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Phase 3 used horses with suspected stifle injury or disease. Five cadaver limbs were used in phase 1 to assess all stifle joints. Phase 2 used standing sedated and locally anesthetized horses. Routine arthroscopic approaches were used in both weight bearing and flexed nonweight bearing positions. In both phase 1 and 2 simultaneous ultrasonographic and arthroscopic examinations were used to confirm extent of diagnostic examination.

The methods developed in phase 2 were used to examine the stifle in 3 horses with suspected stifle disease. In cadaveric limbs and horses, all intra articular structures that constitute a complete arthroscopic examination were identified; no intra -or postoperative morbidity occurred. In phase 3, the needle arthroscope was used in accurate identification of pathologic change and in 1 horse, an osteochondral fragment not detected by ultrasonography and radiography was identified. This preliminary work indicates that an 18 g arthroscope can be used for diagnostic examination of the equine stifle in standing horses.

Determination of the normal arthroscopic anatomy of the femoropatellar and cranial femorotibial joints of cattle. Sylvain Nichols. The arthroscopic approach and anatomy of the bovine femoropatellar and femorotibial joints are described.

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.

Kristie L. Study DesignRetrospective case control study. AnimalsThoroughbred weanlings and yearlings. Outcome measures relating to racing performance number of race starts, wins, places, and prize money earned, from races in their 2- and 3-year-old racing careers and in total from the period studied were defined and then cases were compared to 2 age and sex matched controls using multilevel linear regression models.

The effect of horse age at surgery and surgeon experience on the outcomes for cases with stifle OCD were also examined. Younger horse age at time of surgery and reduced surgeon experience were significantly associated with worse outcomes for stifle OCD cases. Conclusions Stifle OCD cases appear to perform less successfully as racehorses than matched controls.

Horse age at time of surgery has an effect on subsequent racing performance. Radiography of the equine stifle. The stifle is a complex joint and, when faced with a patient suffering from pain in this area, a veterinary surgeon will often use radiography as the first port of call. This article describes the radiographic projections routinely acquired of the stifle region, and the common conditions diagnosed with this imaging modality, while acknowledging that additional imaging modalities are often required to reach a final diagnosis.

Subchondral bone cysts in the equine stifle. Rosanne Barwick. Jul Vet Surg. To describe a direct arthroscopic approach to the suprapatellar pouch SPP , its intra-articular anatomy, and report our clinical experience with SPP arthroscopy. Four femoropatellar joints FPJ were dissected or injected with latex to document surface landmarks and topographic anatomy.

This approach allowed arthroscopic observation of the proximal aspect of the lateral and medial femoral trochlear ridges, the intertrochlear groove, the patellar base, and the synovial recess of the SPP. Suprapatellar arthroscopy improved arthroscopic observation of structures located proximally in the FPJ and facilitated surgical access to the SPP.

Arthroscopic surgery of the femorotibial joint. Dec Clin Tech Equine Pract. Many conditions of the femorotibial joint are difficult to diagnose accurately, and arthroscopy offers unique diagnostic information as well as an opportunity for treatment in some cases. The caudal and cranial pouches of both medial and lateral compartments of the joint can be examined but the mid joint region is inaccessible in the normal horse.

In particular, arthroscopy is useful for the evaluation and treatment of articular cartilage lesions, meniscal and cruciate injuries, subchondral bone cysts, sepsis and intra-articular fracture. A surgical approach to the lateral trochlear ridge of the distal femur of the horse was developed to facilitate evaluation and curettage of osteochondral defects of the lateral trochlear ridge. Surgical exploration of the lateral trochlear ridge was achieved in 11 patients with osteochondral defects of the lateral trochlear ridge using a craniolateral arthrotomy between the middle and lateral patellar ligaments.

The technique described allowed adequate exposure for evaluation, removal of loose osteochondral fragments, and curettage of cartilage abnormalities on the lateral trochlear ridge.

Development of subchondral cystic lesions after articular cartilage and subchondral bone damage in young horses. The objective of this study was to determine if damage to the articular cartilage alone or articular cartilage plus subchondral bone of the distal medial femoral condyle of young, exercised horses resulted in the formation of subchondral cystic lesions. Twelve Quarter Horses age 1—2 years , free of clinical and radiographic signs of osteochondrosis and lameness were used. In 6 horses Group 1 , a 15 times 1 mm linear full thickness defect in the articular cartilage was made arthroscopically on the weightbearing surface of the distal aspect of the medial femoral condyle.

