Evaluation of small-intestinal submucosa implants for repair of meniscal defects in dogs

OBJECTIVE: To assess the effects of porcine small intestinal submucosa (SIS) implants on the healing of meniscal lesions in dogs. ANIMALS: 16 adult Greyhounds of both sexes. PROCEDURE: Unilateral osteotomy was performed at time 0 to disrupt the medial collateral ligament attachment, and two (1 cranial and 1 caudal) 4-mm circular defects were created in the avascular portion of the medial meniscus. One defect was filled with an SIS graft, and the other defect remained empty (control). Three months later, the identical procedure was performed on the contralateral limb. Three months after the second surgery, dogs were euthanatized, and meniscal tissue specimens from both stifle joints were collected for gross, histologic, biomechanical, and biochemical evaluations. RESULTS: Regenerative tissue was evident in 4 (2 SIS-implanted and 2 control) of 16 defects examined histologically. In 3 defects, this thin bridge of tissue was composed of immature haphazardly arranged fibrous connective tissue with a relatively uniform distribution of fibroblasts. Aggregate modulus, Poisson ratio, permeability, and shear modulus were not significantly different between control and SIS-implanted defects either 3 or 6 months after surgery. Hydroxyproline content also did not differ between SIS-implanted and control defects at 3 or 6 months. CONCLUSIONS AND CLINICAL RELEVANCE: Implantation of porcine SIS into experimentally induced meniscal lesions in dogs did not promote tissue regeneration.     

Healing of full-thickness cartilage compared with full-thickness cartilage and subchondral bone defects in the equine third carpal bone.

The effect of lesion depth on the quality of third carpal bone cartilage repair was examined. A 1-cm diameter articular defect penetrating the calcified cartilage in one limb and the subchondral bone plate in the opposite limb was created in the radial facet of the third carpal bones. Clinical and xeroradiographic examinations were performed every 4 weeks until 4 months (3 horses) and 6 months (3 horses) after surgery. The synovial membrane, non-opposing articular surfaces and articular defects were examined grossly, histologically and histochemically. Grossly, deeper defects contained thicker, whiter tissue, but both joints contained generalised degenerative changes. Defects extending through calcified cartilage were filled deeply by fibrocartilage and superficially by fibrous connective tissue. Defects extending through subchondral bone were consistently filled with hyaline-like cartilage in the depths of the lesion, fibrocartilage in the intermediate layer and fibrous connective tissue superficially. The results indicate that subchondral bone is the source of hyaline-like cartilage repair tissue and suggest that quality of healing of cartilage defects may be improved by penetrating the subchondral bone plate. It also appears that the synovitis associated with the procedure must be controlled before the procedure can be advocated for treatment of clinical cases.     

Regeneration of cartilage tissue by autologous chondrocytes transplantation for cartilage defects in a experimental bovine model

To evaluate the effects of chondrocytes transplantation on the regeneration of cartilage by intraarticular injection or injection into blood clots at cartilage defects, eight full-thickness cartilage defects were created surgically on the articular surface of each femoral trochlea of two calves. Autologous chondrocytes were isolated individually from the cartilage pieces collected at the creation of defects. And isolated cells were cultured in monolayers for proliferation. Cells were injected into synovial fluid (Group 2, n=11) or into the blood clots at the cartilage defects (Group 3, n=5) of the left femoropatellar joint on weeks 2 and 3, respectively after the operation. The defects (Group 1, n=16) of right femoropatellar joint were left untreated in the control group. After 14 weeks, repaired tissues were evaluated based on gross and histological examinations. In Group 3, more repaired tissues and a better interface between the repaired tissue and host cartilage were observed compared with the results for Groups 1 and 2. Moreover, cartilaginous tissue were observed more in defects of Group 3 than in defects of other groups. In conclusion, the present study suggests that the injection of cells into the blood clot at a cartilage defect might be applicable for the regeneration of damaged cartilage.     

