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1.
Objective— To evaluate the sensitivity and specificity of arthroscopy and arthrotomy for diagnosis of medial meniscal pathology and to evaluate the diagnostic value of medial meniscal probing. Study Design— Ex vivo study. Animals— Cadaveric canine stifle joints (n=30). Methods— Stifle joints were assigned to either a cranial cruciate ligament (CrCL) deficient or intact group. Within each stifle joint, no medial meniscal tear, a peripheral detachment, or 1 of 3 variants of vertical longitudinal tears of the medial meniscus were created. Each stifle joint had arthroscopy, craniomedial (CrMed), and caudomedial (CdMed) arthrotomy. Diagnoses were made by both observation and probing. Sensitivity, specificity, and correct classification rate (CCR) for diagnosing the state of the medial meniscus using both observation and probing with all diagnostic methods were calculated. Odds ratios were calculated to determine if probing increased diagnostic accuracy. Results— Arthroscopy with probing was the most sensitive and specific diagnostic method and had the highest CCR. For arthrotomy, CrMed was the most sensitive in CrCL‐deficient and CdMed the most sensitive in stable, CrCL‐intact stifle joints. For all methods, probing increased their diagnostic accuracy. Conclusions— Arthroscopy is the most accurate diagnostic method; however, probing the medial meniscus enhances the diagnostic accuracy of all methods. Clinical Relevance— Accurate diagnosis of medial meniscal pathology is ideally achieved by means of arthroscopy; however, if arthrotomy is chosen, CrMed should be selected in unstable and CdMed in stable stifle joints. Regardless, medial meniscal probing should be performed to increase diagnostic accuracy.  相似文献   

2.
Objective— To investigate the use of computed tomography (CT) arthrography in cadaveric canine stifles with particular emphasis on the diagnosis of meniscal injury.
Study Design— Prospective cadaver study.
Sample Population— Pelvic limbs from adult Beagles (n=10).
Methods— After survey CT scan of each stifle oriented in the dorsal plane, positive contrast stifle CT arthrogram (CTA) was performed using the same slice orientation. Each stifle was then randomly allocated into 1 of 2 treatment groups: group A—arthrotomy, cranial cruciate ligament (CCL) transection and simulated injury to the caudal horn of the medial meniscus; group B—arthrotomy and CCL transection only. CT scan was repeated as before and post-arthrotomy images were interpreted by a radiologist unaware of treatment grouping.
Results— The cranial and caudal cruciate ligaments, medial and lateral menisci, menisco-femoral ligament, and long digital extensor tendon were all identifiable on CTA images. CTA was 90% sensitive and 100% specific for diagnosing simulated caudal horn meniscal injury.
Conclusions— Stifle CTA enables identification of intra-articular structures within the stifle and is a reliable method for identifying simulated meniscal injuries in a cadaver model.
Clinical Relevance— CTA imaging of the canine stifle has potential clinical value for detection of meniscal injury.  相似文献   

3.
Folding of the caudal horn of the medial meniscus after surgical severence of the cranial cruciate ligament was investigated. When the stifle was flexed and the tibia was placed in a cranial position, the caudal horn of the medial meniscus could move forward without damaging the meniscus or the caudal joint capsule. Forward movement of the tibia with the stifle extended could damage the meniscus and/or the joint capsule. Abnormal position of the meniscus did not necessarily indicate meniscal damage.  相似文献   

4.
OBJECTIVE: To evaluate the effect of medial meniscal release (MMR) and medial, caudal pole hemimeniscectomy (MCH) on pressure distribution in the cranial cruciate ligament (CCL) deficient canine stifle, and with tibial plateau levelling osteotomy (TPLO). ANIMALS: Twelve adult dogs. METHODS: In experiment one, six pairs of cadaveric canine stifles with an intact CCL were axially loaded with a servo-hydraulic material testing machine and pressure distributions were mapped and quantified using pressure sensitive films. Axial loading of each joint was then repeated following MMR, and again after MCH. In experiment two, six pairs of cadaveric canine stifles with or without TPLO were tested before and after CCL transection, and each MMR and MCH procedure using the same methods of experiment 1. RESULTS: In experiment one, MMR and MCH had significant effects on the pressure distribution resulting in a 2.5-fold increase in the percentage of surface area with pressure higher than 10 MPa. In experiment two, CCL transection resulted in a significant change in pressure distribution only in the stifle without TPLO (P<0.05). Both MMR and MCH resulted in a 1.7-fold increase in the percentage of area with peak pressure in the stifle with TPLO (P<0.05). CONCLUSIONS: Meniscal surgery results in a change in pressure distribution and magnitude within the medial compartment of the stifle. CLINICAL RELEVANCE: Compromised function of the meniscus by either MMR or MCH result in stress concentration which may predispose to osteoarthritis.  相似文献   

