Jandi Avtar S, Schulman Alan J
Veterinary Surgical Referral Services, Los Angeles, CA, USA.
Vet Surg. 2007 Feb;36(2):114-21. doi: 10.1111/j.1532-950X.2006.00226.x.
To report the incidence of loss of stifle extension or flexion and its relationship with clinical lameness after tibial plateau leveling osteotomy (TPLO) for treatment of cranial cruciate ligament (CCL) rupture.
Longitudinal study.
Dogs (n=280) with CCL rupture (n=412).
TPLO was performed without meniscal release or arthrotomy. Angles of extension and flexion of the stifle were measured by goniometry to determine range of motion. Based upon motion loss, stifles were divided in 3 groups: no loss of extension or flexion (n=322), <10 degrees loss of extension or flexion (n=78), > or =10 degrees loss of extension or flexion (n=12).
Loss of extension or flexion > or =10 degrees was associated with significantly (P=.001) higher clinical lameness scores in comparison with no loss, or loss of extension or flexion <10 degrees. Osteoarthrosis in the cranial femorotibial joint was significantly correlated (P<.005, r(2)=0.55) with loss of extension. Loss of extension > or =10 degrees was less tolerable and less amenable to physical rehabilitation than flexion loss.
Loss of extension or flexion > or =10 degrees was responsible for higher clinical lameness scores. Osteoarthrosis in the cranial femorotibial joint led to extension loss.
Loss of extension or flexion should be assessed in dogs with persistent clinical lameness after TPLO so that early intervention can occur. Our study provides guidelines to define clinically relevant loss of extension or flexion of stifle joint after TPLO.
报告胫骨平台水平截骨术(TPLO)治疗颅交叉韧带(CCL)断裂后 stifle 伸展或屈曲丧失的发生率及其与临床跛行的关系。
纵向研究。
患有 CCL 断裂的犬(n = 280 只)(CCL 断裂数 = 412 处)。
在不进行半月板松解或关节切开术的情况下进行 TPLO。通过测角法测量 stifle 的伸展和屈曲角度以确定活动范围。根据活动丧失情况,将 stifle 分为 3 组:无伸展或屈曲丧失(n = 322)、伸展或屈曲丧失<10 度(n = 78)、伸展或屈曲丧失≥10 度(n = 12)。
与无丧失或伸展或屈曲丧失<10 度相比,伸展或屈曲丧失≥10 度与显著更高的临床跛行评分相关(P = 0.001)。颅股胫关节的骨关节炎与伸展丧失显著相关(P < 0.005,r² = 0.55)。伸展丧失≥10 度比屈曲丧失更难以耐受且更不易于进行物理康复。
伸展或屈曲丧失≥10 度导致更高的临床跛行评分。颅股胫关节的骨关节炎导致伸展丧失。
对于 TPLO 后持续临床跛行的犬,应评估其伸展或屈曲丧失情况,以便能进行早期干预。我们的研究提供了定义 TPLO 后 stifle 关节伸展或屈曲临床相关丧失的指导原则。