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1.
CLIFFORD M. HONNAS dvm Diplomate acvs DAVID T. ZAMOS vmd TROY S. FORD DVM Diplomate ACVS 《Veterinary surgery : VS》1993,22(2):115-121
An arthroscopic procedure for examination of the coxofemoral joint was developed in nine foals (four cadavers, five anesthetized) to determine if access was sufficient for evaluation and surgical treatment of intra-articular lesions. The joint was distended and the arthroscope inserted through the notch (incisura trochanterica) between the cranial and caudal parts of the greater trochanter. This portal allowed examination of the cranial, lateral, and caudal aspects of the joint. Mechanical distraction of the joint through an instrument portal located 2 to 4 cm cranial and 1 to 2 cm ventral to the arthroscope portal allowed examination of the ligament of the head of the femur, the femoral head, and articular and nonarticular surfaces of the acetabulum. Adduction and rotation of the limb improved visualization of the craniomedial and caudomedial portions of the femoral head. Traction applied to the distal limb allowed visualization of the same structures that were observed when mechanical distraction was used. Traction also created space for placement of surgical instruments into the joint through the instrument portal. Access to most regions of the joint was adequate, but access to the caudal and medial aspects of the joint was limited. Three foals were killed while they were anesthetized, and their coxofemoral joints were dissected. Two foals were allowed to recover from anesthesia and were observed for 30 days after surgery. One foal was mildly lame for 2 days after surgery. The other foal was not lame after surgery. The incisions healed, and the coxofemoral joints were radiographically normal by postoperative day 30. 相似文献
2.
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
3.
The clinical and ultrasonographic features of seven horses with coxofemoral subluxation are presented. Affected horses included five adult geldings (11–20 years), one large pony (6 years) and a 3-month-old filly. All were lame at the walk except for the pony with grade 3/5 lameness. Lameness was acute in all horses, but three horses progressed after initial improvement. Crepitus, muscle atrophy, and pelvic asymmetry were inconsistent findings. Ultrasonographic diagnosis of subluxation required dynamic visualization of femoral head displacement from the acetabulum while placing weight on the affected limb and subsequent replacement into its normal position upon limb resting. Acetabular rim fractures and joint effusion were visible regardless of weight bearing status in six horses each. No fractures were identified in the pony; the only patient with a good outcome. Six horses had a poor outcome with severe chronic lameness, four of which were euthanized. Postmortem ventrodorsal radiographs obtained in two horses confirmed subluxation only on extended limb projections, but not on hip-flexed projections. Acetabular rim fractures were not visible radiographically in either horse but were confirmed at necropsy. Subluxation was due to an elongated but intact ligament of the head of the femur in both horses. Osteoarthrosis was evident ultrasonographically, radiographically, and at necropsy. Dynamic ultrasonography was readily performed in the standing horse and produced diagnostic images with a low frequency curvilinear transducer. The apparent poor prognosis for horses with subluxation and acetabular fracture illustrate the importance of this imaging technique to identify affected horses. 相似文献
4.
We describe the case of a Simmental calf with congenital unilateral hip dysplasia. In the initial physical exam, the calf was able to stand unsteady when helped and showed severe swinging lameness in the left hind limb. Unilateral hip laxity and a positive Ortolani sign indicated subluxation of the femur within the hip joint. This finding was further confirmed by radiographic examination which also showed malformation of the left femoral head and acetabulum. After a short period of clinical improvement the calf's health deteriorated and it was euthanized due to signs of severe coxarthrosis. Pathological examination of the affected hip joint revealed a severe acetabular and femoral dysplasia with an incomplete formation of the epiphysis of the femoral head and a chronic granulating coxarthritis without evidence of primary infectious events. 相似文献
5.