5.
Objective— To evaluate the biomechanical effects of 5 types of meniscal lesions on contact mechanics in the canine stifle.
Study Design— Experimental study.
Animals— Cadaveric canine stifles (n=12 pair).
Methods— Medial meniscal lesions (radial, vertical longitudinal, nonreducible bucket handle, flap, and complex tears) were simulated in cadaveric stifles. A contact map was recorded from each tear type and contact area (CA) and peak contact pressure (PCP) from each tear type were compared.
Results— A significant difference in PCP was detected between control and nonreducible bucket handle, flap, and complex tears. PCP increased by >45% in nonreducible bucket handle, flap, and complex meniscal tears when compared with control. No significant difference was found in PCP between control and radial and vertical longitudinal tears. No significant difference was found in CA between any of the meniscal conditions.
Conclusions— Nonreducible bucket handle, flap, and complex tears cause a significant increase in PCP. Radial and vertical longitudinal tears had a minimal impact on the contact pressures of the medial compartment of the stifle.
Clinical Relevance— Based on this ex vivo model, we support the clinical recommendation of debriding nonreducible bucket handle, flap, and complex tears because the injured portion of the meniscus no longer contributes significantly to the function of the meniscus. Radial and vertical longitudinal tears do not cause a change in contact mechanics allowing consideration of nonsurgical treatment and meniscal repair, respectively. Future experimental and clinical studies should aim to refine the treatment of specific meniscal injuries.  相似文献   

6.
The effects of three different techniques of intramedullary (IM) pin placement on pin location and incidence of stifle joint injury were evaluated using 70 cadaver canine tibiae after middisphyseal osteotomy. In 50 tibiae, pins were placed retrograde in either a nondirected (group A) or a craniomedially directed fashion (group B) with 25 tibiae in each group. Pins were driven normograde (group N) in 20 tibiae. All the stifles were dissected to qualitatively evaluate pin interference with different joint structures. End-on radiographs of the tibial plateaus were used to quantitatively evaluate pin location. Interference with the caudal cruciate ligament, medial meniscus, lateral meniscus, or meniscal ligaments was not observed in any group. There was a significant association between pinning technique and incidence of involvement of the cranial cruciate ligament ( P < .005), patella ( P < .001), patellar ligament ( P < .005), and femoral condyle ( P < .01). Pin location for group A was significantly different from either other group in a cranial-caudal direction ( P = .003), and was significantly different from group N in a medial-lateral direction ( P = .005). No significant difference was observed between pin location for groups B and N in either plane. It was concluded that although nondirected retrograde pinning cannot be recommended, retrograde pins directed craniomedially may be an acceptable technique for the repair of proximal to mid-diaphyseal tibial fractures if care is taken to properly seat the pins.  相似文献   

7.
Objective— To evaluate after 12 weeks the effects of caudal medial meniscal release (MR) in the cranial cruciate ligament-intact canine stifle.
Study Design— Blinded, prospective in vivo study.
Animals— Purpose-bred hound dogs (n=10).
Methods— Either MR (n=5) or a sham (SH) surgery (n=5) was performed via arthroscopy. Orthopedic examination and subjective lameness evaluation were performed in each dog preoperatively and at 4, 8, and 12 weeks after surgery. Twelve weeks postoperatively, ultrasonographic, radiographic, and arthroscopic examinations were performed on the operated stifles. Gross pathology of the articular cartilage, cruciate ligaments, and menisci was assessed. India ink staining of the femoral and tibial articular surfaces was performed to determine the percent area of articular cartilage damage.
Results— At 8 and 12 weeks after surgery, MR dogs were lamer than SH dogs. At 12 weeks, the degree of radiographic OA was significantly higher in MR stifles than in SH stifles. Gross and sonographic meniscal pathology was more severe in MR stifles compared with SH stifles. MR stifles had significantly more severe articular cartilage pathology compared with SH stifles 12 weeks after surgery; pathology was most severe in the medial compartment.
Conclusions— MR alone is associated with articular cartilage loss, further meniscal pathology, degenerative joint disease, and lameness.
Clinical Relevance— Subsequent osteoarthritis and dysfunction of the stifle joint should be considered when making clinical decisions regarding MR in dogs.  相似文献   