Meniscal damage diagnosed by ultrasonography in horses: A retrospective study of 74 femorotibial joint ultrasonographic examinations (2000–2005)

This retrospective study reports diagnostic findings in 74 horses with ultrasonographic diagnosis of femorotibial joint damage; it describes the ultrasonographic features of meniscal tears and determines the prevalence of medial or lateral meniscal involvement and of associated synovial effusions. Horses were classified into four groups: with medial meniscal damage, with lateral meniscal damage, with lesions in both menisci, and with no ultrasonographic evidence of meniscal damage. After ultrasonographic appearance, meniscal lesions were described as central degeneration, horizontal tear, partial oblique tear of the distal angle, combined horizontal and oblique tears, or complex tear. Meniscal protrusion or other associated ultrasonographic or radiographic abnormalities were recorded. Of the 74 horses, 54 (73%) had medial meniscal damage, 5 (6.75%) had lateral meniscal damage, 5 (6.75%) had lesions in both menisci, and 10 (13.5%) had no meniscal lesion. Meniscal protrusion occurred in 20 cases (27%). Horizontal tears were the most frequent type of meniscal lesion (26 horses). Complex lesions were found in 6 lateral menisci and 14 medial menisci. Lesions of the cranial meniscal ligaments were seen in 10 horses. Synovial effusion of one or several joint compartments was found in 51 cases (68.9%).This study demonstrates the high prevalence of meniscal tears and synovitis in horses with ultrasonographic evidence of femorotibial derangement. Based on this series of clinical cases, horizontal tears of the medial meniscus appear to be the most frequent soft tissue injury of the equine stifle.     

Arthroscopic evaluation of menisci in dogs with cranial cruciate ligament injuries: 100 cases (1999-2000)

OBJECTIVE: To determine prevalence of meniscal injuries by use of arthroscopic examination in dogs with cranial cruciate ligament (CCL) injuries. DESIGN: Retrospective study. ANIMALS: 94 dogs with 100 injured CCLs. PROCEDURE: Records for 94 large dogs (> 20 kg [44 lb]) with 100 naturally occurring CCL injuries that were examined arthroscopically were reviewed. Pathologic findings in the CCL (complete or partial tears), prevalence and type of meniscal injuries, and periarticular osteophytes were recorded. RESULTS: 77% of joints had tears of the lateral meniscus; most were a series of small radial tears of the cranial horn. Fifty-eight percent of joints had tears of the medial meniscus. Positive correlation between complete tears of the CCL and medial meniscal damage was found. No significant relationships were detected between periarticular osteophyte formation and meniscal injury, medial and lateral meniscal injury, or degree of CCL tear and lateral meniscal injury. CONCLUSIONS AND CLINICAL RELEVANCE: There is a strong association between CCL injury and lateral and medial meniscal injuries in dogs. Clinical importance of lateral meniscal lesions is not known; a much higher percentage of dogs had such injuries than has been reported previously, possibly because of use of arthroscopy.     

Contact Mechanics of Simulated Meniscal Tears in Cadaveric Canine Stifles

Objective— To evaluate the biomechanical effects of 5 types of meniscal lesions on contact mechanics in the canine stifle.
Study Design— Experimental study.
Animals— Cadaveric canine stifles (n=12 pair).
Methods— Medial meniscal lesions (radial, vertical longitudinal, nonreducible bucket handle, flap, and complex tears) were simulated in cadaveric stifles. A contact map was recorded from each tear type and contact area (CA) and peak contact pressure (PCP) from each tear type were compared.
Results— A significant difference in PCP was detected between control and nonreducible bucket handle, flap, and complex tears. PCP increased by >45% in nonreducible bucket handle, flap, and complex meniscal tears when compared with control. No significant difference was found in PCP between control and radial and vertical longitudinal tears. No significant difference was found in CA between any of the meniscal conditions.
Conclusions— Nonreducible bucket handle, flap, and complex tears cause a significant increase in PCP. Radial and vertical longitudinal tears had a minimal impact on the contact pressures of the medial compartment of the stifle.
Clinical Relevance— Based on this ex vivo model, we support the clinical recommendation of debriding nonreducible bucket handle, flap, and complex tears because the injured portion of the meniscus no longer contributes significantly to the function of the meniscus. Radial and vertical longitudinal tears do not cause a change in contact mechanics allowing consideration of nonsurgical treatment and meniscal repair, respectively. Future experimental and clinical studies should aim to refine the treatment of specific meniscal injuries.     

