Cranial cruciate ligament rupturunda erken dönem ekstra ve intraartiküler tedavi sonuçlarının magnetik rezonans görüntüleme ve histopatolojik bulgularla karşılaştırılması
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Tarih
2022-03-01
Kurum Yazarları
Sarıl, Canan Altıncı
Süreli Yayın başlığı
Süreli Yayın ISSN
Cilt Başlığı
Yayınevi
Bursa Uludağ Üniversitesi
Özet
Bu çalışmada, cranial cruciate ligament (CrCL) rupturunun erken dönem ekstra ve intraartiküler tedavi sonuçlarının magnetik rezonans görüntüleme (MRI) ve histopatolojik bulgularla karşılaştırılması amaçlandı. Çalışmada 21 adet Yeni Zelanda ırkı tavşan kullanıldı. Tavşanlara grup 1’de (GRI) (n=7) sağ CrCL’nin eksizyonu, grup 2’de (GRII) (n=7), sağ CrCL eksizyonu ve ekstrakapsüler TightRope tekniği ve grup 3’te (GRIII) (n=7), sağ CrCL eksizyonu ve Anchor dikiş ile prostetik CrCL yapıldı. Postoperatif 0, 7, 15 ve 30. günlerde klinik, ortopedik, hematolojik ve radyolojik muayeneler, sinoviyal sıvıda total protein, dansite, MMP-3 ve MMP-13 analizleri yapıldı. Tavşanlar 30. günde dekapite edildi ve MRI incelemeleri yapıldı. Genu eklemleri histopatolojik olarak incelendi ve tüm bulgular gruplararası anlamlılık yönünden “One Way Anova” testi ile analiz edildi. Klinik ve hematolojik bulgularda gruplararası fark yoktu. Topallık derecesi GRI’de şiddetli, GRII ve GRIII’te hafif; çekmece gözü hareketi GRI’de pozitif, GRII ve GRIII’te negatif; meniscal click sesi 30. günde GRI’de 3 ve GRIII’te 1 olguda pozitifti. Eklem efüzyonu 7, 15 ve 30. günlerde tüm gruplarda benzerdi. Total protein ve dansite değerleri 7. günde tüm gruplarda artarken 15 ve 30. günlerde azaldı. Bu durum gruplararası anlamlı değildi. MMP-3 değerleri: 7. günde tüm gruplarda yüksek, 15. günde GRI ve GRIII’te düşükken GRII’de yüksek ve 30. günde GRI ve GRIII’te yüksekken ve GRII’de sabitti. MMP-13 değerleri: tüm gruplarda 7. günde yüksek, 15. günde düşme eğiliminde ve 30. günde de 0. gün değerlerine yaklaşıktı. MMP-3 ve MMP-13 değerleri açısından gruplararası anlamlılık yoktu. Radyolojik, MRI ve histopatolojik bulgular GRI’de daha şiddetliydi. Sonuç olarak, CrCL rupturu tedavisinde ekstra ve intraartiküler yöntemler stabilizasyon sağlar ancak eklem sağlığı düşünüldüğünde ekstraartiküler stabilizasyon yöntemleri tercih edilmelidir.
In this study, it was aimed to compare the early stage results of extra- and intraarticular treatment of cranial cruciate ligament (CrCL) rupture with magnetic resonance imaging (MRI) and histopathological findings. In the study, 21 New Zealand rabbits were used. In rabbits, right CrCL excision in group 1 (GRI) (n=7), right CrCL excision and extracapsular TightRope technique in group 2 (GRII) (n=7), and right CrCL excision and prosthetic CrCL with Anchor suture in group 3 (GRIII) (n=7) were performed. On postoperative 0, 7, 15 and 30 days, clinical, orthopedic, hematological and radiological examinations, and total protein, density, MMP-3 and MMP-13 analyzes in synovial fluid were performed. Rabbits were decapitated on day 30 and MRI examinations was performed. Genu joints were examined histopathologically and all findings were analyzed with “One Way Anova” test between the groups. There was no difference between groups in clinical and hematological findings. The degree of lameness was severe in GRI, mild in GRII and GRIII; cranial drawer motion was positive in GRI, negative in GRII and GRIII; meniscal click sound was positive in 3 cases in GRI and in 1 case in GRIII on the 30th day. Joint effusion was similar in all groups on days 7, 15 and 30. While total protein and density values increased in all groups on the 7th day, they decreased on the 15th and 30th days. This situation was not significant between groups. MMP-3 values were high in all groups on day 7, low in GRI and GRIII on day 15, high in GRII, and high in GRI and GRIII at day 30 and stable in GRII. In all groups, MMP-13 values were high on day 7, tended to decrease on day 15, and were approximate to day 0 values on day 30. There was no significance between groups in terms of MMP-3 and MMP-13 values. Radiological, MRI and histopathological findings were more severe in GRI. In conclusion, extra- and intra-articular methods provide stabilization in the treatment of CrCL rupture, but extra-articular stabilization methods should be preferred when joint health is considered.
In this study, it was aimed to compare the early stage results of extra- and intraarticular treatment of cranial cruciate ligament (CrCL) rupture with magnetic resonance imaging (MRI) and histopathological findings. In the study, 21 New Zealand rabbits were used. In rabbits, right CrCL excision in group 1 (GRI) (n=7), right CrCL excision and extracapsular TightRope technique in group 2 (GRII) (n=7), and right CrCL excision and prosthetic CrCL with Anchor suture in group 3 (GRIII) (n=7) were performed. On postoperative 0, 7, 15 and 30 days, clinical, orthopedic, hematological and radiological examinations, and total protein, density, MMP-3 and MMP-13 analyzes in synovial fluid were performed. Rabbits were decapitated on day 30 and MRI examinations was performed. Genu joints were examined histopathologically and all findings were analyzed with “One Way Anova” test between the groups. There was no difference between groups in clinical and hematological findings. The degree of lameness was severe in GRI, mild in GRII and GRIII; cranial drawer motion was positive in GRI, negative in GRII and GRIII; meniscal click sound was positive in 3 cases in GRI and in 1 case in GRIII on the 30th day. Joint effusion was similar in all groups on days 7, 15 and 30. While total protein and density values increased in all groups on the 7th day, they decreased on the 15th and 30th days. This situation was not significant between groups. MMP-3 values were high in all groups on day 7, low in GRI and GRIII on day 15, high in GRII, and high in GRI and GRIII at day 30 and stable in GRII. In all groups, MMP-13 values were high on day 7, tended to decrease on day 15, and were approximate to day 0 values on day 30. There was no significance between groups in terms of MMP-3 and MMP-13 values. Radiological, MRI and histopathological findings were more severe in GRI. In conclusion, extra- and intra-articular methods provide stabilization in the treatment of CrCL rupture, but extra-articular stabilization methods should be preferred when joint health is considered.
Açıklama
Anahtar kelimeler
Cranial cruciate ligament, Histopatoloji, Biyobelirteç, Magnetik rezonans görüntüleme, Yeni Zelanda tavşanı, Cranial cruciate ligament, Histopathology, Biomarker, Magnetic resonance imaging, New Zealand rabbit
Alıntı
Sarıl, C. A. (2022). Cranial cruciate ligament rupturunda erken dönem ekstra ve intraartiküler tedavi sonuçlarının magnetik rezonans görüntüleme ve histopatolojik bulgularla karşılaştırılması. Yayınlanmamış doktora tezi. Bursa Uludağ Üniversitesi Sağlık Bilimleri Enstitüsü.