8.
Reason for performing study: By study of the translocation and deformation of equine menisci throughout the range of motion, it may be possible to identify potential mechanical factors in the pathogenesis of injury to the cranial horn of the medial meniscus. Objective: To quantitatively document meniscal translocation and deformation using radiographic and MR imaging, and to evaluate for potential variation between the medial and lateral menisci. Methods: Radiographic markers were embedded in the periphery of the menisci in 6 cadaver stifles. Proximal‐distal radiographs were taken at 15° intervals ranging from full flexion (30°) to full extension (160°). Magnetic resonance imaging sequences of 3 additional cadaver stifles were obtained in axial and sagittal planes at the predetermined stifle angles. Results: A significantly greater overall mean cranial‐caudal translocation (1.6 times) of the lateral meniscus relative to the medial was seen from full extension to full flexion (P = 0.002). The cranial horn of the medial meniscus was the least mobile of the 4 horns, yet a significant cranial displacement relative to the cranial horn of the lateral meniscus was seen in the terminal 10° of extension. MRI images revealed a significantly greater axial compressive strain in the cranial horn of the medial meniscus relative to the cranial horn of the lateral meniscus in the terminal 10° of extension (P = 0.017). Conclusion: The equine menisci exhibit a cranial‐caudal translocation over the tibia throughout the range of motion. While the cranial horn of the medial meniscus is the least mobile of the 4 horns, it undergoes significant cranial translocation and axial compression in the terminal 10° of extension. Potential relevance: Hyperextension of the stifle may place the cranial horn of the medial meniscus at risk of injury and thus explain the higher prevalence of meniscal tears at this location.  相似文献   

9.
O bjective : To assess the usefulness of computed tomography arthrography of the stifle in diagnosing meniscal tears in dogs with cranial cruciate ligament insufficiency.
M ethods : A prospective clinical study was performed. Dogs were included if they had evidence of cranial cruciate ligament insufficiency or persistent or recurrent lameness following surgery for cranial cruciate ligament insufficiency. Dogs were sedated for a computed tomography scan of the affected stifle, orientated in the dorsal plane. A survey computed tomography scan was followed by a computed tomography arthrogram. A stifle arthrotomy was performed, and the surgical findings were recorded. The computed tomography scans were reviewed by three blinded reviewers, and the results were compared to the surgical findings.
R esults : Twenty-one computed tomography arthrograms from 20 dogs were included. At surgery, damage to the medial meniscus was identified in 14 stifles. Initial interpretation of computed tomography arthrography images was 57 to 64 per cent sensitive and 71 to 100 per cent specific for diagnosing medial meniscal injuries. Interpretation of the images on retrospective analysis was 71 per cent sensitive and 100 per cent specific, with an accuracy of 0·857.
C linical S ignificance : The accuracy of stifle computed tomography arthrography for the diagnosis of tears to the medial meniscus was found to be good. It is a minimally invasive and repeatable technique, which does not require general anaesthesia or specialist training to obtain the images. The ability to reliably diagnose meniscal injury without the need for surgery may be advantageous, particularly in dogs which had previously had surgery for cranial cruciate ligament insufficiency.  相似文献   

10.
Objectives— To assess a novel technique for arthroscopic evaluation of the canine stifle avoiding the need for fat pad debridement.
Study Design— Prospective study.
Sample Population— Cadaveric canine stifles (n=10); Client-owned dogs (15).
Methods— In cadaveric stifles, the femoropatellar space was assessed before placement of a joint distractor and examination of the femorotibial joint. Time to complete evaluation of the femoropatellar space, to observe the cruciate ligaments, and to completion of examination of the femorotibial joint were recorded. Distractor-assisted arthroscopy was then performed in 15 consecutive clinical cases. Clinical information, time to complete joint evaluation, and ability to perform any additional arthroscopic surgery were recorded.
Results— Observation and palpation of intra-articular structures were possible in all cadaveric stifles. Mean time to evaluate the femoropatellar space was 3.2 minutes (range, 2–4 minutes); to observe the cruciate ligaments, 5.8 minutes (range, 3–8 minutes); and to completion of joint inspection, 9.1 minutes (range 6–13 minutes). In the clinical cases, observation of intra-articular structures was also possible in all stifles. Mean time to complete joint inspection was 21 minutes (range, 10–40 minutes). Partial meniscectomy was performed successfully in 5 stifles.
Conclusions— Use of a joint distractor allowed arthroscopic observation of all relevant structures. Partial meniscectomy was readily performed.
Clinical Relevance— Use of a joint distractor may simplify arthroscopic assessment of the canine stifle and avoid potential morbidity associated with fat pad debridement.  相似文献   

