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1.
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
2.
R. Cole J. Schumacher R. Wilhite J. Newton J. Schumacher 《Equine Veterinary Education》2014,26(2):93-97
The accuracy of a technique for centesis of the bicipital bursa using a 9 cm, spinal needle inserted through the tendon of the biceps brachii muscle was evaluated. A veterinary radiologist who had no previous experience of performing centesis of the bicipital bursa and an equine clinician who had little experience in performing the procedure, attempted to inject a solution of aqueous radiopaque contrast medium into the bicipital bursae of 8 horses using an approach in which the bursa was accessed by directing a needle through the tendon of origin of the biceps brachii muscle until cartilage in the lateral portion of the intertubercular groove was contacted. Centesis of the bicipital bursa using this approach in horses having no signs of disease of the bursa was consistently successful if the cubital joint was flexed and the scapulohumoral joint extended. 相似文献
3.
de Bruin T de Rooster H Bosmans T Duchateau L van Bree H Gielen I 《The Veterinary record》2007,161(22):745-750
The formation and progression of osteoarthrosis in the unaffected contralateral stifle joints of 14 dogs with a unilateral cranial cruciate ligament rupture were monitored radiographically in terms of a global score and the scores for 10 parameters specific for the stifle joint. The dogs were examined initially and six and 12 months later by three observers, and the variability between the observers' scores was also assessed. The score for osteophytes at the tibial attachment site of the ligament was the most reliable parameter, and that for the increase in femoropatellar joint space was the least reliable. In the contralateral stifle joints there were significant increases after six and 12 months in osteophyte formation caudal to the tibial plateau, and in subchondral sclerosis of the tibial plateau and of the long digital extensor muscle groove. These three parameters progressed more regularly during the disease process than the other parameters. The global osteoarthrosis score of the contralateral stifle joint was an important risk factor for sustaining a rupture of the cranial cruciate ligament in that joint during the next six months. 相似文献
4.
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
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The purpose of the present paper was to find out the most suitable localizations to puncture of hip, stifle and hock joints of the domestic cat. These joints are arthrographically presented. Further six contrast mediums in normal commercial usage were tested with regard to there contrast intensity. The only recommendable localization to arthrocentesis of the hip joint is at the cranial border of the greater trochanter of the femur. The stifle joint is approachable either at the medial or lateral border of the Lig. patellae. To puncture the proximal row of the hock joint the recommendable puncture site was found distal of the lateral malleolus between the tendons of the lateral digital extensor muscle and m. extensor digitorum longus. Any arthrocentesis of the distal row of the hock joint isn't recommendable. Contrast mediums with a iodine concentration below 300 mg/ml were not sufficient for arthrography. 相似文献
7.
Reif U Dejardin LM Probst CW DeCamp CE Flo GL Johnson AL 《Veterinary surgery : VS》2004,33(4):368-375
OBJECTIVE: To evaluate the effect of limb positioning and measurement technique on the magnitude of the radiographically determined tibial plateau angle (R-TPA). STUDY DESIGN: In vitro study, R-TPA was determined by 6 blinded observers and image measurement software. ANIMALS: Five canine cadaver hind limbs. METHODS: The legs were positioned on a custom-made positioning device simulating a radiographic tabletop technique in lateral recumbency. True lateral positioning was defined by superimposition of femoral and tibial condyles on the radiographic projection. Radiographs were taken while the specimens were relocated in a proximal, distal, caudal, and cranial direction with respect to the radiographic beam. For each specimen, 25 different radiographic views were obtained and 6 blinded observers determined the radiographic TPA using 2 different methods. The conventional method used precise anatomic landmarks to determine the tibial plateau. To simulate osteoarthritic changes complicating identification of these landmarks, the tangential method estimated the tibial plateau as the tangent to the central portion of the tibial plateau. After periarticular soft tissue dissection the anatomic tibial plateau angle (A-TPA) was determined. The A-TPA and the R-TPA