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Open Access Technical advance

A low morbidity surgical approach to the sheep femoral trochlea

Patrick Orth12 and Henning Madry12*

Author Affiliations

1 Center of Experimental Orthopaedics and Osteoarthritis Research, Saarland University, Homburg/Saar, Germany

2 Department of Orthopaedic Surgery, Saarland University Medical Center, Homburg/Saar, Germany

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BMC Musculoskeletal Disorders 2013, 14:5  doi:10.1186/1471-2474-14-5

Published: 3 January 2013

Abstract

Background

The 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.

Methods

Bilateral 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.

Results

The 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.

Conclusions

The 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.

Keywords:
Cartilage; Sheep; Trochlea; Patella; Luxation; In vivo