11.
OBJECTIVE: To determine biomechanical and biochemical properties of the medial meniscus in a semi-stable stifle model and in clinical patients and to determine the effect of canine recombinant somatotropin hormone (STH) on those properties. ANIMALS: 22 healthy adult dogs and 12 dogs with meniscal damage secondary to cranial cruciate ligament (CCL) rupture. PROCEDURE: The CCL was transected in 15 dogs, and stifles were immediately stabilized. Implants releasing 4 mg of STH/d were placed in 7 dogs, and 8 received sham implants. Seven dogs were used as untreated controls. Force plate analysis was performed before surgery and 2, 5, and 10 weeks after surgery. After 10 weeks, dogs were euthanatized, and menisci from surgical and contralateral stifles were harvested. The torn caudal horn of the medial meniscus in dogs with CCL rupture comprised the clinical group. Creep indentation determined aggregate modulus (HA), Poisson's ratio (v), permeability (k), and percentage recovery (%R). Water content (%W), collagen content (C), sulfated glycosaminoglycan (sGAG) content, and collagen type-I (cI) and -II (cII) immunoreactivity were also determined. RESULTS: Surgical and clinical groups had lower HA, k, %R, C, sGAG, cI, and clI and higher %W than the non-surgical group. Surgical stifles with greater weight bearing had stiffer menisci than those bearing less weight. Collagen content was higher in the surgical group receiving STH than the surgical group without STH. CONCLUSIONS AND CLINICAL RELEVANCE: Acute stabilization and moderate weight bearing of the CCLdeficient stifle appear to protect stiffness of the medial meniscus. Normal appearing menisci from CCL-deficient stifles can have alterations in biomechanical and biochemical properties, which may contribute to meniscal failure.  相似文献   

12.
OBJECTIVE: To describe clinical signs, arthroscopic findings, and outcome in a group of dogs undergoing second look arthroscopy for the treatment of meniscal tears following original surgery to correct a CCL deficient stifle joint. METHODS: The medical records of 26 dogs from the Veterinary Teaching Hospital at Texas A&M University and the Veterinary Orthopedic Center (Round Rock, Texas) that had second look arthroscopy for lameness following an original surgical procedure were reviewed. Pre-operative clinical findings, 2nd look arthroscopic findings and owner assessed outcome were documented. RESULTS: Postliminary bucket handle tears of the medial meniscus were detected in 22 (75.9%) cases. Other postliminary meniscal injuries included frayed caudal horn tears of the medial meniscus 6 (20.7%), and longitudinal tears of the lateral meniscus 1 (3.4%). An audible or palpable click was present in 27.6% of cases. An improvement or resolution of lameness was reported in 96.5% of cases reported. In conclusion, tears of the medial meniscus are a significant cause of lameness in dogs subsequent to surgery for cranial crucial ligament ruptures. Increased lameness or acute onset of lameness after surgery for cranial crucial rupture is a consistent finding. In rare cases, a palpable or audible click will be appreciated. Arthroscopic evaluation and partial meniscectomy improve or resolve lameness in the majority of cases. CLINICAL SIGNIFICANCE: Sudden or increased lameness in dogs with historical CCL stabilization surgery should be evaluated and treated arthroscopically for postliminary meniscal injury if another cause for lameness can not be determined.  相似文献   

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14.
OBJECTIVE: To assess functional outcome in dogs with cranial cruciate ligament (CrCL) disease after tibial tuberosity advancement (TTA) using force plate gait analysis, and to evaluate parameters potentially influencing outcome. STUDY DESIGN: Prospective clinical study. ANIMALS: Consecutive clinical patients (n = 37) with CrCL-deficient stifles (n = 40). METHODS: The stifle joints were examined arthroscopically prior to TTA. Meniscal release was not performed if the medial meniscus was intact. Open medial arthrotomy and partial meniscectomy were performed in the presence of meniscal tears. Vertical ground reaction forces were measured preoperatively and at follow-up examinations four to 16 months postoperatively (mean: 5.9 months). The ground reaction forces of a group of 65 healthy dogs were used for the comparison. The potential effects of clinical parameters on functional outcome were evaluated statistically. RESULTS: Complete CrCL rupture was identified in 28 joints, and partial CrCL rupture in 12 joints. The medial meniscus was damaged in 21 stifles. Vertical ground reaction forces were significantly higher at follow-up (P < 0.01), but remained significantly lower than those of control dogs (P < 0.01). Complications were identified in 25% of joints, and the dogs with complications had significantly lower peak vertical forces at follow-up than the dogs without complications (P = 0.04). Other clinical parameters did not influence outcome. CONCLUSIONS: Tibial tuberosity advancement significantly improved limb function in dogs with CrCL disease, but did not result in complete return to function. Complications adversely affected functional outcome. CLINICAL SIGNIFICANCE: A return to a function of approximately 90% of normal can be expected in dogs with CrCL disease undergoing TTA.  相似文献   