Diagnostic accuracy of magnetic resonance imaging for meniscal tears in dogs affected with naturally occuring cranial cruciate ligament rupture

A stifle magnetic resonance (MR) imaging protocol was developed based on the appearance of the cruciate ligaments and menisci in normal dogs. Proton density images were subjectively considered to have the highest likelihood of detecting a meniscal lesion. Following this initial evaluation, the accuracy of high-field MR imaging to detect meniscal tears in dogs was evaluated in 11 dogs suffering from naturally occurring cranial cruciate ligament rupture. Dogs underwent MR imaging of the affected stifle before surgery. MR imaging and surgical findings were assessed independently, and then compared. Five tears of the medial meniscus were correctly diagnosed with MR imaging and 19 normal menisci were accurately characterized as such, based on MR images. In one medial meniscus, changes consistent with meniscal degeneration were seen on MR images but this was not seen at surgery. With regard to the lateral meniscus, one false positive diagnosis of a tear was made and this likely represented a normal variation. One other lateral meniscus had changes consistent with meniscal degeneration but, as with the similar lesion seen in the medial meniscus, this was not confirmed surgically. The global sensitivity of MR imaging for the diagnosis of a meniscal tear was 100% and the specificity was 94%. High-field MR imaging is a reliable method to diagnose meniscal tears preoperatively and this may be useful in selecting the surgical approach to clinically abnormal joints and may decrease the need for arthrotomy.     

Meniscal injury following initial cranial cruciate ligament stabilization surgery in 26 dogs (29 stifles)

OBJECTIVE: To describe clinical signs, arthroscopic findings, and outcome in a group of dogs undergoing second look arthroscopy for the treatment of meniscal tears following original surgery to correct a CCL deficient stifle joint. METHODS: The medical records of 26 dogs from the Veterinary Teaching Hospital at Texas A&M University and the Veterinary Orthopedic Center (Round Rock, Texas) that had second look arthroscopy for lameness following an original surgical procedure were reviewed. Pre-operative clinical findings, 2nd look arthroscopic findings and owner assessed outcome were documented. RESULTS: Postliminary bucket handle tears of the medial meniscus were detected in 22 (75.9%) cases. Other postliminary meniscal injuries included frayed caudal horn tears of the medial meniscus 6 (20.7%), and longitudinal tears of the lateral meniscus 1 (3.4%). An audible or palpable click was present in 27.6% of cases. An improvement or resolution of lameness was reported in 96.5% of cases reported. In conclusion, tears of the medial meniscus are a significant cause of lameness in dogs subsequent to surgery for cranial crucial ligament ruptures. Increased lameness or acute onset of lameness after surgery for cranial crucial rupture is a consistent finding. In rare cases, a palpable or audible click will be appreciated. Arthroscopic evaluation and partial meniscectomy improve or resolve lameness in the majority of cases. CLINICAL SIGNIFICANCE: Sudden or increased lameness in dogs with historical CCL stabilization surgery should be evaluated and treated arthroscopically for postliminary meniscal injury if another cause for lameness can not be determined.     

Biochemical changes in articular cartilage opposing full- and partial-thickness cartilage lesions in horses

Using arthroscopic technique, identical diameter defects were created in the proximal articular surface of both intermediate carpal bones of 6 horses. One of each pair of defects was deepened to penetrate the subchondral plate. Removed cartilage was assayed for [35S] sulfate incorporation, total hexosamine content, and DNA content. Six weeks later, cartilage was harvested and similarly analyzed from the distolateral portion of the radius directly opposite the created lesions and the distomedial portion of the radius distant from the lesion. The repair tissue filling the full-thickness defect and the cartilage at the periphery of the partial-thickness lesion also were analyzed. There was a marked increase in synthetic activity (35S sulfate incorporation) opposite the full-thickness defect, compared with the cartilage opposite the partial-thickness defect. A marked decrease in glycosaminoglycan content in the cartilage opposite the full-thickness defect was found as compared with that opposite the partial-thickness defect. The repair tissue filling the full-thickness defect was highly cellular, high in synthetic activity, but low in glycosaminoglycan content. Insignificant changes occurred in the cartilage adjacent to the partial-thickness defect. On the basis of these results, we suggest that full-thickness defects at 6 weeks result in more detrimental change to the cartilage opposite it than do partial-thickness lesions of the same diameter.     

