, the medial approach is expected to be the most accurate in live horses. Further investigations are required to evaluate the diagnostic and therapeutic potential of this method in clinical practice.  相似文献   

12.
The purpose of this study was to establish the normal percutaneous ultrasonographic appearance of anatomic structures within the equine sacroiliac region. Percutaneous ultrasonography was performed in a cranial-to-caudal direction in 10 normal adult live horses. The following structures were examined in detail: supraspinous ligament, lumbar and sacral spinous processes, thoracolumbar fascia and its caudal extension, tubera sacralia, ilial wings, dorsal and lateral portions of the dorsal sacroiliac ligaments, lateral part of the sacrum, and the lateral sacral crest. After ultrasonography, all animals were euthanized and detailed dissection of the lumbosacropelvic region was performed in six horses. Four lumbosacropelvic specimens were frozen and sectioned transversely for evaluation of cross-sectional anatomy. Gross anatomic findings were correlated with ante-mortem ultrasonographic images. On percutaneous ultrasonography, all horses had tubera sacralia with a mild-to-moderate roughened surface with occasional irregular hyperechoic mineralizations located within the apophyseal cartilage of younger horses. At the level of the tuber sacrale the caudal extension of the thoracolumbar fascia joined the dorsal portion of the dorsal sacroiliac ligament and assumed two different configurations relative to the dorsal portion of the dorsal sacroiliac ligament, with the predominant configuration of the thoracolumbar fascia located medial to the dorsal portion of the dorsal sacroiliac ligament. The less frequently encountered configuration had the thoracolumbar fascia positioned dorsal to the dorsal portion of the dorsal sacroiliac ligament. Caudal to the tuber sacrale the dorsal portion of the dorsal sacroiliac ligament and thoracolumbar fascia consolidated to form a single, fused structure with a common insertion on the sacral spinous processes. A large variability in linear fiber pattern, echogenicity (small focal hypoechoic areas), ligament height, and cross-sectional measurements was identified in the fused dorsal portion of the dorsal sacroiliac ligament and thoracolumbar fascia of normal horses. Diagnosing mild-to-moderate desmitis of the fused dorsal portion of the dorsal sacroiliac ligament and thoracolumbar fascia based solely on ultrasonography may therefore be difficult. To correlate ultrasonography with histology, samples of a fused dorsal portion of the dorsal sacroiliac ligament and thoracolumbar fascia with bilateral hypoechoic lesions were submitted for histology and revealed diffuse mild-to-moderate loss of fiber density, multifocal fibrocyte degeneration, and cartilagenous metaplasia with multifocal, mild myofiber mineralization, which was compatible with age-related changes. As controls, sections of ultrasonographically normal fused dorsal portion of the dorsal sacroiliac ligament and thoracolumbar fascia from three horses demonstrated similar but milder histologic findings, which were considered normal.  相似文献   

13.
Reasons for performing study: Clinical experiences indicate that centesis of the lateral compartment of the femorotibial joint is often unsuccessful. Objective: To determine the accuracy of 2 published and 2 unpublished techniques of centesis of the lateral compartment of the femorotibial joint. Hypothesis: It was hypothesised that a drug can be administered into the lateral compartment of the femorotibial joint via a diverticulum of this joint that surrounds the medial aspect of the long digital extensor tendon and that this technique is more accurate than described techniques of centesis of this compartment. Methods: Twenty‐four stifles of 12 horses were divided equally into 4 groups and a radiocontrast medium injected into the lateral compartment of the femorotibial joint of each group using a hypodermic needle inserted: 1) caudal to the lateral patellar ligament and proximal to the tibial plateau, 2) caudal to the long digital extensor tendon and proximal to the tibial plateau, 3) between the long digital extensor tendon and bone of the extensor groove of the tibia or 4) directly through the long digital extensor tendon until it contacted bone. Twelve veterinary students who had no experience using any of these techniques performed the injections. Accuracy of each technique was determined by examining radiographs obtained after injecting the contrast medium. Results: The most successful technique for arthrocentesis was by inserting a needle through the long digital extensor tendon. This approach was successful in all attempted cases, whilst other techniques had lower rates of success. Conclusions: The lateral compartment of the femorotibial joint can be accessed accurately by inserting a needle through the long digital extensor tendon as it lies within the extensor groove. Other techniques may not be as accurate for clinicians inexperienced in arthrocentesis of the lateral compartment of the femorotibial joint.  相似文献   