were compared. RESULTS: The R-TPA significantly decreased as limb position with respect to the X-ray beam changed from cranial proximal to caudal distal. The maximal mean radiographic R-TPA difference was 3.6 degrees with the first and 5.7 degrees with the second method. Regardless of the method used there was no significant difference between A-TPA and R-TPA in the true lateral position. In the peripheral positions, however, significant differences between anatomic and radiographic TPA were seen. CONCLUSIONS: Limb positioning influenced the radiographic appearance of the tibial plateau and the magnitude of the measured TPA. Cranial and proximal positioning of the limb relative to the X-ray beam leads to overestimation whereas caudal and distal positioning leads to underestimation of the TPA. CLINICAL RELEVANCE: True lateral positioning of the tibia defined by superimposition of the femoral and tibial condyles should be used for accurate TPA determination before tibial plateau leveling osteotomy. 相似文献
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Yukihiro Fujita 《Canadian journal of veterinary research》2021,85(4):312
The cross-pin technique for the treatment of distal femoral physis fractures (specifically, Salter-Harris Type I fractures) was investigated using femurs collected from beagle cadavers. The pin was inserted from the medial surface of the femur at an inclination of approximately 30 to 45° relative to the long axis of the femur in the anteroposterior direction; the pin exit was set proximal to the origin of the long digital extensor tendon. Digital and radiographic images of the femur in the anteroposterior and lateral directions were obtained. In both types of images, the insertion angle of the pin relative to the long axis was measured. Results suggest that when inserting a pin proximal to the fracture line, the ideal position can be achieved by inclining the pin approximately 20° cranially relative to the long axis of the lateral direction of the femur, in addition to the previously described criteria. 相似文献
10.
Vanderperren K Ghaye B Snaps FR Saunders JH 《American journal of veterinary research》2008,69(5):631-638
OBJECTIVE: To determine the detailed computed tomography (CT) anatomy of the metacarpophalangeal (MCP) joint in healthy horses. SAMPLE POPULATION: 10 cadaveric forelimbs from 10 adult horses without orthopedic disease. PROCEDURES: CT of the MCP joint was performed on 4 forelimbs. In 1 of the limbs, CT was also performed after intra-articular injection of 30 mL of contrast medium (40 mg of iodine/mL). Transverse slices 1-mm thick were obtained, and sagittal and dorsal planes were reformatted with a slice thickness of 2 mm. The CT images were matched with corresponding anatomic slices from 6 additional forelimbs. RESULTS: The third metacarpal bone, proximal sesamoid bones, and proximal phalanx could be clearly visualized. Common digital extensor tendon; accessory digital extensor tendon; lateral digital extensor tendon; superficial digital flexor tendon (including manica flexoria); deep digital flexor tendon; branches of the suspensory ligament (including its attachment); extensor branches of the suspensory ligament; collateral ligaments; straight, oblique, and cruciate distal sesamoidean ligaments; intersesamoidean ligament; annular ligament; and joint capsule could be seen. Collateral sesamoidean ligaments and short distal sesamoidean ligaments could be localized but not at all times clearly identified, whereas the metacarpointersesamoidean ligament could not be identified. The cartilage of the MCP joint could be assessed on the postcontrast sequence. CONCLUSIONS AND CLINICAL RELEVANCE: CT of the equine MCP joint can be of great value when results of radiography and ultrasonography are inconclusive. Images obtained in this study may serve as reference for CT of the equine MCP joint. 相似文献
11.
Avulsion of the origin of the tendon of the extensor digitalis longus muscle in a Dobermann pinscher
Avulsion of the tendon of the extensor digitalis longus muscle is a rare condition in young, large breed dogs or as a consequence of chronic lateral patellar luxation in adult dogs. Current technique of fixation consists into reattaching the fragment with a lag screw at its origin in the extensor fossa of the lateral femur condyle. If the fragment was considered too friable and reactive to be reattached, it was amputated and the tendon was sutured to the joint capsula. In this present case a adaptation screw with a washer was inserted distally to the sulcus extensorius through the tendon. The proximal part of the tendon was sutured to the joint capsula. The postoperative result was excellent, with recovery of full function of the Musculus extensor digitalis longus. 相似文献
12.
