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1.
Osteochondral defects of the lateral trochlear ridge of the distal femur were identified in 15 joints of 10 horses. Lesions were bilateral in five horses and unilateral in five horses. Thirteen of these 15 defects were treated by curettage through a craniolateral femoropatellar arthrotomy. Subcutaneous seroma formation and partial skin dehiscence occurred in nine stifles. Lameness attributable to the stifle joint was no longer apparent at 6 and 12 months after surgery. The normal subchondral bony contour of the lateral trochlear ridge was altered in all joints after surgery. The subchondral bone was uniformly increased in density in all joints, and six lateral trochlear ridges had small focal radiolucent regions within the subchondral bone, which suggested that complete removal of the original lesion had not been achieved. Healing of the surgical site between 2 weeks and 14 months was evaluated in four joints. Granulation tissue from mesenchymal elements in subchondral marrow spaces gradually filled the defects with fibrocartilage.  相似文献   

2.
Lateral luxation of the patella in four femoropatellar joints of three foals was repaired by recession sulcoplasty and medial imbrication of the joint. One foal was euthanatized because of septic arthritis caused by incisional dehiscence, and the other two foals were normal 2 years after surgery. Recession sulcoplasty combined with medial imbrication of the joint capsule resulted in a functional femoropatellar joint and should be considered in foals affected with lateral patellar luxation.  相似文献   

3.
Forty limbs with femoropatellar osteochondritis dissecans in 24 horses were treated with arthroscopic surgery. Lesions were bilateral in 16 horses and unilateral in eight horses. Diagnostic examination and surgical treatment were performed through a single arthroscopic portal; five different instrument portal locations and six instrument approaches were used. Lesions were localized to the lateral trochlear ridge of the femur in 31 affected joints, medial trochlear ridge in two joints, lateral and medial trochlear ridges together in two joints, lateral trochlear ridge plus patella in four joints, and patella alone in one joint. The lesions consisted of subchondral defects containing chondral or osteochondral flaps or fragments, or were seen as dimpling, cracking, fibrillation, or erosion of articular cartilage, or intact cartilage over a subchondral defect. Loose bodies were found in three joints. There was a poor correlation between radiologic and arthroscopic findings. Surgical manipulations included removal of flaps, fragments, and undermined articular cartilage, and debridement of the subchondral defect. Three horses were euthanized: one electively to assess the joint grossly, one because of complications following surgery and salmonellosis, and one because of unrelated forelimb abnormalities. Immediate clinical improvement after surgery was seen in the 22 horses permitted to survive. Long-term follow-up on seven of 10 racehorses revealed that two have raced successfully, two are "ready to race," three are training sound, two are sound at pasture (still in convalescence), and one has been reoperated. Of six horses used for show or pleasure, three are being shown sound, one is sound for pleasure, and two are training sound. The remaining horses are convalescing.  相似文献   

4.
Surgical curettage of an osteochondrosis lesion in an equine scapulohumeral joint was performed. A modified approach to the scapulohumeral joint through a longitudinal infraspinatus tenotomy is described. This technique was performed on a second horse that was free of osteochondrosis lesions to further assess the clinical course of healing following this technique. Both operative sites healed well with no evidence of dehiscence. Previously, four similar clinical cases of osteochondrosis were operated on at the same institution through a transverse infraspinatus tenotomy. All four cases exhibited dehiscence with attendant septic arthritis during the postoperative period. The use of a longitudinal infraspinatus tenotomy to approach the equine scapulohumeral joint for surgical curettage does not appear to clinically compromise the lateral collateral support of the shoulder. When compared retrospectively to other cases of transverse infraspinatus tenotomy performed at this clinic, the described technique appears to have a less complicated postoperative period.  相似文献   