15.
Objective— To evaluate potential iatrogenic medial meniscal (MM) damage during tibial plateau leveling osteotomy (TPLO) and to establish a safe zone (SZ) for hypodermic needle (HN) identification of the medial aspect of the stifle joint.
Study Design— Prospective cohort.
Animals— Cadaveric canine stifles (n=40).
Methods— HN (20 or 25 G) were inserted through the medial collateral ligament (MCL) of the femorotibial joint and through the SZ insertion points. The medial meniscus was inspected for iatrogenic damage. Statistical comparison of MM damage caused by different needle sizes and insertion sites was performed using Fisher's exact test with significance at P <.05.
Results— Twenty-gauge group: 65% of stifles had minor MM damage with MCL insertion compared with 35% of stifles with SZ insertion ( P =.0049). Severe MM damage occurred in 25% of stifles with MCL insertion compared with 0% of stifles with SZ insertion ( P =.0014). Twenty-five-gauge group: 85% of stifles had minor MM damage with MCL insertion compared with 30% after SZ insertion ( P =.0011); however, no severe MM injury was noted.
Conclusions— HN insertion though the MCL can produce iatrogenic damage to the MM. Use of a 25 G HN and SZ site for insertion reduced the frequency and severity of MM damage.
Clinical Relevance— HN insertion into the medial aspect of the femorotibial joint during TPLO can cause gross iatrogenic MM damage, which may contribute to the incidence and misdiagnosis of latent MM injuries after TPLO.  相似文献   

16.
OBJECTIVE: To evaluate the biomechanical effects of medial meniscal release (MMR) and medial, caudal pole hemimeniscectomy (MCH) on joint stability in the cranial cruciate ligament (CCL)-deficient canine stifle before and after tibial plateau leveling osteotomy (TPLO). STUDY DESIGN: Experimental study. ANIMALS: Thirty-one dogs. METHODS: In experiment 1, 16 pairs of normal hindlimbs randomly assigned to an intact or transected CCL group were studied to determine the magnitude of tibial translation after MMR and MCH under 20% body weight load using radiographic imaging of radio-opaque markers. In experiment 2, 15 pairs of CCL-deficient hindlimbs were randomly assigned to a TPLO or sham TPLO group. The remainder of the experiment was performed as described for experiment 1. The effect of CCL transection, MMR, MCH and TPLO were analyzed using 2-way repeated measures ANOVA; P<.05 was considered significant. RESULTS: We found a greater effect of MMR on tibial translation in transected CCL stifles than in intact stifles (P=.0016). We found no further effect of MCH after MMR (P>.05). We found a greater effect of MMR in sham TPLO than TPLO stifles (P=.0013) but no further effect of MCH after MMR (P>.05). CONCLUSIONS: By resisting tibial translation the medial meniscus might be at greater risk of tearing in CCL-deficient stifles. TPLO may spare the medial meniscus by neutralizing the tibial thrust and eliminating the wedge effect of the medial meniscus. CLINICAL RELEVANCE: MMR may not be indicated in the CCL-deficient stifle stabilized by TPLO.  相似文献   