14.
OBJECTIVE: To compare accuracy of 2 methods for injection of the podotrochlear bursa in horses. DESIGN: Observational study. ANIMALS: 17 French Standardbreds. PROCEDURE: In each horse, contrast medium was injected into the podotrochlear bursa of 1 foot by use of a distal palmar approach with the needle inserted parallel to the sole (DPPS) and into the podotrochlear bursa of the other foot by use of a distal palmar approach to the navicular position (DPNP). Podotrochlear bursa injection was evaluated by means of radiographic examination in all horses and postmortem examination in 6. RESULTS: Contrast medium was successfully injected into the podotrochlear bursa in 6 of 16 feet in which the DPPS method was used and 14 of 17 feet in which the DPNP method was used; these results were significantly different. Failure was attributed to contrast medium invading the distal interphalangeal joint, contrast medium pooling palmar to the deep digital flexor tendon, contrast medium located in the podotrochlear bursa and the distal interphalangeal joint, contrast medium located in the podotrochlear bursa and the area palmar to the deep digital flexor tendon, and an inability to inject contrast medium despite adequate needle placement. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that the DPNP technique can be used successfully for injection into the podotrochlear bursa in horses. However, radiographic assessment should be used to confirm that material was injected into the bursa.  相似文献   

15.
OBJECTIVE: To describe the prevalence, characteristics, and severity of soft-tissue and osseous lesions in the caudal portion of the thoracic and lumbosacral vertebral column and pelvis in Thoroughbred racehorses. ANIMALS: 36 Thoroughbred racehorses that died or were euthanatized at California racetracks between October 1993 and July 1994. PROCEDURE: Lumbosacral and pelvic specimens were collected and visually examined for soft-tissue and osseous lesions. RESULTS: Acute sacroiliac joint injury was observed in 2 specimens. Signs of chronic laxity or subluxation of the sacroiliac joint were not observed in any specimens. Impingement of the dorsal spinous processes and transverse processes was observed in 92 and 97% of specimens, respectively. Thoracolumbar articular processes had variable degrees of degenerative change in 97% of specimens. Degenerative changes were observed at lumbar intertransverse joints and sacroiliac articulations in all specimens. Some degenerative changes were widespread and severe. CONCLUSIONS: Numerous degenerative changes affected vertebral processes, intervertebral articulations, and sacroiliac joints in these Thoroughbred racehorses. CLINICAL RELEVANCE: Various types of vertebral and pelvic lesions need to be considered during clinical evaluation of the back and pelvis in horses. Undiagnosed vertebral or pelvic lesions could be an important contributor to poor performance and lameness in athletic horses.  相似文献   

16.
A cranial technique for entry of the medial femorotibial (MFT) joint in the horse was validated. It was hypothesised that the frequency of correct placement into the MFT joint using the described cranial technique would be similar to using a standard medial approach. Twenty‐four limbs from 15 horses were injected with a latex mixture. Limbs with stifle joint effusion and/or known stifle pathology were grouped separately to those without. When effusion/pathology was not present the medial technique (93%) was almost twice as successful as the cranial technique (53%), including when extremes of size were removed from the population. With the presence of femoropatellar or medial femorotibial effusion, the cranial technique (20%) was 5 times less successful than using the medial technique (100%). When extremes of size were removed from the population of horses with effusion, the success of the cranial technique was marginally improved (33%). When an ‘average size’ of horse is used with or without joint effusion, the cranial technique is successful in entering the MFT joint in approximately 50% of cases, and may hence be of use in a fractious animal without sedation, a stallion, or in the presence of a wound/skin infection at the site of the medial needle entrance.  相似文献   

17.
The frontal, caudal maxillary, and rostral maxillary sinuses of 10 equine cadavers were examined endoscopically, and the findings were confirmed by sinusotomy. Similar endoscopic examinations were performed in five conscious, adult horses by using sedation and local anesthesia. Useful portals of entry for the arthroscope in adult horses were: for the frontal sinus, 60% of the distance in a lateral direction from midline to the medial canthus and 0.5 cm caudal to the medial canthus; for the caudal maxillary sinus, 2 cm rostral and 2 cm ventral to the medial canthus; and for the rostral maxillary sinus, 50% of the distance from the rostral end of the facial crest to the level of the medial canthus and 1 cm ventral to a line joining the infraorbital foramen and the medial canthus. The frontal sinus portal was most useful for examination of the frontal and caudal maxillary sinuses. The caudal maxillary sinus portal was most useful for examining the sphenopalatine sinus. Structures in the frontal and caudal maxillary sinuses could be approached surgically by viewing them through the frontal sinus portal and guiding an instrument to them through the caudal maxillary sinus portal. Tooth root identification was reliable for the second and third upper molars in animals older than 5 years, but was more difficult for the rostral teeth and in younger animals. Endoscopy was not difficult to perform and was well tolerated in standing, sedated horses. The only complication of this procedure was mild, local subcutaneous emphysema that resolved spontaneously within 14 days.  相似文献   