透明质酸钠与软骨下钻孔对兔软骨损伤修复的对比试验

试验通过建立兔部分软骨损伤模型,采用外源性注射透明质酸钠和软骨下钻孔两种治疗方法,比较两种方法的修复效果及早期修复机制,为临床应用提供试验依据。试验选用36只哈白兔建立膝关节软骨损伤模型后随机均分为3组：自愈组（阴性对照）、用药组（透明质酸钠注射）、钻孔组（软骨下钻孔）。术后1、4、6、8周,采用RT-PCR方法检测修复物中Ⅱ型胶原（Col Ⅱ）、蛋白聚糖（Agg）、Ⅹ型胶原（Col Ⅹ）、Ⅰ型胶原（Col Ⅰ）及Runx2的mRNA表达量;术后8周,制作软骨切片进行HE染色、番红-固绿染色和甲苯胺蓝染色,分析3组的修复效果及修复机制。结果显示,两试验组软骨损伤都被明显修复,染色结果显示修复组织中软骨细胞增多,具有软骨典型的陷窝样结构,用药组阳性着色优于钻孔组。用药组软骨的特异性基因Agg和Col Ⅱ的mRNA表达量显著高于钻孔组（P < 0.05）,软骨细胞肥大相关基因Col Ⅹ和Runx2的表达量显著低于钻孔组（P < 0.05）。自愈组Col Ⅰ的mRNA表达量最高,钻孔组次之,用药组最低。试验结果表明,用药及钻孔对关节软骨损伤都有不同程度的治疗修复作用,自愈组修复物成分主要为纤维组织,透明质酸钠治疗后产生了较多的透明软骨成分,而钻孔修复后的表层覆盖薄层纤维软骨成分,在骨缺损短期修复中,透明质酸钠的修复效果优于钻孔疗法。     

THREE-DIMENSIONAL ULTRASONOGRAPHIC IN VITRO IMAGING OF LESIONS OF THE MENISCUS AND FEMORAL TROCHLEA IN THE EQUINE STIFLE

The purpose of this in vitro study was to evaluate the value of three-dimensional (3D) ultrasonography for the diagnosis of equine meniscal and trochlear ridge lesions under in vitro conditions. Lesions were created in the isolated meniscus and femoral trochlea of 25 cadaver stifle joints. Cylindric, conic, and cuboid lesions were created on the trochlear ridge. Five different meniscal tear configurations were created. A total of 107 lesions of the trochlear ridge and 103 lesions of the meniscus were created. 3D ultrasonography was performed in a waterbath, using a 7.5 MHz 3D scanner. Trochlear ridge lesions were seen as either hypoechoic or anechoic breaks in continuity or as irregular notches. One-hundred and one out of the 107 trochlear lesions were visible using 2D ultrasonography whereas 104 out of the 107 lesions could be seen using the 3D Cine mode. Three lesions could not be detected by either technique. Eighty-five out of the 103 meniscal lesions were seen with 2D ultrasonography and 90 with 3D Cine mode. Radial tears and horizontal tears were the least commonly visualized 3D. The 3D Cine mode led to a small improvement in lesion detection. 3D ultrasound could be considered as an extension and refinement of the ultrasound techniques already in use and can increase the diagnostic capabilities. However, technical improvements have to be achieved before 3D ultrasound can be used in the daily practice for diagnosis of equine stifle joint disorders.     

Effects of intramuscular polysulfated glycosaminoglycan on chemical and physical defects in equine articular cartilage.