5.
Communications between the femoropatellar, medial femorotibial, and lateral femorotibial joints were studied, using fresh equine cadaver specimens. A total of 90 specimens from 45 horses were used. Horses were randomly assigned to 3 groups with 15 horses/group. Each group was assigned an injection site (femoropatellar joint, medial femorotibial joint, or lateral femorotibial joint), and red latex was injected into the respective location of each joint in each group. Immediately after injection, the joints were flexed and extended 100 times. The stifles were frozen in slight flexion, then cut into 1-cm sagittal sections. The communications between the femoropatellar and medial and lateral femorotibial joints were determined. None of the specimens in this study had communication between all 3 joint compartments. When the femoropatellar joint was injected, 18 of 30 joints (60%) communicated with the medial femorotibial joint, and 1 of 30 (3%) communicated with the lateral femorotibial joint. Injection of the medial femorotibial joint revealed 24 of 30 (80%) joints that communicated with the femoropatellar joint, and 1 of 30 (3%) that communicated with the lateral femorotibial joint. Injection of the lateral femorotibial joint resulted in communication with the femoropatellar joint in 1 of 30 (3%) joints. Communication did not exist between the medial and lateral femorotibial joints.  相似文献   

6.
This paper tests the hypothesis that the local analgesic agent mepivacaine diffuses between adjacent equine synovial structures in the hindlimb and with greater frequency than latex, gelatine dye or contrast media. We report the incidence of diffusion of mepivacaine between the tarsometatarsal, centrodistal and tarsocrural joints, and the 3 synovial compartments of the stifle in 33 fresh equine cadavers. The tarsometatarsal joint and one synovial compartment of the stifle in the left limb and the centrodistal joint and a different synovial compartment of the stifle in the right limbs were injected with mepivacaine. Following flexion and extension of the limb, synovial fluid was aspirated from the noninjected centrodistal and tarsometatarsal joints and the tarsocrural joints of the hock and the noninjected compartments of the stifle. Concentrations of mepivacaine in these samples were assayed using an enzyme linked immunosorbent assay. For samples obtained by dilution of synovial fluid the concentration of mepivacaine was determined by comparing the concentration of urea in the diluted synovial fluid and the concentrations of the serum urea. Mepivacaine was detected in 25/25 (100%) adjacent tarsometatarsal and centrodistal joints after diffusion in both directions, in 23/25 (92%) of tarsocrural joints after diffusion from tarsometatarsal joints and in 22/25 (88%) tarsocrural joints after diffusion from centrodistal joints in the hocks. Diffusion from the femoropatellar to medial and lateral femorotibial joints and between the medial and lateral femorotibial joints in both directions were 20/20 (100%). Diffusion from the lateral femorotibial to the femoropatellar joint was 18/20 (90%) and from the medial femorotibial to femoropatellar joints 17/20 (85%). Mepivacaine was detected at concentrations >0.3 mg/l in a proportion of samples ranging from 15/25 (60%) in the tarsocrural joint following tarsometatarsal joint injection to 18/20 (90%) in the lateral femorotibial joint after femoropatellar joint injection. At mepivacaine concentrations >100 mg/l, detection ranged from 3/20 (15%) in the lateral femorotibial joint from the medial femorotibial joint to 19/25 (76%) in the centrodistal joint from the tarsometatarsal joint. At mepivacaine concentrations >300 mg/l, detection ranged from 1/25 (4%) in the tarsocrural joint from the tarsometatarsal joint to 16/25 (64%) in the from centrodistal joint the tarsometatarsal joint. The results show greater diffusion of mepivacaine between these adjacent synovial structures than assumed from previous anatomical, latex injection and contrast arthrographic studies. Therefore, commonly performed intrasynovial local analgesic techniques in the hindlimb of the horse are not as specific as first thought.  相似文献   

7.
Four dogs with haemangiopericytoma of the subcutaneous tissue overlying and infiltrating the biceps femoris muscle were successfully managed using complete resection of the involved muscle with 2 to 3 cm skin margins. Postoperatively, no local recurrence was noted in any of the dogs in a follow-up period of four to 33 months (mean 22 months). Wound dehiscence, attributed to increased tension and inadequate exercise restriction, occurred in two of the four cases. Closure of the large cutaneous deficit in the craniolateral thigh and stifle was achieved by rotation of a flank-fold skin flap in one case. Strict exercise restriction and the use of a Robert Jones dressing may prevent muscle suture disruption. These measures should enable primary wound healing in the region to progress without complication.  相似文献   

