title: Use of bovine carpal joints as a training model for cruciate ligament repair.
abstract: BACKGROUND
  Currently, there is a lack of cheap and effective training models to allow orthopaedic surgery trainees to learn the basics of anterior cruciate ligament reconstruction. The aim of this paper was to investigate the viability of using various animal joints as models for the training of anterior cruciate ligament reconstruction.
  
  
  METHODS
  Equine stifles, bovine stifles and carpal joints, sheep stifles and porcine stifles, were sourced from a local abattoir. Each joint was assessed for the following criteria: suitable tendons for harvesting, ease of arthroscopy access, adequacy of arthroscopy view and suitable joint surfaces. Tendon harvesting, preparation, joint arthroscopy and tendon tunnelling were performed on the most suitable joint.
  
  
  RESULTS
  Equine, bovine, sheep and porcine stifles were found to be unsuitable. The bovine carpal joint was similar to a human wrist joint with two rows of carpal bones and fused metacarpal bones, but with deeper flexion - similar to a human knee joint. The distal joint space was found to provide a greater range of flexion and space than the narrower proximal joint space. The joint capsule provided sufficient integrity during saline irrigation to allow adequate visualization of joint structures. Tendons surrounding the joint were found to be of similar diameter to human hamstring tendons and easily accessible. Tendon tunnelling was successfully performed in a manner similar to human anterior cruciate ligament repair.
  
  
  CONCLUSIONS
  The use of bovine carpal joints is a cost-effective, safe and easily reproducible model for education on basic anterior cruciate ligament repair skills and technique prior to patient contact.
authors.affiliation: Clinical Services, Royal Perth Hospital, Perth, Western Australia, Australia.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Calvert
authors.forename: Nicholas
authors.initials: N
authors.lastname: Grainger
authors.forename: Mark
authors.initials: M
authors.lastname: Hurworth
mesh_terms: D000818:Animals; D059549:Anterior Cruciate Ligament Reconstruction / Q000193:education*; D001182:Arthroscopy; D050824:Carpal Joints / Q000033:anatomy & histology / Q000601:surgery*; D002417:Cattle; D005240:Feasibility Studies; D006801:Humans; D023421:Models, Animal; D017145:Models, Educational
keywords: arthroscopy; cruciate ligament repair