We report a case of complete rupture of the tendon of origin of the long digital extensor at the myotendinous junction, with concurrent ruptures of the posterior cruciate and lateral collateral ligaments in the stifle joint of a cat. Stabilization was accomplished by direct suturing of the long digital extensor injury, imbrication of the joint capsule and lateral retinacular fascia, and creation of a synthetic lateral collateral ligament 相似文献
13.
OBJECTIVE: To report a technique for surgical alteration of the slope of the tibial plateau by a proximal tibial intraarticular ostectomy (PTIO) after injury to the canine cranial cruciate ligament (CCL) and to determine the outcome. STUDY DESIGN: Prospective clinical study. ANIMALS: Dogs (n=52) with CCL injury in 60 stifle joints. METHODS: CCL injury was treated by lateral stifle arthrotomy, removal of CCL remnants, and appropriate meniscal surgery. PTIO was performed to remove a wedge of bone from the proximal aspect of the tibia. The ostectomy site was reduced and stabilized using a bone plate and screws applied to the medial surface of the tibia as well as a craniocaudal positional screw. Dogs were evaluated at 6 weeks, 6, and 12 months by complication assessment, lameness scores, stifle range of motion (ROM), thigh circumference, radiographic assessment, degenerative joint disease (DJD) scores, and surgeon and owner evaluation of function. RESULTS: Lameness scores improved by 6 and 12 months in all but 1 dog. Thigh circumference and DJD were increased at 6 and 12 months. Complications occurred in 20% of dogs with all but 1 occurring perioperatively or within 6 weeks; most common were injury to the long digital extensor tendon (4 dogs) and plate failure (3); 2 other dogs required surgery to treat complications. Most owners (98%) reported that lameness had improved by 12 months; 90% were extremely or very satisfied with the procedure and 90% would have the same procedure performed on another dog. CONCLUSION: PTIO to level the tibial plateau provided a satisfactory clinical outcome in dogs >20 kg with CCL injury and the complication rate was similar to tibial plateau levelling osteotomy (TPLO). Stifle osteoarthritis continued to progress radiographically. CLINICAL RELEVANCE: PTIO represents an alternative to TPLO that does not require specialized surgical equipment. 相似文献
14.
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
15.
Vandeweerd JM Kirschvink N Muylkens B Depiereux E Clegg P Herteman N Lamberts M Bonnet P Nisolle JF 《Veterinary journal (London, England : 1997)》2012,193(2):426-432
Although ovine stifle models are commonly used to study osteoarthritis, meniscal pathology and cruciate ligament injuries and repair, there is little information about the anatomy of the joint or techniques for synovial injections. The objectives of this study were to improve anatomical knowledge of the synovial cavities of the ovine knee and to compare intra-articular injection techniques. Synovial cavities of 24 cadaver hind limbs from 12 adult sheep were investigated by intra-articular resin, positive-contrast arthrography, computed tomography (CT) arthrography and gross anatomical dissection. Communication between femoro-patellar, medial femoro-tibial and lateral femoro-tibial compartments occurred in all cases. The knee joint should be considered as one synovial structure with three communicating compartments. Several unreported features were observed, including a communication between the medial femoro-tibial and lateral femoro-tibial compartments and a latero-caudal recess of the lateral femoro-tibial compartment. No intermeniscal ligament was identified. CT was able to define many anatomical features of the stifle, including the anatomy of the tendinous synovial recess on the lateral aspect of the proximal tibia under the combined tendon of the peroneus tertius, extensor longus digitorum and extensor digiti III proprius. An approach for intra-articular injection into this recess (the subtendinous technique) was assessed and compared with the retropatellar and paraligamentous techniques. All three injection procedures were equally successful, but the subtendinous technique appeared to be most appropriate for synoviocentesis and for injections in therapeutic research protocols with less risk of damaging the articular cartilage. 相似文献
16.
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
17.