8.
The arthroscopic approach and anatomy of the bovine femoropatellar and femorotibial joints are described. A 4-mm diameter, 15-cm long arthroscope with a 30° forward angle view was used. The structures viewed were recorded according to the position of the arthroscope within the joint. The femoropatellar joint was best accessed via a lateral approach, between the middle and lateral patellar ligaments. The axial portion of the medial femorotibial joint was viewed from a medial approach between the middle and medial patellar ligaments and the abaxial portion was viewed from a lateral approach between the middle and the lateral patellar ligaments. The axial portion of the lateral femorotibial joint was viewed from a lateral approach between the middle and the lateral patellar ligaments and the abaxial portion was viewed from a medial approach between the middle and medial patellar ligaments. The results of this study provide guidelines regarding the location of arthroscopic portals to evaluate precisely different areas of the stifle in cattle.  相似文献   

9.
In phase I, tissue expanders were implanted subcutaneously over the lateral crural region of four dogs. The expanders were inflated daily to maintain a constant intraluminal pressure for 7 days. All animals tolerated the pressurized expanders well. Some animal patient discomfort was associated with repeated injections into the subcutaneous filling port. One dog developed a limited area of tissue loss and exposure of the expander. Tissue response to the expanders included epidermal hyperplasia, dermal collagen compression with early fibroplasia, and subcutaneous granulation tissue formation adjacent to the expander pocket. In phase II, a second group of four dogs underwent rapid skin expansion over 7 days. The pressure applied to the expanding skin was determined daily and adjusted to approximate the value reported for capillary pressure in the dog. Tissue discoloration occurred in two dogs, suggestive of impaired circulation. Skin flaps were developed from expanded skin and rotated over the talocrural region. Wound dehiscence occurred along the distal flap margin in three phase II dogs. These wounds healed by second intention. Branches of the caudal saphenous artery were identified, using angiography, as the primary blood supply to the skin flaps.  相似文献   

10.
OBJECTIVE: To determine the anatomic communications among compartments within the carpus, metacarpophalangeal and metatarsophalangeal joints, stifle joint, and tarsus in llamas. SAMPLE POPULATION: 88 limbs from 22 llamas necropsied because of reasons unrelated to disease of the carpus; tarsus; or metacarpophalangeal, metatarsophalangeal, or stifle joints. PROCEDURE: 1 compartment (randomly assigned) of each joint was injected with blue latex solution. Communication between joint compartments was determined by observation of latex in adjacent compartments following frozen sectioning. RESULTS: Of the 44 carpi, 30 (68%) had anatomic separation between the radiocarpal and middle carpal joints, whereas the remaining 14 (32%) had communication between the radiocarpal and middle carpal joints. In the metacarpophalangeal or metatarsophalangeal joints, medial and lateral joint compartments remained separate in 83 of 88 (94%) joints injected. The tibiotarsal and proximal intertarsal joints communicated in all tarsi examined, whereas 14 of 38 (37%) communicated between the proximal intertarsal and distal intertarsal joints. Communication between the distal intertarsal and tarsometatarsal joints was detected in 17 of 25 (68%) specimens; all 4 tarsal joints communicated in 11 of 42 (26%) specimens examined. Examination of 33 stifle joints that were successfully injected revealed communication between the femoropatellar, medial femorotibial, and lateral femorotibial joints. CONCLUSIONS AND CLINICAL RELEVANCE: These data suggest that it is important to determine the joint communications specific to each llama prior to treatment of septic arthritis. The metacarpophalangeal or metatarsophalangeal joint compartments may be considered separate, although the lateral and medial compartments infrequently communicate along the proximal palmar or plantar aspect.  相似文献   

11.
Radiographs of 72 femoropatellar and femorotibial joints from 50 horses were evaluated. Ninety four arthroscopically evaluated areas were graded according to a predetermined system. The radiographic grade was then compared to arthroscopic findings in the same location. Statistical analysis was performed to determine the association between the radiographic subchondral bone changes and arthroscopic findings. Radiographically normal areas in the femoropatellar joint were arthroscopically positive for cartilaginous changes in 40% of the femoropatellar joints. Areas of mild subchondral bone flattening (grade I) in the lateral trochlear ridge were arthroscopically positive for cartilage changes 78% of the time. Ninety six percent of moderate to severe subchondral bone changes (grades II-V) were arthroscopically positive for cartilage damage. This research demonstrates that (1) a significant number of radiographically normal joints will have cartilage changes, (2) areas of mild subchondral bone flattening have cartilage changes present in the majority of cases and (3) areas of moderate to severe subchondral bone changes have arthroscopically detectable cartilage changes present.  相似文献   

