Fatma SATILMIŞ, Kurtuluş PARLAK, Mustafa ARICAN

Köpeklerde articulatio genu lezyonlarının tanısında artroskopi uygulamaları

Amaç: Bu çalışma ile köpeklerde sık rastlanan Articulatio genu (art. genu) lezyonlarının tanımlanması için artroskopi yönteminin kullanılması ve sonuçlarının tartışılması amaçlanmıştır.Gereç ve Yöntem: Yirmisekiz adet değişik ırk, cins, yaş ve ağırlıkta topallık şikayetleri ile getirilen köpeğin sağ, sol veya her iki art. genu eklemi değerlendirildi. Operasyonda 2.7 mm çapında 0. ve 30 derecelik artroskopik teleskop ve Storz marka kamera sistemi kullanıldı. Ligamentum patellare'nin sağ veya solundaki bölgeden, 19 numara iğne ile eklem içine girildi. Sodyum izotonik veya laktat ringer solusyonundan 10-20 mL eklem içine verilerek eklem kapsulası gergin hale getirildi. Lig. patellare'nin lateralinden 0.5 cm boyunda deri ensizyonu yapıldı. Keskin uçlu obturator, eklem içine yönlendirilerek femur ile patella arasından mediale ilerletildi. Art. genu'nun muayenesine art. femorotibialis'in medial kompartmanından başlandı. Condylus femoralis medialis, medial meniscus, medial tibial plato, meniscal ligament ve sinovyal zar muayene edildi. Daha sonra intercondyler boşluk ve lig. cruciata'lar değerlendirildi.Bulgular: Yirmisekiz eklemde (%100) synovial hiperplazinin değişik dereceleri ile karşılaşıldı. 8 eklemde (%28.5) periartiküler osteofit, 3 eklemde (%10.7) menisküslerde horizontal yırtıklar, 17 eklemde (%60.7) anterior cruciate ligamentin parsiyel yırtıkları, 3 eklemde (%10.7) kıkırdak dejenerasyonu (eburnasyon, erozyon), 4 olguda osteofit üreme ve 2 eklemde (%7.1) eklem faresi gözlendi.Öneri: Artroskopi, art. genu hastalıklarının tanı ve sağaltımında gelişmiş görsellik sağlayan bir yöntemdir. Eklem içi yapılarını büyüterek anatomik detaylar ve patolojik değişiklikler hakkında bilgi almamızı sağlayan minimal invaziv bir uygulamadır.

Arthroscopy applications for diagnosis of stifle joint lesions of dogs

Aim: In this study, the use and evalutation of arthroscopy for diagnosis of stifle joint on common lesions in dogs were aimed .Material and Methods: Twenty eight of different breed, sex, age and weight of the dogs with lameness of right, left or both stifle were evaluated. In the operation, 2.7 mm in 00 and 300 arthroscopic telescopes, Storz cold light source, was used. 19-gauge needle was inserted into the joint from left or right sides of patellare ligament. 10-20 mL of isotonic saline or sodium lactate ringer's solution was given into the joint capsule. 0.5 cm of skin incision was made of patellar lig. laterally. Sharp-tipped obturator directed into the joint was passed medially between the patella and femoral condyle. Stifle joint examination was started femorotibialis launch of the medial compartment. The medial femoral condyle, medial meniscus, medial tibial plateau, meniscal ligament and synovial membrane were examined. Intercondylar space, and then cranial cruciata lig. were evaluated.Results: Twenty eight joints (100%) was encountered with varying degrees of synovial hyperplasia. Eight joints (28.5%) of periarticular osteophytes, three joints (10.7%) meniscus in the horizontal tears, 17 articular (60.7%) of the anterior cruciate ligament partial tears, the third joint (10.7 %) cartilage degeneration, osteophytes were shown in 4 cases. Chip fractures were observed in two joint (7.1 %).Conclusions: Arthroscopic application in the diagnosis and treatment of stifle joint is a method of providing enhanced visuals. Magnifies the anatomy and pathological changes of intra-articular structures that enable us to retrieve information about a minimally invasive application.