The effect of intramuscular polysulfated glycosaminoglycan (PSG) on repair of cartilage injury was evaluated in eight horses. In each horse, one middle carpal joint had both a partial-thickness and a full-thickness articular cartilage defect created. In the contralateral middle carpal joint, chemical articular cartilage injury was created by intra-articular injection of 50 mg sodium monoiodoacetate (MIA). Horses were divided into two groups for treatment. Group 1 horses (control) received an intramuscular injection of normal saline every four days for a total of seven injections starting seven days after cartilage injury. Group 2 horses received 500 mg of PSG intramuscularly every four days for seven treatments starting seven days after cartilage injury. Horses were maintained for 12 weeks. Horses were evaluated clinically, and their middle carpal joints were evaluated radiographically and arthroscopically at the end of the study. Joint tissues were also collected and examined microscopically. The only significant difference between groups was slightly greater matrix staining intensity for glycosaminoglycans in the radiate articular cartilage layer in MIA injected and PSG treated joints. Partial-thickness defects had not healed and the predominant repair tissue in full-thickness defects was fibrous tissue. It was concluded that using this joint injury model, 500 mg PSG administered intramuscularly had no effect on the healing of articular cartilage lesions, and minimal chondroprotective effect from chemically induced articular cartilage degeneration.     

In vivo kinetic study on uptake and distribution of intramuscular tritium-labeled polysulfated glycosaminoglycan in equine body fluid compartments and articular cartilage in an osteochondrial defect model

The uptake and distribution of intramuscularly (IM) administered tritium-labeled polysulfated glycosaminoglycan (³H-PSGAG) in serum, synovial fluid, and articular cartilage of eight horses was quantitated, and hyaluronic acid (HA) concentration of the middle carpal joint was evaluated in a pharmacokinetic study. A full-thickness articular cartilage defect, created on the distal articular surface of the left radial carpal bone of each horse served as an osteochondral defect model. ³H-PSGAG (500 mg) was injected IM, between 14 and 35 days after creation of the defects. Scintillation analysis of serum and synovial fluid, collected from both middle carpal joints at specific predetermined times up to 96 hours post-injection, revealed mean ³H-PSGAG concentrations peaked at 2 hours post-injection. ³H-PSGAG was detected in cartilage and subchondral bone 96 hours post-injection in samples from all eight horses. There were no statistically significant differences in ³H-PSGAG concentration of synovial fluid or cartilage between cartilage defect and control (right middle carpal) joints.

HA assay of synovial fluid revealed concentrations significantly increased at 24, 48, and 96 hours post-injection in both joints. The concentration nearly doubled 48 hours post-injection. However, no statistically significant differences were found between synovial concentrations of HA in cartilage defect and control joints.

³H-PSGAG administered IM to horses, was distributed in the blood, synovial fluid, and articular cartilage. HA concentrations in synovial fluid increased after IM administration of polysulfated glycosaminoglycan.     

LOW-FIELD MRI AND ARTHROSCOPY OF MENISCAL LESIONS IN TEN DOGS WITH EXPERIMENTALLY INDUCED CRANIAL CRUCIATE LIGAMENT INSUFFICIENCY

Little is known about the magnetic resonance imaging (MRI) appearance of canine meniscal lesions. The aim of this study is to describe the MR appearance of meniscal lesions in dogs with experimentally induced cranial cruciate ligament (CCL) deficiency. The pilot study revealed dogs weighing approximately 10 kg to be too small for meniscal evaluation on low-field MRI. In the main study, dogs weighing approximately 35 kg were used. The left CCL was transected and low-field MRI was performed regularly until 13 months post-surgery. Normal menisci were defined as grade 0. Intrameniscal lesions not reaching any surface corresponded to grade 1 if focal and to grade 2 if linear or diffuse. Grade 3 lesions consisted in linear tears penetrating a meniscal surface. Grade 4 lesions included complex signal changes or meniscal distortion. Between 2 and 13 months post-surgery, all dogs developed grade 4 lesions in the medial meniscus. Most of them corresponded to longitudinal or bucket handle tears on arthroscopy and necropsy. Two dogs showed grade 3 lesions reaching the tibial surface of the lateral meniscus on MRI but not in arthroscopy. Such tears are difficult to evaluate arthroscopically; MRI provides more accurate information about the tibial meniscal surface. Grades 1 and 2 lesions could not be differentiated from presumably normal menisci with our imaging technique. An MRI grading system better adapted to canine lesions has yet to be developed. MRI is a helpful tool for the diagnosis of complete tears in the canine meniscus, especially in larger dogs.     

