Duerr Felix M, Duncan Colleen G, Savicky Roman S, Park Richard D, Egger Erick L, Palmer Ross H
Department of Clinical Sciences, Veterinary Medical Center, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, CO 80523, USA.
Vet Surg. 2008 Jan;37(1):49-62. doi: 10.1111/j.1532-950X.2007.00348.x.
To identify surgical techniques performed by veterinary surgeons for the treatment of cranial cruciate ligament disease in large-breed dogs with excessive tibial plateau angle (eTPA), compare their outcomes, identify risk factors for postoperative complications, and compare outcome and complication rate with tibial plateau leveling osteotomy (TPLO) in dogs without eTPA.
Multicenter, case-control study.
eTPA group (TPA>or=35 degrees)=58 dogs (78 stifles); control group (TPA<or=30 degrees)=58 dogs (72 stifles).
Control and eTPA group dogs were identified. Medical records, radiographic reviews, and pet-owner interviews were used to identify surgical treatments performed, their complications, and outcome. Odds ratios with 95% confidence intervals, chi(2) tests, and t-tests were calculated to discern differences between eTPA and control-group dogs.
TPLO was the most common treatment for eTPA. Owner-perceived outcome was superior for eTPA group dogs when TPLO resulted in TPA<or=14 degrees compared with those with postoperative TPA>14 degrees. Loss of tibial plateau leveling during convalescence was the most commonly observed major complication; addition of ancillary implants to TPLO significantly reduced its incidence. Postoperative complications were more common in dogs with eTPA than in dogs without eTPA; however, no difference in owner-perceived outcome was identified.
Surgical treatment of dogs with eTPA has a higher complication rate, but comparable outcome to that of dogs without eTPA.
Postoperative TPA<or=14 degrees and addition of ancillary implants are recommended when using TPLO to treat dogs with eTPA.
确定兽医治疗胫骨平台角过大（eTPA）的大型犬颅交叉韧带疾病所采用的手术技术，比较其疗效，确定术后并发症的风险因素，并将其疗效和并发症发生率与无eTPA的犬胫骨平台水平截骨术（TPLO）进行比较。
多中心病例对照研究。
eTPA组（TPA≥35度）=58只犬（78个 stifles关节）；对照组（TPA≤30度）=58只犬（72个stifles关节）。
确定对照组和eTPA组的犬。使用病历、影像学检查结果回顾以及宠物主人访谈来确定所实施的手术治疗、并发症及疗效。计算95%置信区间的比值比、卡方检验和t检验，以辨别eTPA组和对照组犬之间的差异。
TPLO是治疗eTPA最常用的方法。当TPLO术后TPA≤14度时，eTPA组犬主人感知的疗效优于术后TPA>14度的犬。恢复期胫骨平台水平丢失是最常见的主要并发症；TPLO术中增加辅助植入物可显著降低其发生率。eTPA犬术后并发症比无eTPA犬更常见；然而，在主人感知的疗效方面未发现差异。
eTPA犬的手术治疗并发症发生率较高，但疗效与无eTPA犬相当。
使用TPLO治疗eTPA犬时，建议术后TPA≤14度并增加辅助植入物。