REASONS FOR PERFORMING STUDY: An alternative technique of radiographing the pelvis in the standing horse is required, to avoid the risks associated with general anaesthesia. HYPOTHESIS: That lateral oblique radiography in the standing horse would be a useful technique in the investigation of pelvic injury. OBJECTIVES: To describe the technique of lateral oblique pelvic radiography in the standing horse and demonstrate the feasibility and usefulness of this technique. METHODS: A technique for lateral oblique radiography in the standing horse was devised and retrospective review made of radiographic findings in 18 clinical cases. RESULTS: The caudal iliac shaft, greater trochanter of the femur, femoral head, acetabulum and coxofemoral articulation on the side under investigation were visualised consistently using this technique. Of the 18 cases, 3 iliac shaft fractures, 1 acetabular fracture, 2 coxofemoral luxations and 4 horses with new bone formation around the coxofemoral joint and/or proximal femur were identified. CONCLUSIONS: Lateral oblique radiography in the standing, conscious horse can be used to investigate conditions affecting the caudal iliac shaft, coxofemoral articulation and proximal femur in the horse. POTENTIAL RELEVANCE: The technique is straightforward, noninvasive and useful in the investigation of horses with suspected pelvic injury. However, not all pelvic injuries would be identified, and normal radiographic findings do not rule out injury or fractures elsewhere in the pelvis. 相似文献
6.
7.
Geoffrey W Pye Chris Hamlin-Andrus Jennifer Moll 《Journal of zoo and wildlife medicine》2008,39(1):61-68
A retrospective/prospective radiographic study documented 55 cases of moderate to severe hip dysplasia, with varying degrees of shallowing of the acetabulum, flattening or loss of the femoral head, widening or loss of the femoral neck, and femoral diaphyseal abnormalities in northern koalas (Phascolarctos cinereus) in the San Diego Zoo (San Diego, California, USA) collection. For the retrospective study, historic radiographs were examined when availble. For the prospective study, three standard views (ventrodorsal extended leg, ventrodorsal frog leg, and lateral extended leg) were used. A scoring system was developed using four areas (acetabulum, femoral head, femoral neck, and femur) and ranges of 0 to 5 (0 = not affected to 5 = severely affected) for each area, creating a total score out of 40. Scores were graded as follows: 0-2 = normal dysplasia; 3-6 = mild dysplasia; 10-19 = moderate dysplasia; and 20-40 = severe dysplasia. Thirty koalas were graded as severe, 25 koalas as moderate, and 38 koalas as excellent or mild. Affected koalas may or may not demonstrate gait abnormalities. Mild to severe degenerative joint disease may develop and symptoms may be alleviated with glucosamine/chondroitin sulfate and nonsteroidal anti-inflammatory drugs. The etiology of hip dysplasia in koalas is not currently understood. 相似文献
8.
Edinger DT Hayashi K Hongyu Y Markel MD Manley PA 《American journal of veterinary research》2000,61(10):1267-1272
OBJECTIVE: To describe cancellous architecture of the proximal portion of the femur in dogs with osteoarthritis. ANIMALS: 30 dogs with coxofemoral osteoarthritis. PROCEDURE: All dogs had femoral head and neck excision or total hip arthroplasty. Histomorphometry software was used to analyze computer images of 100-microm-thick coronal and transverse plane sections of the head and neck of the femur. Histologic preparations of coronal and transverse sections of articular cartilage were graded. RESULTS: Bone volume/total volume, trabecular thickness, trabecular number, and bone surface/total volume were significantly higher in the femoral head than femoral neck. Trabecular alignment (anisotropy) and separation were significantly higher in the femoral neck than femoral head. Anisotropy was significantly increased in the medial portion of the femoral head in the coronal plane and in the cranial portion of the femoral neck in the transverse plane, compared with healthy dogs. The medial half of femoral head cartilage that overlies the proximomedial cancellous bone region had significantly more degraded cartilage than the lateral half. Histologic grades for cranial and caudal halves of femoral head articular cartilage were similar. CONCLUSIONS AND CLINICAL RELEVANCE: Most findings were similar to those in healthy dogs. Greater trabecular alignment in the proximomedial region of the femoral head and craniolateral region of the femoral neck in dogs with osteoarthritis suggests an altered transfer of load through the coxofemoral joint. Greater cartilage degradation on the medial half of the femoral head supports an association between increased trabecular alignment and cartilage degradation. 相似文献
9.