Effect of meniscal release on rate of subsequent meniscal tears and owner-assessed outcome in dogs with cruciate disease treated with tibial plateau leveling osteotomy

OBJECTIVE: To determine and compare rates of meniscal tears after tibial plateau leveling osteotomy (TPLO) among 3 groups of dogs based on treatment method: arthrotomy with meniscal release (openR), arthrotomy without meniscal release (openNR), arthroscopy without meniscal release (scopeNR), and compare long term owner-assessed outcomes for the same groups. STUDY DESIGN: Retrospective cohort study. SAMPLE POPULATION: Stifles (n=254) of dogs that had TPLO. METHODS: The three groups were compared for significant (P<.05) differences in rate of subsequent tears using a chi(2) test. Odds ratios for likelihood of subsequent meniscal tears were determined. Data for signalment, outcome, time to peak function, and time to subsequent tear were compared for significant differences using ANOVA, t-test, or rank sum test. RESULTS: Subsequent meniscal tears were diagnosed in 16 cases (6.3%). Of dogs with subsequent meniscal tears, 9 had openNR, 4 had openR, and 3 had scopeNR; the proportion of subsequent meniscal tears was significantly different (P=.035) among groups. Odds ratio indicated that subsequent meniscal tear was 3.8 times more likely to occur for openNR than openR or scopeNR. No significant differences among groups were noted for measures of outcome. CONCLUSIONS: Meniscal release did not reduce the rate of subsequent meniscal tears when compared with cases treated arthroscopically or when compared with all cases combined, but may be advantageous when meniscal pathology cannot be comprehensively assessed in the cranial cruciate deficient stifle. Meniscal release had no effects on owner-assessed outcome as determined in this study. CLINICAL RELEVANCE: The low rates of subsequent meniscal tears in conjunction with the relatively high and equivocal levels of owner-assessed outcome and time to peak function for all 3 treatment groups suggest that any of these surgical management strategies can be considered acceptable. We suggest that a meniscal release be performed when complete and thorough exploration of the joint and meniscus cannot be, or are not, performed.     

Induction of a barrier membrane to facilitate reconstruction of massive segmental diaphyseal bone defects: an ovine model

OBJECTIVES: To report an ovine model that can be used to evaluate the efficacy of bone substitutes for repair of segmental diaphyseal bone defects. STUDY DESIGN: Experimental study. ANIMALS: Eleven 2-year-old Pré-Alpes Sheep. METHODS: Mid-diaphyseal metatarsal bone defects (25 mm long) were stabilized by a dynamic compression plate over a polymethylmethacrylate (PMMA) cement spacer, and by external coaptation. The PMMA spacer was removed at 6 weeks by incising the encapsulating membrane. The defect remained unfilled (Group 1; n=5) or was filled with morselized autologous corticocancellous graft (Group 2; n=6), the membrane sutured closed, and external coaptation applied for 6 months, when healing was evaluated. RESULTS: Radiographic, computed tomographic, and histologic examinations at 6 months after the 2nd surgery revealed non-union in ungrafted defects whereas grafted defects showed bone healing. The induced membrane had blood vessels, CBFA1+ cells, and very few macrophages entrapped in a collagenous tissue positive for type I collagen. CONCLUSION: This ovine metatarsal defect model resulted in a critical-size defect (non-union) that healed when grafted. The PMMA-induced membrane constrained the graft, was well vascularized, and may have osteogenic properties. CLINICAL RELEVANCE: This model may be useful to evaluate new strategies in bone tissue engineering because the PMMA-induced membrane may help confine bone morphogenetic proteins, skeletal stem cells, or other agents to the defect cavity where they could be useful to enhance bone formation.     

