Arthroscopically Guided Proximal Tibial Epiphysiodesis Screw Placement as Treatment of a Bilateral Partial Cranial Cruciate Ligament Injury in a Juvenile Dog

VCOT Open Pub Date : 2020-07-01 DOI:10.1055/s-0040-1716821
Mélanie Olive, A. Caron, A. Fournet, M. Vanel
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Abstract

Abstract This study aimed to describe surgical technique of arthroscopically guided proximal tibial epiphysiodesis screw placement in the treatment of a bilateral partial cranial cruciate ligament (CrCL) rupture in a 5.6-month-old Golden Retriever. A 19-kg, 5.6-month-old female Golden Retriever was diagnosed with bilateral partial CrCL rupture. Proximal tibial epiphysiodesis was performed bilaterally under arthroscopic guidance. Arthroscopic stifle joint inspection was performed bilaterally with a 2.7 mm arthroscope. A medial port at the level of the distal one-third of the patella was used as camera portal. A lateral instrument port was positioned at the level of the distal one-third of the patella. A 3.0 mm diameter headless cannulated self-compressive screw was placed into the centre of the tibial cranial intercondyloid area as parallel as possible to the tibial shaft axis under arthroscopic control. Screw head was buried. Arthroscopic guidance allowed good accuracy in screw placement, specifically in its insertion point. However, the screw orientation was less satisfactory. The tibial plateau angle progressively decreased in both stifles to achieve 15 degrees on the left and 16 degrees on the right at the last follow-up. A varus deformity developed on both stifles. No clinical consequences were observed. Recurrence of right pelvic lameness occurred 1 year postoperatively because of a medial meniscal lesion, which necessitated partial caudal meniscectomy. Arthroscopically guided proximal tibial epiphysiodesis is technically feasible and is a minimally invasive treatment of CrCL injury in a juvenile dog.
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关节镜引导下胫骨近端表皮固定螺钉置入治疗幼年犬双侧部分颅交叉韧带损伤
摘要本研究旨在描述关节镜引导下胫骨近端表皮固定螺钉置入治疗双侧部分颅交叉韧带(CrCL)断裂的手术技术。一只19公斤,5.6个月大的雌性金毛猎犬被诊断为双侧部分CrCL破裂。在关节镜引导下进行双侧胫骨近端表皮成形术。双侧2.7 mm关节镜下进行膝关节镜检查。髌骨远端三分之一水平处的内侧门用作照相门。外侧器械口位于髌骨远端三分之一的水平。在关节镜控制下,将一枚直径3.0 mm的无头空心自压螺钉放置于胫骨颅骨髁间区中心,尽可能平行于胫骨轴。螺钉头被埋。关节镜引导使螺钉置入具有良好的准确性,特别是在其插入点。然而,螺钉的定位不太令人满意。在最后一次随访时,两组胫骨平台角逐渐减小,左侧为15度,右侧为16度。两个膝关节都出现了内翻畸形。没有观察到临床后果。由于内侧半月板病变,术后1年右侧骨盆跛复发,需要行部分尾侧半月板切除术。关节镜引导下胫骨近端骨骺成形术在技术上是可行的,是幼犬CrCL损伤的微创治疗方法。
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