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[Development, standardisation and evaluation of a model for arthroscopic surgery of the joint. An experimental study
W M H Kaduk1, H-R Metelmann, K K H Gundlach
1Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie/Plastische Operationen, Universität Greifswald. kaduk@uni-greifswald.de
Aim Of The Study:
The aim of this study was to establish a reliable educational model for and a further refinement of arthroscopic surgery in the temporomandibular joint (TMJ).
Material And Methods:
As a first step, the lateral-medial (length) and anterior-posterior distances (width) of the mandibular head of nine pig cadavers (country breed) of about 30 ( n=3), 60 ( n=3) and 90 kg ( n=3) body weight were measured and compared with findings in 12 adult human cadavers. The best points of access for the arthroscopic and lavage channels using the triangulation technique were determined. As determined by these findings, 15 arthroscopies were performed on eight pig TMJs under general anaesthetic. A control arthroscopy was performed after 2 weeks followed by another clinical follow-up at 4 weeks before the pigs were sacrificed.
Results:
The TMJ of the pigs between 30 and 60 kg body weight was found to be highly comparable to the human TMJ. The best locations for puncturing the upper joint compartment of the TMJ in pigs were 5.0 cm and 6.1 cm anterior to the tragus on a line drawn along the lower margin of the zygoma. The only complication encountered was a subcutaneous infection treated successfully by antibiotics and incision.
Conclusions:
In our opinion, a standard and easily reproducible model is necessary for further studies in arthroscopic TMJ-surgery. The country bred pig represents a good model for educational purposes and for studying further refinements of arthroscopic technique.