Evaluation of the repair process of cartilage defects of the equine third carpal bone with and without subchondral bone perforation

To determine the effect of subchondral bone drilling (forage) on the cartilage repair process after injury has occurred, a cartilage defect (1 cm in diameter) was created on the radial facet of the proximal surface of each third carpal bone in 6 adult horses. In one of the third carpal bones (right or left thoracic limb) of each horse, a 1-cm cartilage defect was created, and 5 holes (1 mm in diameter and 10 mm deep) were drilled through the subchondral bone into the cancellous bone. In the other thoracic limb, an identical defect was created, but not drilled. Analyses of cell numbers and types in the synovia and the mucin precipitate quality were done before, at 1 week after, and 3 weeks after surgical manipulation was done and showed no significant difference between the joint environment of drilled carpi and those of nondrilled carpi. At 21 weeks after surgical manipulation was done, each joint was examined radiographically, macroscopically, and microscopically to compare the condition of the joints and the state of repair of the cartilage in each defect. The amount of surface of the defect covered by the dense fibrous and fibrocartilagenous repair tissue and the thickness of the repair tissue were significantly greater (P less than 0.05 and P less than 0.01, respectively) in the drilled carpal bones. In addition, the attachment of the repair tissue to underlying chondro-osseous tissue was better in the drilled carpal bones. Fibrocartilage was resurfacing the drilled defects, whereas only fibrous tissue was present in the nondrilled defects.(ABSTRACT TRUNCATED AT 250 WORDS)     

A study of the anatomy and injection techniques of the ovine stifle by positive contrast arthrography, computed tomography arthrography and gross anatomical dissection

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.     

Repair of oronasal fistulae using auricular cartilage grafts in five cats

OBJECTIVE: To describe repair of chronic palatine defects in cats, with free cartilage graft harvested from either the pinna (scapha) or vertical ear canal (annular cartilage). STUDY DESIGN: Retrospective study. ANIMALS: Cats (n=5) with chronic oronasal fistula. METHODS: Cartilage was harvested from either the scapha or annular cartilage and epithelium removed. After preparation of the edges of the palatal defect by separation of the oral and palatal mucosa circumferentially, the graft was inserted between the epithelial layers and secured without tension. The graft acted as a scaffold for migration of granulation tissue and epithelialization. RESULTS: Oronasal fistulae were successfully repaired in 5 cats (3 pinna grafts; 2 annular cartilage grafts); 1 cat required a second graft after the first graft was dislodged. CONCLUSIONS: Auricular cartilage provides a reliable framework for repair of oronasal fistulae in cats. CLINICAL RELEVANCE: Chronic oronasal fistulae refractory to conventional repair can be treated by use of auricular free graft (pinna or annular cartilage) without disfigurement. Use of annular cartilage to support palatal repairs offers surgeons an additional option when other methods have failed. We recommend using conchal cartilage as the initial treatment approach for repair of small oronasal fistulae in cats.     

Risk factors for medial meniscal injury in association with cranial cruciate ligament rupture

Objectives : To determine the significant risk factors for medial meniscal injury in naturally occurring cranial cruciate ligament rupture and to quantify the risk using multivariate analysis. Methods : A retrospective case control study was performed of dogs that had undergone surgery for cranial cruciate ligament rupture. Data recorded included patient signalment (age, breed and sex), the duration of the lameness, the extent of the cranial cruciate ligament rupture (complete or partial) and the condition of the medial meniscus. Logistic regression was used to analyse the relationship between these variables and tears in the medial meniscus. Results : One hundred and sixty-one of 443 stifles (36·3%) in 366 dogs had a medial meniscal tear. The risk of a medial meniscal tear was increased by 12·9 times in association with complete cranial cruciate ligament rupture (OR 12·9; 95% CI 6·8 to 24·2), by approximately 2·6% for each additional week of lameness (OR 1·026; 95% CI 1·009 to 1·043) and by approximately 1·4% for each additional kilogram of bodyweight (OR 1·014; 95% CI 1·000 to 1·028). Golden retrievers and Rottweilers were at increased risk and West Highland white terriers were at reduced risk of medial meniscal tears compared with Labrador retrievers. Clinical Significance : To minimise the risk of medial meniscal tears, surgical stabilisation should not be unnecessarily delayed.