RESUMEN
The purpose of the study was to determine the histo-morphological effects on villous synovium after synovectomy using two different motorized synovial resectors and two different intensities ex-vivo. Thirty-three (n = 33) equine metacarpophalangeal/metatarsophalangeal joints were used. Synovectomy was performed along the dorsomedial/dorsolateral synovium (n = 66) using two motorized synovial resectors (aggressive full radius resector, AFRR, used at two intensities: single treatment, n = 24 vs. triple treatment, n = 21 vs. aggressive meniscus side cutter, AMSC, n = 21). Arthroscopic images were evaluated blindly for resector type and intensity. Histological images were evaluated descriptive for synovial morphology and the extent of tissue loss using a microscopic scale. Scanning electron microscopy described the synovial morphology. The synovectomized areas were specific for each resector used and distinguishable from arthroscopic images. The AFRR demonstrated a clear demarcation between treated and non-treated areas and removed the stratum synoviale completely including parts of the underlying stratum fibrosum. In contrast, the AMSC showed less clear demarcation, villous scaffolds and no involvement of the stratum fibrosum. Triple intense treated AFFR samples resulted in significantly deeper lesions compared to single treatments (p = 0.037) but could not be distinguished on arthroscopic images. The morphological effects on villous synovium differ according to the resector type used. The extent of synovial tissue loss cannot be estimated from arthroscopic images but histologically. The type and use of motorized synovial resector determines the morphological alterations of the treated synovium. Arthroscopic control is considered unsuitable to control synovectomy depth.
Asunto(s)
Artroscopía , Sinovectomía , Caballos , Animales , Sinovectomía/veterinaria , Artroscopía/métodos , Artroscopía/veterinaria , Membrana Sinovial/patología , Membrana Sinovial/ultraestructuraRESUMEN
OBJECTIVES: The object of this study was to describe previously defined soft tissue structures by using spin and gradient sequences in a 0.5 Tesla magnetic resonance system in order to improve the characterisation of tendon and ligaments at the plantar region of the equine tarsus and metatarsus while considering possible age-related variations. METHODS: Cadaveric hindlimbs from twenty-two Warmblood horses with an age range from one month to twenty-five years were examined in spin and gradient echoes. The proximal suspensory ligament from six limbs was dissected to assign the signal intensities histologically. For statistical analysis, horses were divided into two groups (≤3 years and >3 years) for evaluating signal intensity and homogeneity of the plantar tendons and ligaments. RESULTS: Focal increase of the signal intensity within the deep digital flexor tendon was significantly more present in horses older than three years. Signal alterations of the long plantar ligament were seen without a significant dependency to age. The accessory ligament of the deep digital flexor tendon could not be visualized on all images within the region of interest. The morphology of the proximal suspensory ligament was not affected by age-related changes. CLINICAL RELEVANCE: Spin and gradient echoes in MRI were suitable to identify and assess soft tissue structures at the plantar aspect of the equine tarsus and proximal metatarsus. Age-related appearance must be considered when interpreting magnetic resonance images.