In the other 6 horses Group 2 , a 15 times 3 mm full thickness elliptical cartilage defect was made, followed by burring a 5 mm diameter, 4 mm deep hole into the subchondral bone.

Three weeks after surgery, all horses were hand walked and trotted for 2 weeks and then exercised for 6 min daily, 5 days a week for the next 14 weeks on a treadmill. They were then turned onto a small paddock for 6 weeks 6 months total.

The development of subchondral cystic lesions was determined using radiography. Bone activity in the femoral condyle was monitored with nuclear scintigraphy.

All horses that developed subchondral cystic lesions radiographically were subjected to euthanasia for gross and histological examination of the lesions. Arthroscopic treatment of osteochondritis dissecans. J F Guhl. The author surveys the possibilities of surgical treatment of osteochondritis dissecans of the knee joint under arthroscopic supervision by drilling and curetting of the affected area. The experience to date is presented.

Suturing and Knot Tying in Laparoscopy. Laparoscopic surgery is evolving, and its applications are growing to include most abdominal operations.

Tissue approximation by means other than mechanical clips or staples will be increasingly important. Laparoscopic surgeons must learn and apply basic suturing and knot-tying skills in this remote, two-dimensional operating theater. The authors advocate practice of these skills using inanimate and animate training models prior to application in the clinical setting. Arthroscopic surgery for osteochondritis dissecans of the femoropatellar joint of the horse.

Arthroscopic surgery for the treatment of osteochondritis dissecans was undertaken on femoropatellar joints in horses 82 Thoroughbreds, 39 Quarter Horses, 16 Arabians, 9 Warmbloods and 15 others of various breeds. There were 53 females and males. Ninety-one had bilateral involvement and 70 had unilateral disease. A significantly higher success rate was also noted for horses operated on as 3-year-olds compared with the remainder of the study population.

A significantly lower success rate was noted for yearlings than for the remainder of the population. There was no significant difference in outcome as related to sex of animal involved, racehorse versus non-racehorse, lesion location, unilateral versus bilateral involvement, presence or absence of patellar or trochlear groove lesions, or presence or absence of loose bodies.

Arthroscopic removal of an osteochondral fragment from the caudal pouch of the lateral femorotibial joint in a colt. An osteochondral fragment was removed from the caudal pouch of the lateral femorotibial joint in a 2-year-old Trakehner colt by use of arthroscopic surgery and a lateral approach.

The approach to this aspect of the femorotibial joints was developed in another horse. The fragment was not attached and resembled an osteochondritis dissecans lesion. The intermittent lameness associated with the fragment resolved after surgical removal. A positive response to diagnostic anesthesia of the femorotibial joint in the absence of a confirmed diagnosis following radiographic and arthroscopic evaluations of the other aspects of the stifle joint is an indication for arthroscopic exploration of the caudal pouches of the femorotibial joints of stifles in horses.

Osteochondral fragmentation of the distal aspect of the patella in horses. C W McIlwraith. A condition characterised by osteochondral fragmentation of the distal aspect of the patella in 15 horses is described.

The problem was unilateral in six horses and bilateral in nine. A previous medial patellar desmotomy had been performed on 12 of the 15 horses. The condition manifested as hindlimb lameness and stiffness ranging from mild to severe. There was fibrous thickening in the stifle area in the 12 cases with a previous medial patellar desmotomy, and synovial effusion in seven of 12 cases. Synovial effusion was present in two of the three cases in which a previous medial patellar desmotomy was not performed.

The radiographic changes included bony fragmentation, spurring with or without an associated subchondral defect , subchondral roughening and subchondral lysis of the distal aspect of the patella. All horses were treated with arthroscopic surgery. The lesions at arthroscopy varied from flaking, fissuring, undermining or fragmentation of the articular cartilage to fragmentation or lysis of the bone at the distal aspect of the patella. The subchondral bone was involved in all cases that had a previous medial patellar desmotomy.