12.
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   

13.
The mechanisms and completeness of equine articular cartilage repair were studied in ten horses over a nine month period. Large (15 mm square) and small (5 mm square) full-thickness lesions were made in weight bearing and nonweight bearing areas of the radiocarpal, middle carpal and femoropatellar joints. The horses were euthanized in groups of two 1, 2.5, 4, 5 and 9 months later. Gross pathology, microradiography, and histopathology were used to evaluate qualitative aspects of articular repair. Computer assisted microdensitometry of safranin-O stained cartilage sections was used to quantitate cartilage matrix proteoglycan levels. Structural repair had occurred in most small defects at the end of nine months by a combination of matrix flow and extrinsic repair mechanisms. Elaboration of matrix proteoglycans was not complete at this time. Statistically better healing occurred in small weight bearing lesions, compared to large or nonweight bearing lesions. Synovial and perichondrial pannus interfered with healing of osteochondral defects that were adjacent to the cranial rim of the third carpal bone. Clinical and experimental experience suggests that these lesions are unlikely to heal, whereas similar lesions in the radiocarpal and femoropatellar joints had satisfactory outcomes. Observations made in this study support the use of early postoperative ambulation, passive flexion of operated joints, and recuperative periods of up to a year for large cartilage defects.  相似文献   

14.
An arthroscopic approach to the palmaroproximal or plantaroproximal pouch of the distal interphalangeal joint was developed in six cadaver limbs and seven limbs of three clinically normal horses. The dorsal aspect of the proximal border and the proximal articular margin of the distal sesamoid (navicular) bone, the palmar aspect of the distal articular margin of the middle phalanx, the collateral sesamoidean ligaments of the distal sesamoid bone, and the joint capsule attachments were readily accessible. Distending the joints with fluid gave access to portions of the articular surface between the distal sesamoid bone and the middle phalanx in all joints, and to a small portion of the distal phalanx in two hind distal interphalangeal joints. Two horses allowed to recover from anesthesia were not lame on days 30 and 37, respectively. Problems encountered initially were difficulty entering the joint, hemarthrosis, and minimal iatrogenic cartilage damage.  相似文献   

15.
Six fractures of the midshaft or distal third of the humerus were repaired through a modified craniolateral approach in which the brachialis muscle was transected rather than retracted to improve exposure of the bone. The approach simplified fracture reduction and fixation. Normal fracture healing and excellent limb function resulted in each case.  相似文献   

16.
Medial patellar desmotomy was performed on one (treated) hindlimb, and a sham operation on the other (control) hindlimb, of 12 normal horses. The horses were examined for lameness before medial patellar desmotomy and at months 1, 2, and 3. The femoropatellar joints were examined radiographically and arthroscopically at month 3. All horses were lame on the treated limb at months 1, 2, or 3. Radiographic changes, including fragment formation at the distal aspect of the patella and bone production at the attachment of the middle patellar ligament on the patella, were present in 11 horses at month 3. Articular cartilage fibrillation or detachment was seen arthroscopically on the patellas of all treated limbs. In six horses, loosely attached fragments of bone and cartilage were removed arthroscopically from the distal aspect of the patella of the treated limb. The control limbs were clinically, radiographically, and arthroscopically normal throughout the study. Medial patellar desmotomy results in pathologic changes in the articular cartilage of the patella and adjacent soft tissues. Use of this surgical procedure should be reserved for persistent and confirmed cases of upward fixation of the patella.  相似文献   

17.
A modified Cloward's technique was performed for arthrodesis of one metacarpophalangeal (MCP) joint in eight horses. Dorsal arthrotomies were performed medial and lateral to the common digital extensor tendon and two 16 mm holes were drilled through the joint. A perforated cylindrical stainless steel basket filled with cancellous bone was impacted into each hole. The limbs were supported in casts for 8 weeks. The joints were examined and radiographed at 4 weeks, 8 weeks, 6 months, and 10 months. One horse was euthanatized at week 14 to assess the progress of the arthrodesis. In the other seven horses, there was clinical fusion at month 6. Dynamographic evaluations were performed 11 months after surgery at the walk and trot. The maximum vertical forces exerted during weight bearing by treated and control limbs were compared. No difference was detected at the walk; however, a significant difference was present at the trot (p less than 0.05). It was calculated that at the trot the horses placed 90% as much force on the treated limb as on the control limb. Eleven months after surgery, the baskets contained compact and cancellous bone. Ingrowth of bone occurred through all openings, completely filling the baskets and fusing the joints.  相似文献   