The caudal cruciate ligament assists the medial femorotibial ligament in supporting the medial aspect of the femorotibial joint. It also limits the outward rotation of the tibia during weight bearing. In two lame horses tearing of the caudal portion of the femoral attachment of the caudal cruciate ligament was recorded together with cracking and tearing of the medial meniscus. In one case, synovitis and restrictive fibrous periarthritis were the sequelae of secondary stifle sepsis. 相似文献
10.
Edinger DT Hayashi K Hongyu Y Markel MD Manley PA 《American journal of veterinary research》2000,61(3):268-274
OBJECTIVE: To describe the cancellous bone architecture of the head and neck of the femur in healthy dogs by use of automated histomorphometry techniques in conjunction with histologic grading of articular cartilage. ANIMALS: 30 mature male dogs with healthy coxo-femoral joints PROCEDURE: Dogs were 1.5 to 4 years old and weighed 27 to 37 kg. Computer images of fine-detail radiographs of 100-microm-thick coronal and transverse plane sections of the head and neck of the femur (14 dogs) were analyzed by use of histomorphometry software. Statistical comparisons among histomorphometric indices of 4 regions were performed. Histologic preparations of coronal and transverse plane sections of femoral head articular cartilage (16 dogs) were graded. Median grades for lateral, medial, cranial, and caudal halves of the femoral head articular cartilage were determined. RESULTS: Bone volume/total volume, trabecular thickness and number, and bone surface/total volume were significantly higher in the femoral head than in the femoral neck. Anisotropy (trabecular alignment) and trabecular separation were significantly higher in the femoral neck than in the femoral head. Anisotropy was significantly higher in the caudal half of the femoral neck than in the cranial half. Cartilage had histologic grades indicating health without significant differences among lateral, medial, cranial, and caudal halves of femoral head cartilage. CONCLUSIONS AND CLINICAL RELEVANCE: A predictable cancellous architecture in the head and neck of the femur is associated with healthy cartilage. 相似文献
11.
DAVID T. ZAMOS vmd CLIFFORD M. HONNAS dvm Diplomate acvs ANTON G. HOFFMAN dvm PhD 《Veterinary surgery : VS》1994,23(3):161-166
Arthroscopic examination of structures within the plantar pouch of the tarsocrural joint was accomplished via portals in both the plantaromedial and plantarolateral aspects of the joint. Flexion and extension of the tarsus while examining the joint through either portal allowed observation of the proximal and plantar aspects of the lateral and medial trochlear ridges, the trochlear groove, the caudal aspect of the distal tibia, and the deep digital flexor tendon (DDFT) in its sheath. From a plantarolateral portal, the plantar talocalcaneal ligament and the plantar aspect of the lateral malleolus could be observed. The caudal aspect of the medial malleolus could not be observed with flexion or extension of the joint from a plantaromedial portal, but in some horses, the caudal aspect of the lateral malleolus could be observed. The dorsolateral and dorsomedial aspects of the plantar pouch were best examined from a portal on the ipsilateral side of the joint. An instrument portal opposite either arthroscope portal allowed access to most regions of the joint except the abaxial surface of the trochlear ridge opposite the instrument. 相似文献
12.
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
13.
The effectiveness of ultrasound in depicting the normal anatomy of the coxofemoral joint in puppies was evaluated. Ultrasound images were obtained from twenty Springer Spaniel puppies ranging from one day to twelve weeks of age. The anatomy of the hip joint could be identified up to eight weeks of age. By twelve weeks of age the degree of ossification prevented complete hip joint evaluation. Three different views were utilized. The longitudinal and dorsolateral views were the most useful. Motion of the femoral head within the acetabulum could be observed. Measurements of the acetabulum, femoral head and joint space could be obtained however these measurements were inconsistent. The technique appears to be useful for depicting the anatomy of the neonatal coxofemoral joint however, additional studies utilizing both normal and dysplastic puppies are recommended to determine if this examination will be useful in discriminating between normal and dysplastic puppies. 相似文献
14.