Of the 12 horses that had a previous medial patellar desmotomy, eight became sound at their intended use, one was sold in training without problems, one is in early training without problems, one never improved and one is in convalescence. Of the three that did not have a patellar desmotomy, two performed their intended use well but one was unsatisfactory.

Injuries to the cranial cruciate ligament and associated structures: summary of clinical, radiographic, arthroscopic and pathological findings from 10 horses. The clinical, radiographic, arthroscopic and pathological findings of 10 horses with injury to the cranial cruciate ligament are presented. The most consistent clinical signs included moderate to severe distension of the femoropatellar joint and a Grade III to a Grade V out of V lameness.

Craniocaudal instability could be elicited in five horses under general anaesthesia and in one conscious horse. Radiographic evaluation of the stifles revealed that avulsion fracture of the medial intercondylar eminence was the most common finding in six out of 10 horses. Arthroscopic examination of the affected femorotibial joints were performed in five horses. This confirmed the presumptive diagnosis of cranial cruciate ligament injury or rupture.

Post mortem examinations were performed on two horses which documented partial tears of the cranial cruciate ligament. Cruciate and collateral ligament failure in the equine stifle: seven cases Medical records of 7 adult horses with single or multiple ligament failure of the femorotibial ligaments were reviewed to evaluate signalment, history, diagnostic and treatment methods, outcome, and long-term follow-up information.

Acute onset of lameness was recorded for most of the horses. Horses with multiple ligament injury had more severe clinical signs than did horses with single ligament injury. Horses with single ligament injury generally required manipulative tests to localize the lameness to the stifle. In all horses, radiography of the stifle assisted in the diagnosis. Of the 4 surviving horses, 2 became successful breeding animals, 1 was awaiting breeding, and 1 was used unsuccessfully as a breeding animal.

Necropsy findings in 2 of the 3 horses euthanatized after diagnosis revealed early articular damage in 1 horse 1 day after injury, and degenerative joint disease in the other horse 1 year after injury. Arthroscopic Examination of the Femorotibial Joints of Horses. A technique for satisfactory arthroscopic examination of the lateral and medial femorotibial joints of the horse is described. The entry portal is made between the middle and medial patellar ligaments with the horse on its back and the stifle flexed.

This position allows easy access to view the intercondylar eminence of the tibia. From this reference point, examination of all but the most caudal and medial structures of the joints are possible by manipulating the sleeve and telescope and maintaining joint distention.

In a series of 20 examinations, iatrogenic trauma was recognized only once. Surgery of the Hock, Stifle, and Shoulder. Aug Results of treatment of subchondral bone cysts in the medial condyle of the equine femur with autogenous cancellous bone graft. S E Kold J Hickman. The results of surgical treatment of 10 subchondral bone cysts, all located in the medial femoral condyle, are presented. A cancellous bone graft was used in nine cases and a two component acrylic bone cement was used in the case of an extremely large cyst.

Eight out of the 10 cases made a satisfactory clinical recovery. Diagnostic and Surgical Arthroscpy in the Horse. This paper reviews the current status of diagnostic and surgical arthroscopy in the horse. Arthroscopy has been used as a diagnostic aid since and is useful for evaluation of abnormalities in synovial membrane and articular cartilage. Surgical arthroscopy is a more recent advance that has replaced conventional arthrotomy in 90 per cent of the author's cases.

Clinical conditions currently being treated using arthroscopic techniques rather than arthrotomy include all chip fractures in the carpus, chip fractures of the first phalanx, chronic proliferative synovitis in the fetlock and osteochondritis dissecans of the femoropatellar and tibiotarsal joints.

Routine diagnostic arthroscopy is performed initially to confirm ACL injury and evaluate other knee pathologic conditions.

Bony landmarks are identified and marked Fig 1. The lateral femoral epicondyle is palpated with 5-mm transverse skin incision made just anterior to it. After this, dissection is made sharply to the bone Fig 2. Femoral insertion point of the ALL is just anterior and distal to the lateral femoral condyle and can be confirmed under image intensifier with a small curved artery forceps before a 2.

After this, both the passing pin and the drill pit are removed Fig 4. A 5- to mm transverse incision for the tibial insertion point is made just proximal to the midpoint between the head of the fibula and Gerdy tubercle with sharp dissection is made to the bone Fig 2.

