Emalee M Blumhagen, Daniel I Spector, Anthony J Fischetti
{"title":"Impact of arthroscopy on post-procedure intra-articular elbow injections: A cadaveric study.","authors":"Emalee M Blumhagen, Daniel I Spector, Anthony J Fischetti","doi":"10.1111/vsu.14122","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To determine the influence of arthroscopy and injection volume on post-procedure intra-articular (IA) injection extravasation.</p><p><strong>Study design: </strong>Ex vivo prospective study.</p><p><strong>Sample population: </strong>A total of 40 paired canine cadaver forelimbs.</p><p><strong>Methods: </strong>After radiographs and computed tomography (CT) scans with three-dimensional (3D) digital bone model reconstructions, elbows were randomly assigned to the arthroscopy or control group and randomly assigned to receive an IA injection of 2 or 4 mL of contrast. Elbow arthroscopy was performed on assigned specimens, followed by IA injections of contrast in all elbows, and imaging was repeated. 3D digital model volumes were compared. Images were interpreted and scored for extravasation by a radiologist unaware of treatment and volume assignments.</p><p><strong>Results: </strong>Based on CT images and regardless of treatment group, IA injections of 4 mL resulted in a mean extravasation score of 2.25 (SD 0.97) versus 1.55 (SD 1.05) (p = .02) for 2 mL IA injections. The change in 3D model volumes after IA injections was a mean of 13.2 cm<sup>3</sup> (SD 5.85) after 4 mL injections, compared to 6.97 cm<sup>3</sup> (SD 6.28) (p = .003) after 2 mL injections. On radiographic evaluation, but not CT, the mean extravasation scores were 2.45 (SD 1.15) for the arthroscopy group and 1.25 (SD 0.79) for the control group (p < .001).</p><p><strong>Conclusion: </strong>A larger volume of IA injection resulted in higher CT extravasation scores and larger 3D volumes regardless of arthroscopic treatment.</p><p><strong>Clinical significance: </strong>IA injections performed immediately after arthroscopy resulted in 50% or less extravasation, especially with a smaller IA injection volume.</p>","PeriodicalId":23667,"journal":{"name":"Veterinary Surgery","volume":null,"pages":null},"PeriodicalIF":1.3000,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Veterinary Surgery","FirstCategoryId":"97","ListUrlMain":"https://doi.org/10.1111/vsu.14122","RegionNum":2,"RegionCategory":"农林科学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/6/6 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"VETERINARY SCIENCES","Score":null,"Total":0}
引用次数: 0
Abstract
Objective: To determine the influence of arthroscopy and injection volume on post-procedure intra-articular (IA) injection extravasation.
Study design: Ex vivo prospective study.
Sample population: A total of 40 paired canine cadaver forelimbs.
Methods: After radiographs and computed tomography (CT) scans with three-dimensional (3D) digital bone model reconstructions, elbows were randomly assigned to the arthroscopy or control group and randomly assigned to receive an IA injection of 2 or 4 mL of contrast. Elbow arthroscopy was performed on assigned specimens, followed by IA injections of contrast in all elbows, and imaging was repeated. 3D digital model volumes were compared. Images were interpreted and scored for extravasation by a radiologist unaware of treatment and volume assignments.
Results: Based on CT images and regardless of treatment group, IA injections of 4 mL resulted in a mean extravasation score of 2.25 (SD 0.97) versus 1.55 (SD 1.05) (p = .02) for 2 mL IA injections. The change in 3D model volumes after IA injections was a mean of 13.2 cm3 (SD 5.85) after 4 mL injections, compared to 6.97 cm3 (SD 6.28) (p = .003) after 2 mL injections. On radiographic evaluation, but not CT, the mean extravasation scores were 2.45 (SD 1.15) for the arthroscopy group and 1.25 (SD 0.79) for the control group (p < .001).
Conclusion: A larger volume of IA injection resulted in higher CT extravasation scores and larger 3D volumes regardless of arthroscopic treatment.
Clinical significance: IA injections performed immediately after arthroscopy resulted in 50% or less extravasation, especially with a smaller IA injection volume.
研究目的确定关节镜和注射量对术后关节内注射外渗的影响：研究设计：体外前瞻性研究：研究设计：体外前瞻性研究：方法：在对犬肘部进行射线照相、计算机断层扫描（CT）和三维（3D）数字骨模型重建后，将犬肘部随机分配到关节镜组或对照组，并随机分配接受 2 mL 或 4 mL 造影剂的 IA 注射。对指定标本进行肘关节镜检查，然后在所有肘部进行造影剂IA注射，并重复成像。比较三维数字模型体积。由一名不了解治疗和体积分配的放射科医生对图像进行解读，并对外渗情况进行评分：结果：根据 CT 图像和治疗组别，4 mL IA 注射的平均外渗评分为 2.25（SD 0.97），而 2 mL IA 注射的平均外渗评分为 1.55（SD 1.05）（P = 0.02）。IA 注射后 3D 模型体积的变化为：4 mL 注射后平均为 13.2 cm3（SD 5.85），而 2 mL 注射后平均为 6.97 cm3（SD 6.28）（p = .003）。关节镜组的平均外渗评分为 2.45（标清 1.15），对照组为 1.25（标清 0.79）（P = 0.003）：无论采用何种关节镜治疗，IA注射量越大，CT外渗评分越高，三维体积越大：临床意义：关节镜手术后立即进行 IA 注射可减少 50% 的外渗，尤其是 IA 注射量较少时。
期刊介绍：
Veterinary Surgery, the official publication of the American College of Veterinary Surgeons and European College of Veterinary Surgeons, is a source of up-to-date coverage of surgical and anesthetic management of animals, addressing significant problems in veterinary surgery with relevant case histories and observations.
It contains original, peer-reviewed articles that cover developments in veterinary surgery, and presents the most current review of the field, with timely articles on surgical techniques, diagnostic aims, care of infections, and advances in knowledge of metabolism as it affects the surgical patient. The journal places new developments in perspective, encompassing new concepts and peer commentary to help better understand and evaluate the surgical patient.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