17.
Objective— To describe the surgical technique, early results and complications of tibial tuberosity advancement (TTA) for treatment for cranial cruciate ligament (CrCL)-deficient stifle joints in dogs.
Study Design— Retrospective clinical study.
Animals— Dogs (n=101) with CrCL-deficient stifles (114).
Methods— Medical records of 101 dogs that had TTA were reviewed. Complications were recorded and separated into either major or minor complications based on the need for additional surgery. In-hospital re-evaluation of limb function and time to radiographic healing were reviewed. Further follow-up was obtained by telephone interview of owners.
Results— Complications occurred in 31.5% of the dogs (12.3% major, 19.3% minor). Major complications included subsequent meniscal tear, tibial fracture, implant failure, infection, lick granuloma, incisional trauma, and medial patellar luxation; all major complications were treated with successful outcomes. All but 2 minor complications resolved. The mean time to documented radiographic healing was 11.3 weeks. Final in-hospital re-evaluation of limb function (mean, 13.5 weeks), was recorded for 93 dogs with lameness categorized as none (74.5%), mild (23.5%), moderate (2%), and severe (1%). All but 2 owners interviewed were satisfied with outcome and 83.1% reported a marked improvement or a return to pre-injury status.
Conclusions— TTA is a procedure comparable with alternate methods of CrCL repair with expected good to excellent functional outcome.
Clinical Relevance— TTA procedure can be successfully used to obtain the dynamic stability of a CrCL-deficient stifle joint in dogs.  相似文献   

18.
OBJECTIVE: To evaluate the effect of tibial tuberosity advancement (TTA) on tibiofemoral shear force as reflected by measurement of cranial tibial subluxation (CTS) and patella tendon angle (PTA) in the canine cranial cruciate ligament (CrCL) deficient stifle joint. STUDY DESIGN: In vitro cadaver study. ANIMALS: Canine cadaveric hind limbs (n=10). METHODS: CTS and PTA were evaluated from lateral radiographic projections in axially loaded intact CrCL stifle joints, after transection of the CrCL, at a maximally advanced tibial tuberosity position, and at a critical point position. A custom-designed hinge plate allowed alteration of the tibia to tibial tuberosity distance (Ti-TT) under axial load. Digitized radiographic images were used to quantify CTS, PTA, and Ti-TT. Comparisons within groups were made using 1-way repeated measures ANOVA. A post hoc Tukey's HSD test was used to determine post-ANOVA pair-wise comparison within these groups. Significance was set at a value of P<.05. RESULTS: CTS occurred after CrCL transection, which was significantly different from the intact position (P<.01). Subsequent stability of the stifle joint was obtained by advancing the tibial tuberosity. In the maximally advanced tibial tuberosity position, caudal tibial thrust was generated resulting in caudal tibial subluxation that was significantly different from the transected CrCL position (P<.01) and from the intact CrCL position (P<.01). Despite a stable joint, there was slight CTS at the critical point position, which was significantly different from the intact CrCL position (P<.05). The PTA at the maximally advanced position was significantly different from the intact, critical point and reference 90 degrees PTAs (P<.01). The PTA at the critical point position was significantly different from the intact and maximally advanced tibial tuberosity PTAs (P<.01), but not different (P>.05) from the reference 90 degrees PTA. CONCLUSION: We demonstrated that advancement of the tibial tuberosity neutralized cranial tibial thrust, and converted cranial tibial thrust into caudal tibial thrust. Neutralization of tibiofemoral shear forces occurred at a PTA of 90.3+/-9.0 degrees. CLINICAL RELEVANCE: TTA can effectively change the magnitude and direction of the tibiofemoral shear force, and thus may be used to prevent craniotibial translation in a CrCL deficient stifle joint.  相似文献   

19.
Caudocranial stifle radiographs with variations in positioning were made in two greyhound cadavers. Radiographs were repeated after each of three interventions: cranial cruciate desmotomy; release of the caudal horn of the medial meniscus; complete medial meniscectomy. The joint space on medial and lateral aspects of the joint was measured by a observer who was unaware of positioning or intervention. One dog had significantly wider joint space than the other (1.0 vs. 1.5mm). The lateral aspect of the joint space was wider than the medial aspect (1.7 vs. 0.7 mm). Medial rotation of the stifle resulted in an increase of 0.4 mm in width of the lateral joint space, whereas lateral rotation of the stifle reduced the lateral joint space by an average of 0.4 mm. Decentering the X-ray beam had no significant effect on joint space width. Tension increased the width of the medial joint space by an average of 1.2 mm and the lateral aspect by an average of 1.3 mm. Cranial cruciate desmotomy resulted in an average 0.3 mm increase in width of the joint space, and medial meniscectomy with an average 0.2 mm reduction of the joint space. Although the femorotibial joint space was affected by iatrogenic stifle injuries and by medial or lateral rotation, these changes were less than the differences between the two dogs. Hence it seems unlikely that the small changes in joint space width associated with cruciate ligament desmotomy and medial meniscectomy will be detectable in clinical practice.  相似文献   

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