The passing pin is drilled transversely across the proximal tibia to the medial side followed by the 4. Traction sutures for the anterior cruciate ligament graft through femoral tunnel and anteromedial portal white arrow. Incision for hamstrings graft harvest for anterior cruciate ligament yellow arrow. Passing pin is drilled transversely across proximal tibia to the medial side, right knee.

After the completion of tunnel drilling for the ACL reconstruction, the passing pin is pulled through the femoral tunnel followed by a No. A curved artery forceps is passed from the tibial incision to the femoral one under the ITB to pull the 2 ends of the polyester tape out from the tibial incision Fig 9. Passage of the ACL graft and fixation is done. Only skin is closed in routine fashion Fig 13 and light dressing is applied. Standard ACL rehabilitation program is followed in the postoperative period.

Weight bearing and knee flexion are allowed as tolerated. Quadriceps strengthening exercises in the form of quadriceps drill and straight-leg raising are encouraged immediately to maintain full knee extension. Femoral tunnel passing pin is pulled, followed by a No.

Cortical fixation button yellow arrow with its loop loaded with a polyester tape is pulled medially and flipped over the medial cortex, right knee. Curved artery forceps white arrow is passed from the tibial incision to the femoral one under the iliotibial band to pull the 2 ends of the polyester tape yellow arrow out from the tibial incision, right knee.

Passing pins of the 2 tibial tunnels are pulled out from the medial side followed by 2 monofilament sutures white and yellow arrows that will act as a relay suture. A After making a 5-mm incision yellow arrow white arrow, traction sutures for the cortical fixation button , B relay sutures are used to pull each end of the polyester tape striped white and yellow arrows out from the medial cortex, right knee. Extra-articular reconstruction techniques for management of ACL injuries were pioneered by Strickler , Lemaire , and MacIntosh s , using a lateral extra-articular tenodesis to control anterolateral tibial subluxation.

This then led the way to combined intra- and extra-articular reconstruction. Interestingly, although the combined procedure by and large went out of fashion in the late s, extra-articular tenodesis is making somewhat of a resurgence, with a number of authors using the procedure to aid control of rotational laxity, particularly in revision scenarios. Current techniques of ACL reconstruction may not achieve normal control of knee rotation. Placing value on the anterolateral structures for the management of ACL injuries is not a recent trend, but with the evolution of intra-articular reconstructions, it was being left aside.

The rationale of combining intra- and extra-articular procedures in ACL reconstruction is to limit the internal rotation of the reconstructed knee, thus providing more knee stability in the rotational axis and preventing excessive stresses on the ACL graft. Many studies have already investigated the role of such extra-articular procedures. The concept of using braided polyester tape has shown positive results, with a low rate of complications for tendon repair in shoulder rotator cuff tendons 32 and tendoachilles injuries 33 as well as in ligament reconstruction for lateral ankle ligaments 34 and coracoclavicular ligament injuries.

In this technique for percutaneous reconstruction of the ALL, using a synthetic ligament with a polyester tape has many potential advantages, including minimal invasiveness, no additional graft donor morbidity, strength and stiffness with no laxity, secured methods of fixation, minimal precautions needed after surgery, and no joint reaction. The authors report that they have no conflicts of interest in the authorship and publication of this article.

Surgical steps for the technique of percutaneous reconstruction of anterolateral ligament of the knee using polyester tape, right knee. Patient lying supine with the knee flexed over the side of the table and resting on the surgeon's thigh. National Center for Biotechnology Information , U. Journal List Arthrosc Tech v. Arthrosc Tech. Published online Jul 4. Ahmad M. Wagih , M.

Elguindy , M. Author information Article notes Copyright and License information Disclaimer. Although the molecular basis of inheritance is well established, clinical features are variable. It is known that deformity can occur, however its natural history in relation to the presence of local exostoses is poorly understood.

The literature review identifies some features of local deformity that suggest a causal effect however there are no level III studies. The result of exostosis excision has only been studied in the forearm in four case-series and the results are contradictory. In a proportion of patients an improvement may be expected to occur.

Optimal timing of surgery in relation to patient age and degree of deformity has not been established. Downsides to excision surgery are chiefly exostosis recurrence and failure to achieve the desired improvement in deformity. Peripheral Compartment Approach to Hip Arthroscopy. Arthroscopic management of an intraarticular osteochondroma of the hip. The role of hip arthroscopy in the management of femoroacetabular impingement FAI has been advancing rapidly.