18.
An arthroscopic technique for examination and surgical treatment of conditions of the shoulder joint was evaluated in eight normal horses and two horses with osteochondrosis lesions. A single arthroscope entry point caudal to the infraspinatus tendon allowed inspection of the cranial, lateral, and caudal surfaces of the shoulder joint. With the humeral head and glenoid cavity distracted by a curved forceps, the entire cartilage surface of the shoulder could be examined. The caudomedial portion of the humeral head was seen better with a 70 degree angled arthroscope. Instruments for intra-articular manipulation were introduced through a separate skin incision 2 to 4 cm caudal to the arthroscope entry point. Two horses with osteochondrosis lesions of the shoulder were examined arthroscopically and debrided with instrument triangulation. Five normal horses and both horses with osteochondrosis lesions were euthanized immediately after the procedure and a necropsy was performed. Minor iatrogenic damage to the cartilage surfaces and joint capsule resulted from the technique. Three horses recovered from anesthesia and were killed 3, 30, or 60 days after surgery. Subcutaneous fluid that accumulated during surgery had resorbed by 3 days and lameness was evident for 12 to 24 hours. Gross examination and histopathologic findings of specimens collected at 30 and 60 days showed several small nonhealing partial-thickness cartilage defects attributed to instrument insertion. Arthroscopy is a satisfactory method to examine the joint surfaces and to evaluate and treat osteochondrosis lesions of the shoulder joint in horses.  相似文献   

19.
Reason for performing study: Current noninvasive techniques for imaging the soft tissue structures of the stifle have limitations. Arthroscopy is commonly used for the investigation and treatment of stifle pain. Cranial and caudal arthroscopic approaches to the femorotibial joints are used. However, complete examination of the axial aspect of the medial femorotibial joint (MFTJ) is not possible currently. Objective: To develop a cranial approach to the caudal pouch of the MFTJ and to assess whether it would allow a more complete examination of the compartment and facilitate the caudomedial approach. Method: The regional anatomy was reviewed and the technique developed on cadavers. A series of nonrecovery surgeries were performed to evaluate the procedure, which was then used in 7 clinical cases. Advantages compared to existing techniques and complications encountered were recorded. Results: Successful entry into the caudal pouch of the MFTJ was achieved in 20 of 22 cadaver legs, 8 of 8 joints of nonrecovery surgery horses and 6 of 7 clinical cases operated. The caudal ligament of the medial meniscus could be visualised, along with other axial structures of the caudal joint pouch. The technique was used to facilitate a caudomedial approach and allowed better triangulation within the joint space. Complications were minor and included puncture of the caudal joint capsule and scoring of the axial medial femoral condyle. Conclusions and potential relevance: It is possible to access the caudal pouch of the MFTJ arthroscopically using a cranial intercondylar approach. The technique has advantages when compared to existing techniques and is associated with few significant complications. A cranial approach to the caudal pouch of the MFTJ could complement existing techniques and be useful clinically.  相似文献   

20.
Ultrasound‐guided intraarticular injection of cervical articular process joints is a well‐established procedure in both humans and horses for neck pain resulting from osteoarthritis, but the technique has not been described in dogs. Aims of this study were to describe the ultrasonographic anatomy and landmarks for cervical articular process joint injections in the dog, develop a technique for articular process joint injections using these landmarks, and determine the accuracy of injections and factors that may influence it. Eleven canine cadavers were used and bilateral joint spaces from C2–3 to C7‐T1 were injected under ultrasound guidance with a blue radiopaque solution. A computed tomographic scan was acquired following each injection, and an injection score was assigned and compared with other patient‐specific factors. Of the 132 injections performed, 110 (83.3%) were intraarticular, 20 (15.1%) were periarticular within 5 mm, and 2 (1.5%) were periarticular beyond 5 mm from the joint. There was no significant difference in mean scores between dogs. Only C2–3 had a significantly lower mean score than any other joint. There was no significant correlation between injection score and any other factors measured. The transverse processes of the cervical vertebrae served as excellent ultrasonographic landmarks for identifying the cervical articular process joints in dogs regardless of the size of the dog or location along the vertebrae. Accuracy of ultrasound‐guided intraarticular process joint injection was 83% in dogs and similar to published techniques in horses. Further studies are needed to examine the safety and efficacy of this procedure in live animals.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号