Abstract

BackgroundThe ovine stifle joint is an important location for investigations on the repair of articular cartilage defects in preclinical large animals. The classical medial parapatellar approach to the femoral trochlea is hazardous because of the high risk of postoperative patellar luxation. Here, we describe a low morbidity surgical exposure of the ovine trochlea without the necessity for intraoperative patellar luxation.MethodsBilateral surgical exposure of the femoral trochlea of the sheep stifle joint was performed using the classical medial parapatellar approach with intraoperative lateral patellar luxation and transection of the medial patellar retinaculum in 28 ovine stifle joints. A low morbidity approach was performed bilaterally in 116 joints through a mini-arthrotomy without the need to transect the medial patellar retinaculum or the oblique medial vastus muscle nor surgical patellar luxation. Postoperatively, all 72 animals were monitored to exclude patellar luxations and deep wound infections.ResultsThe novel approach could be performed easily in all joints and safely exposed the distal two-thirds of the medial and lateral trochlear facet. No postoperative patellar luxations were observed compared to a postoperative patellar luxation rate of 25% experienced with the classical medial parapatellar approach and a re-luxation rate of 80% following revision surgery. No signs of lameness, wound infections, or empyema were observed for both approaches.ConclusionsThe mini-arthrotomy presented here yields good exposure of the distal ovine femoral trochlea with a lower postoperative morbidity than the classical medial parapatellar approach. It is therefore suitable to create articular cartilage defects on the femoral trochlea without the risk of postoperative patellar luxation.

Highlights

  • The ovine stifle joint is an important location for investigations on the repair of articular cartilage defects in preclinical large animals

  • While easy to perform in patients [13], a significant rate of postoperative patellar luxations may occur in sheep or goats when applying the classical approach

  • Such patellar luxations are based on the different anatomy of the ovine and caprine stifle joint when compared to the human knee: in extension, the patella is located proximal to the trochlea and glides within the trochlear groove only in flexion of the stifle joint

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Summary

Introduction

The ovine stifle joint is an important location for investigations on the repair of articular cartilage defects in preclinical large animals. While easy to perform in patients [13], a significant rate of postoperative patellar luxations may occur in sheep or goats when applying the classical approach Such patellar luxations are based on the different anatomy of the ovine and caprine stifle joint when compared to the human knee: in extension, the patella is located proximal to the trochlea and glides within the trochlear groove only in flexion of the stifle joint. This special feature of the more posteriorly angled trochlea, in combination with a relatively small lateral femoral condyle, makes complications very likely if a medial parapatellar incision and lateral patellar luxation is chosen. Even if no patellar luxation occurs, osteoarthritis may frequently result from using the classical approach, possibly jeopardizing surgical results considerably [14]

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