In this case report, we describe the use of hip arthroscopy to successfully treat a femoral neck osteochondroma that caused a symptomatic labral tear in a 37 year old woman.

Hip arthroscopy offers several advantages to surgical dislocation of the hip in the management of intraarticular pathology and FAI. Hip arthroscopy is minimally invasive without the significant trauma to hip musculature, is useful in treatment of labral tears generated by FAI, and can be used to resect small lesions on the femoral head. Hip arthroscopy without traction: In vivo anatomy of the peripheral hip joint cavity.

Nov Michael Dienst S. To describe the in vivo anatomy of the peripheral compartment of the hip joint using a systematic sequence of examination without traction. Type of Study: Case series. We performed 35 hip arthroscopies without traction from an anterolateral portal in the supine position. Free draping and a good range of movement of the hip joint were used to relax parts of the capsule and increase the intra-articular volume of the area that was inspected.

Each procedure was documented on a standard protocol including detailed information on technical features and normal and pathologic intra-articular findings. A comprehensive inspection of the peripheral compartment was obtained from the anterolateral portal. A systematic sequence of examination was developed separating the periphery of the hip joint into 7 areas: anterior neck area, medial neck area, medial head area, anterior head area, lateral head area, lateral neck area, and posterior area.

The arthroscopic in vivo anatomy of each area is described. In 3 patients, 1 to 3 loose bodies were removed. In 1 patient with a synovial chondromatosis, 40 chondromas were retrieved. In osteoarthritis, impinging osteophytes were trimmed in 3 cases and partial synovectomy was performed in 10 patients. Segal, Rajiv R. Ratan, Jacqueline C. Bresnahan, and Michael S. Harik, and Peng Yuan. Harik, and Tong Zhao. Crabtree and Jennifer R. Smith, Andrew B. Clifton, and Chris T. Maiti, and Nrisingha Dey.

Allen, David B. John Fleckenstein. Crabtree, David Q. Hunsucker, and Jennifer R. Sullivan, William Rosenberg, and John F. Beckham, Liecheng Sun, and Barry Butcher. Mahboub and Donn E. Barrett, Joseph D. Crabtree, Jerry G. Pigman, and Jennifer R.

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Bridges, Satrio Husodo, Matthew S. Discouraging Election Contests , Joshua A. Gold, David A. Balota, Sara J. Jones, David K. Powell, Charles D. Smith, and Anders H. Distinctive interactions of the Arabidopsis homolog of the 30 kD subunit of the cleavage and polyadenylation specificity factor AtCPSF30 with other polyadenylation factor subunits , Suryadevara Rao, Randy D.

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Documentation of body mass index and control of associated risk factors in a large primary care network , Stephanie A. Rose, Alexander Turchin, Richard W. Grant, and James B. Does comorbidity explain the ethnic inequalities in cervical cancer survival in New Zealand?

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Drugs and the Brain: Part 3. Wooley, and Neil Rippingale. O'Connor and Min Chen. EbookMobile 2. Editor's Introduction and Acknowledgments , Andrew Moreman. Editor's Note , James Hanlon. Editor's Preface , Marcia England. Editor's Preface , Jessica Hollis. Editor's Preface and Acknowledgements , Brandon Absher. Educational Spending: Kentucky vs. Baskin, Carol C. Allen, Carl G. Mattacola, and David H. Ochsendorf, Carl G. Mattacola, and Brent L. Pigman, and Eric R. Page, Stephen R. Voss, Amy K.

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Effects of genetic deficiency of cyclooxygenase-1 or cyclooxygenase-2 on functional and histological outcomes following traumatic brain injury in mice , Matthew L.

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7 thoughts on “Interarticular Ligament Of Hip Joint Instrumental - Digital Velvet - Digital Velvet (File)

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  3. Osteochondritis dissecans (OCD) of the femoral head is not a common source of hip pain. Hip arthroscopy is becoming a more frequent indication for intra-articular pathologies of the hip. Osteochondral autologous transplantation is a promising technique that theoretically can reconstruct osteochondral lesions of the femoral head. We describe our technique for arthroscopic antegrade Cited by:
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