18.
Medial patellar desmotomy was performed on one (treated) hindlimb, and a sham operation on the other (control) hindlimb, of 12 normal horses. The horses were examined for lameness before medial patellar desmotomy and at months 1, 2, and 3. The femoropatellar joints were examined radiographically and arthroscopically at month 3. All horses were lame on the treated limb at months 1, 2, or 3. Radiographic changes, including fragment formation at the distal aspect of the patella and bone production at the attachment of the middle patellar ligament on the patella, were present in 11 horses at month 3. Articular cartilage fibrillation or detachment was seen arthroscopically on the patellas of all treated limbs. In six horses, loosely attached fragments of bone and cartilage were removed arthroscopically from the distal aspect of the patella of the treated limb. The control limbs were clinically, radiographically, and arthroscopically normal throughout the study. Medial patellar desmotomy results in pathologic changes in the articular cartilage of the patella and adjacent soft tissues. Use of this surgical procedure should be reserved for persistent and confirmed cases of upward fixation of the patella.  相似文献   

19.
Periarticular anatomy and techniques for arthroscopic access to the equine elbow were studied in six joints from cadavers. Caudomedial and craniolateral approaches were evaluated subsequently in 11 anesthetized horses. The caudomedial approach was made between the flexor carpi radialis and flexor carpi ulnaris muscle bellies. Most of the caudal articular surfaces of the humeral condyles, the caudal perimeter of the radius, and the trochlear notch and portions of the anconeal process of the ulna could be identified. The voluminous caudal joint capsule cul-de-sac proximal to the anconeal process was readily entered. A 70 degree arthroscope allowed examination of more of the joint recesses and articular surfaces of the olecranon fossa than a 25 degree arthroscope. A second portal for intraarticular instrument manipulation was made caudal and slightly proximal to the arthroscope entry. Entry more proximal than the level of the radiohumeral articulation carried significant risk of damage to the ulnar nerve and collateral ulnar artery and vein. For examination of the cranial regions of the elbow, a craniolateral portal was established cranial to the lateral collateral ligament. An instrument portal was made through the muscle bellies of the extensor carpi radialis or common digital extensor muscles. The cranial articular surfaces of the humeral condyles were readily exposed by extension of the elbow. The weight-bearing articular surface of the radius could not be seen. Eight horses were euthanatized without recovery from anesthesia and the elbows were dissected for examination. Three horses were allowed to recover from anesthesia and were euthanatized on days 3, 30, and 60.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

20.
OBJECTIVE: To evaluate areas of articular contact of the proximal portions of the radius and ulna in normal elbow joints of dogs and the effects of axial load on size and location of these areas. SAMPLE POPULATION: Forelimbs obtained from cadavers of 5 adult mixed-breed dogs. PROCEDURE: After forelimbs were removed, liquid-phase polymethyl methacrylate was applied to articular surfaces of the elbow joint, and limbs were axially loaded. Articular regions void of casting material were stained with water-soluble paint. Relative articular contact areas were determined by computer-assisted image analyses of stained specimens. Repeatability of the technique was evaluated by analyses of casts from bilateral forelimbs of 1 cadaver. Incremental axial loads were applied to left forelimbs from 4 cadavers to determine effects of load on articular contact. RESULTS: Specific areas of articular contact were identified on the radius, the craniolateral aspect of the anconeus, and the medial coronoid process. The medial coronoid and radial contact areas were continuous across the radioulnar articulation. There was no articular contact of the medial aspect of the anconeus with the central trochlear notch. Coefficients of variation of contact areas between repeated tests and between contralateral limbs was < 20%. Significant overall effects of axial load on contact area or location were not identified. CONCLUSIONS: Three distinct contact areas were evident in the elbow joint of dogs. Two ulnar contact areas were detected, suggesting there may be physiologic incongruity of the humeroulnar joint. There was no evidence of surface incongruity between the medial edge of the radial head and the lateral edge of the medial coronoid process.  相似文献   

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