PDF

___

Acar SE, Altunatmaz K, Devecioğlu Y, Şadalak DJ, 2004. Kö- peklerde eklem içi hastalıkların tanısında direkt ve indi- rekt radyografiler (artrografi) ile artroskopinin karşılaştı- rılması. İstanbul Üniv Vet Fak Derg, 30, 103-122.
Alkan Z, Bumin A, Temizsoylu D, Sarıerler M, 2001. Köpekler- de diz eklemi lezyonlarının direkt radyografik, artrografik ve artroskopik tanısı üzerine klinik ve deneysel uygulama- ların karşılaştırılması. Turk J Vet Anim Sci, 25, 57-64.
Anderson J. 1994. The stifle, in: Manual of Small Animal Art- hrology, Eds: Houlton JEF, Collinson RW, BSAVA Publicati- ons, Cheltenham, pp. 267-300.
Arıcan M, 2012. Veteriner Genel Radyoloji ve Kedi, Köpek İçin Tanısal Radyografi Atlası, Cilt II, Konya, Turkey, pp: 390- 402.
Beale B, Hulse D, Shulz K, Whitney WO, 2003. Small Animal Arthroscopy, Philadelphia, Saunders, USA, pp: 46-48.
Bright SR, May C, 2011. Arthroscopic partial patellectomy in a dog. J Small Anim Pract, 52, 168-171.
Brinker WO, Piermattei DL, Flo GL, 1990. Handbook of Small Animal Orthopedics and Fracture Treatment. 2nd edition WB Saunders, Philadelphia, USA, pp: 477-481.
Dupuis J, Harari J, 1993. Cruciate ligament and meniscal inju- ries in dogs. Comp Cont Educ, 15, 215-232.
Franklin SP, Gilley RS, Palmer RH, 2010. Meniscal injury in Dogs with cranial cruciate ligament rupture. Compend Contin Educ Vet, 1-10.
Harasen G, 2002. Diagnosing rupture of the cranial cruciate ligament. Can Vet J, 43, 475-476.
Hulse DA, 2000. Equipment and Instrumentation for Endos- copic Assisted joint Surgery in: First Series of UK Rigid En- doscopy Practical Courses for Small Animals. Module 3: Canine Arthroscopy, Bristol, UK, pp: 6-13.
Jackson RW, 2000. The introduction of arthroscopy to North America. Clin Orthop, 374, 183-186.
Lewis DD, Goring RL, Parker RB, CurasYPA, 1987. A compa- rison of diagnostic methods used in the evaluation of early dejenerative joint disease in the dog. J Am Anim Hosp A s - soc, 23, 305-315.
Lhermette P, Sobel D. 2008. BSAVA Manual of canine and fe- line endoscopy and endosurgery, BSAVA Stepheus&George Ltd. Merthyr Tydfil, Mid Glamorgan, USA, pp: 188-219.
Lieben NH, 1986. Intra-articulaire kniestabilisatie met synthetisch materiaal. Een praktijkgerichte stabilisatie- techniek. Tijdschr Diergeneesk, 23,1160-1166.
Mc Carthy TC, 2005. Veterinary Endoscopy. Small Animal Practitioner. Elsevier Saunders, USA, pp: 447-556.
Miller ME, 1993. Arthrology, in: Miller's Anatomy of the Dog, Ed: Evans HE, thirth edition, volume 1, WB Saunders, Phi- ladelphia, USA, pp: 219-257.
Miller CW, Presnel KR, 1985. Examination of the canine stifle arthroscopy versus arthrotomy. J Am Anim Hosp Assoc, 21, 623-629.
Muir P, 2010. Advances in the Canine Cranial Cruciate Liga- ment. Edition first published. Wiley-Blackwell, USA, pp: 43-87.
Myers SL, Brandt KD, Ehlich, JW, Braunstein EM, Shelbourne KD, Heck DA, Kalasinski, LA, 1990. Synovial inflammation in patients with early osteoarthritis of the knee. J Rheuma- tol, 17, 1662-1669.
Payne J, 2008. Arthroscopic surgery in the dog, Proceedings of the Western Veterinary Conference, Las Vegas, Nv, USA.
Person MW, 1985. A procedure for arthroscopic examination of the canine stifle joint. J Am Anim Hosp Assoc, 21, 179- 186.
Piermattei DL, Decamp CE, 2006. Handbook of Small Animal Orthopedics and Fracture Repair, WB Saunders, Philadelp- hia, USA, pp: 447-642.
Plesman R, Gilbert P, Campbell J. 2013. Detection of meniscal tears by arthroscopy and arthrotomy in dogs with cranial cruciate ligament rupture. A retrospective, cohort study. Vet Comp Orthop Traumatol, 26, 42-46.
Pond MJ, Campbell JR,1972. The canine stifle joint. I. Rupture of the anterior cruciate ligament. An assessmentof conser- vative and surgical treatment. J Small Anim Pract, 13, 1-10.
Rooster H, 2001. Cranial Cruciate Ligament Disease in the dog: Contributions to etiology, diagnosis and treatment. Doctor in de Diergeneeskundige Wetenschappen aan de Faculteit Diergeneeskunde Universiteit Gent.
Tams TR, Rawlings CA, 2011. Small Animal Endoscopy, third edition, Elsevier Mosby, UK, pp: 635-649.
van Gestel MA, 1987. Diagnostic accuracy of stifle arthros- copy in the dog. J Am Anim Hosp Assoc, 23, 305-315.
Vasseur PB, 2002. Stifle joint, in: Textbook of Small Animal Surgery, Ed: Slatter D, third edition, WB Saunders, Phila- delphia, USA, pp: 2090-2132.
Whitehair JG, Vasseur PB, Willits NH, 1993. Epidemiology of cranial criciate ligament rupture in dog. J Am Vet Med As- soc, 203, 1016-1019.