The objective of this study was to establish a technique for radiographic examination of the coxofemoral joint and adjacent bony structures in standing cattle. Left (or right) 30° dorsal-right (or left) ventral radiographic views of the coxofemoral joint region of standing cattle (n = 10) with hind limb lameness were evaluated retrospectively. In addition, an experimental study of oblique laterolateral views of the coxofemoral joint region of a bovine skeleton at angles of 15-45° was carried out to determine the optimal position for visualization of the hip region. In the 10 clinical patients, the bodies of the ilium and ischium, the acetabulum and proximal third of the femur could be assessed. Six of these cattle had fractures of the body of the ilium and body of the ischium, five with and one without involvement of the acetabulum, two had craniodorsal and one caudoventral luxation of the femur and one had a femoral neck fracture. The described laterodorsal-lateroventral radiographs of the hip region in standing cattle were suitable for assessing the coxofemoral joint, the proximal aspect of the femur and parts of the ischium, ilium and pubis. After testing the optimal angle on the skeleton, it was seen that distortion and superimposition were minimized by positioning the X-ray beam at an angle of 25° to the horizontal plane. It can be concluded that the described technique improves the evaluation of injuries of the coxofemoral region in cattle. With the appropriate angle, the technique can also be applied in recumbent cattle. 相似文献
15.
Osteochondrosis affecting the acetabula in horses is rarely reported. Osteochondrosis dissecans in foals only a few weeks old is also an uncommon finding. Lesions compatible with osteochondrosis dissecans in the acetabulum were found to be the cause of a chronic coxofemoral lameness in a 3-week-old Arabian filly. The history, physical examination findings, joint fluid analysis, gross pathologic and histopathologic findings are described. 相似文献
16.
ROBIN M. DABAREINER dvm MS KENNETH E. SULLINS dvm MS Diplomate ACVS NATHANIEL A. WHITE II dvm MS Diplomate ACVS 《Veterinary surgery : VS》1993,22(6):515-523
The clinical and radiographic progression, and arthroscopic findings for nine young horses (<1 year of age) with femoropatellar osteochondrosis (OCD) are presented. Horses had a 2 to 12 week history of bilateral (8 horses) or unilateral (1 horse) hindlimb lameness. The most consistent clinical signs included femoropatellar joint distention and bilateral hindlimb lameness. At the onset of clinical signs, radiographic lesions were not present (4 horses) or subtle (5 horses), but were easily identified on radiographs taken 4 to 24 weeks later. Arthroscopic surgery was delayed until radiographic changes became obvious. Surgical findings in 20 femoropatellar joints were most commonly osteochondral "flaps" located on the proximal lateral trochlear ridge of the femur and were larger than had been indicated by the radiographs. Eight horses were being used for their intended purpose, which was racing (3 horses were racing and 3 were in race training), dressage (1 horse) or pleasure riding (1 horse). One horse required a second surgery when similar lesions developed in the opposite stifle, and was euthanatized 2 months later because of persistent lameness. Once clinical signs are observed, osteochondrosis lesions of the distal femur can progress in foals younger than 9 months of age and the full extent of the radiographic lesion may take several weeks to develop. 相似文献
17.
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
18.
Introduction: In many breeds osteoarthrosis of the hip joint is the most typical orthopaedic disease. Numerous studies concerning etiology, pathogenesis and therapy of this disease still consider an exact congruity to be the basis of a physiological joint function. No data, however, are available as far as the distribution of load in the articular surfaces is concerned. Aims: It was the aim of this investigation to describe the biomechanical features of the canine hip joint as exactly as possible with respect to long‐term and momentary loading. Material and Methods: Hip joints from 43 dogs (bodyweight >20 kg) with an average age of 6 years were investigated. The subchondral bone density was determined with the method of CT‐osteoabsorptiometry. With help of cartilaginous and osseus split lines the preferential orientation of the collagen fibres could be determined. In an in vitro experimental setup the contact areas and the contact pressure distribution within the joint have been measured. Results: In the acetabulum, maxima of subchondral bone density were distributed tricentrically: cranially, dorsally and caudally. In the femoral head, only the area close to the attachment of the ligament was highly mineralized. Cartilagineous and osseous split lines within the acetabulum gave evidence of a long‐term tensile stress. In contrast to these findings, there was no clear preferential orientation in the caput ossis femoris. With load increasing initially isolated contact areas extended and became confluent at a loading force of 75% body weight. Values of maximal joint pressure (maximal joint reaction force applied: 400% bodyweight) reached 8–10 MPa. Discussion: The findings clearly show that the articular surfaces of the hip joint are loaded inhomogeneously. For the first time, it was possible to demonstrate that the healthy canine hip joint is physiologically incongruent. Furthermore, areas of cartilage degeneration within the joint surface coincide with regions that are loaded to a higher extent a priori. From the biomechanical point of view it is recommended that all kinds of acetabular fractures – even those affecting the caudal third of the acetabulum – should be surgically repaired in an adequate way. 相似文献
19.