REASONS FOR PERFORMING STUDY: Centesis of the bicipital bursa using an 8.9 cm long spinal needle has been reported but the alternative of employing a 3.8 cm long hypodermic needle requires validation. OBJECTIVE: To compare the efficacy of 2 different methods of centesis of the bicipital bursa and to evaluate the usefulness of ultrasonographic imaging to determine the location of solution administered when centesis of the bursa is attempted. METHODS: For Trial 1, 6 clinicians, who had no previous experience of centesis of the bicipital bursa, attempted to inject a solution composed of an aqueous radiopaque contrast medium and physiological saline solution (PSS) into the bicipital bursae of 2/12 horses using the previously described distal approach to inject one bursa and a proximal approach to inject the contralateral bursa. The bicipital tendon and bursa were examined ultrasonographically before and after injection; and both shoulders were examined radiographically to identify the location of the medium. In Trial 2, another 6 clinicians, also with no previous experience of centesis, repeated Trial 1, using 6 horses, but the radiopaque contrast medium was mixed with air instead of PSS. RESULTS: Accuracy of centesis using the proximal approach was 39% and that of the distal approach 28%. Ultrasonographic examination of the shoulder allowed the location of solution and air to be accurately predicted in all 12 shoulders examined. CONCLUSIONS: Clinicians who have had no previous experience performing centesis of the bicipital bursa are unlikely to be successful in centesis using either approach. Radiographic examination after injecting a radiopaque contrast medium may be necessary to assess the success of centesis especially if bursal fluid is not obtained during centesis. Injecting air along with the radiopaque contrast medium provides more accurate ultrasonographic confirmation of centesis and better radiographic definition than does injection without air. 相似文献
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Gandini M 《Journal of the American Veterinary Medical Association》2007,231(2):254-258
OBJECTIVE: To compare 3 dorsal techniques for arthrocentesis of the distal interphalangeal joint in horses with regard to ease of performing the technique and to determine the role of operator experience in ease of performing these techniques. DESIGN: Observational study. Sample Population-Forelimbs from 17 equine cadavers and 12 horses (16 joints) undergoing arthrocentesis for therapeutic or diagnostic purposes. PROCEDURES: In both forelimbs from 7 of the equine cadavers, 3 arthrocentesis techniques (dorsal perpendicular, dorsolateral, and dorsal inclined) were performed in random order by a single experienced individual, and number of attempts needed to successfully insert the needle into the joint was recorded. For the forelimbs from the remaining 10 cadavers, veterinary students without experience in arthrocentesis performed each of the 3 arthrocentesis techniques (2 limbs/student) in random order, and number of attempts was recorded. In the clinical patients, arthrocentesis was performed by means of the dorsal inclined technique. RESULTS: For both the experienced individual and the veterinary students, number of attempts needed was significantly lower with the dorsal inclined technique than with the dorsal perpendicular or dorsolateral technique. Arthrocentesis was successful with the dorsal inclined technique in all 16 joints in the clinical patients; synovial fluid was recovered from 14 of the 16 joints. The procedure was well tolerated in all horses, except one that reacted to needle insertion. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggested that the dorsal inclined technique for arthrocentesis of the distal interphalangeal joint was easier to perform than was the dorsal perpendicular or dorsolateral technique, regardless of experience level of the operator. 相似文献
20.
J Kofler 《Veterinary journal (London, England : 1997)》1999,158(1):21-32
The stifle region of 18 healthy cattle (14 cows, four bull calves) and the stifles of five bovine cadavers were examined using 7.5 MHz linear or convex and 5 MHz sector transducers. The normal ultrasonographic appearance of soft tissues and bony structures was studied.The homogeneously echogenic patellar and collateral ligaments, the combined tendon of the long digital extensor and peroneus tertius muscles, the popliteus tendon, the anechoic articular cartilage of the femoral trochlea, the echogenic menisci and the hyperechoic bone surfaces were imaged successfully in all cattle and cadavers. The boundaries of the joint pouches only became partially identifiable, when small amounts of anechoic fluid were present in the medial and lateral femorotibial joint pouches. After experimental filling in cadavers, the distended synovial cavities were imaged as clearly demarcated, anechoic areas. Measurement values of cross-sectional diameters of the ligaments, tendons and the popliteal lymph node, the width of normal joint pouches, where visible, and articular cartilage thickness are presented. The established results should serve as reference data for ultrasonography of bovine stifle disorders. 相似文献