K. R. E. SQUIRE MVSc MSC PhD J. F. FESSLER DVM MS Diplomate ACVS J. P. TOOMBS DVM MS Diplomate ACVS D. C. VAN SICKLE DVM PhD W. E. BLEVINS DVM MS Diplomate ACVR 《Veterinary surgery : VS》1991,20(6):453-458
Femoral head ostectomy was performed in six horses, three ponies, and four cattle for treatment of fractures of the femoral capital physis, coxofemoral luxation, fractured acetabulum, or severe degenerative joint disease. The procedures were performed via a cranial approach that did not involve osteotomy of the greater trochanter. A dorsal approach for femoral head ostectomy via osteotomy of the greater trochanter was evaluated in three healthy adult ponies. Three animals (2 ponies, 1 calf) were euthanatized within a month and one horse was euthanatized at year 2 due to postoperative complications. Nine animals were discharged to owners and six of them fulfilled their intended functions of breeding, milking, and being kept as companions. One horse was lost to follow-up and two horses died of causes unrelated to the surgery. All surviving animals had a residual lameness that was described by owners as mild to moderate. None of the horses were used as riding animals. The mean age and weight of 10 animals that regained weight-bearing locomotion was 3.1 months and 84 kg; for three unsuccessful cases it was 34 months and 174 kg. We concluded that femoral head ostectomy was a viable salvage procedure for large animals with capital femoral physeal fracture, chronic coxofemoral luxation, or acetabular fracture. Surgical prognosis appeared to be favorable in young cattle and fair in young horses or ponies weighing less than 100 kg. Osteotomy of the greater trochanter resulted in superior exposure of the intact coxofemoral joint and allowed easier, less traumatic surgical luxation of the joint to facilitate femoral head ostectomy. 相似文献
20.
AMANDA RISLER JULIA M. KLAUER NICHOLAS S. KEULER WILLIAM M. ADAMS 《Veterinary radiology & ultrasound》2009,50(2):157-166
Ventrodorsal extended hip radiographs were analyzed from Foxhounds, Irish setters, Greyhounds, and Labrador retrievers radiographed four to seven times between 8 and 110 weeks of age. Occurrence in these 91 dogs of a puppy line, an ill-defined zone of proximal femoral metaphyseal sclerosis, a femoral neck linear sclerosis, or circumferential linear femoral head osteophytosis at 15–17 weeks of age were compared with hip joint laxity, as measured by distraction index, and to later findings of caudal curvilinear femoral neck osteophytes, circumferential femoral head osteophytes, hip incongruity consistent with hip dysplasia and degenerative joint disease by 52 weeks of age. A puppy line and/or femoral metaphyseal sclerosis was common at 15–17 weeks of age for dogs at mimimal risk (Greyhounds) and high risk (Foxhounds) of developing early degenerative joint disease associated with canine hip dysplasia. Though 44% of Greyhound hips had puppy lines and 28% had femoral metaphyseal sclerosis at 15–17 weeks of age, no Greyhound had a caudolateral curvilinear osteophyte or circumferential femoral head osteophyte at 24–27 or 52 weeks of age. No significant relationship was found between occurrence of a puppy line, a circumferential femoral head osteophyte or femoral metaphyseal sclerosis at 15–17 weeks and canine hip dysplasia or degenerative joint disease incidence at 42–52 weeks. Presence of a caudolateral curvilinear osteophyte in at least one hip at 24–27 weeks was significantly related to the diagnosis of canine hip dysplasia by 42–52 weeks. When both a caudolateral curvilinear osteophyte and a circumferential femoral head osteophyte were present in a hip at 24–27 weeks, degenerative joint disease was evident in all such hips by 42–52 weeks of age. 相似文献