Stein S, Schmoekel H
Great Western Referrals, Shrivenham Road, Swindon SN1 2NR, UK.
J Small Anim Pract. 2008 Aug;49(8):398-404. doi: 10.1111/j.1748-5827.2008.00592.x. Epub 2008 Jul 10.
OBJECTIVE: To describe the perioperative complications and the six weeks and eight to 12 months outcome of cases of canine cranial cruciate ligament damage treated with a tibial tuberosity advancement. METHODS: The medical records including the six weeks' postoperative re-evaluation and radiographs of dogs with a tibial tuberosity advancement (70 operated stifles) were analysed regarding the short-term outcome and the recorded complications. A questionnaire for the evaluation of the eight to 12 months outcome was sent to the owners and the answers tabulated. RESULTS: The complication rate was comparable with previous reports of cranial cruciate ligament rupture treated with a tibial tuberosity advancement or a tibial plateau leveling osteotomy (TPLO). The most frequent complication was a symptomatic late secondary meniscal damage in six cases (8.5 per cent). These cases were successfully treated with a partial meniscectomy during a minimal invasive procedure. The six-week re-evaluation showed advanced healing of the tibial crest osteotomies in 94 per cent of the cases and a significant reduction of the lameness in all dogs. Eighty-three per cent of the owners reported that their dogs are never lame or only after heavy exercise eight to 12 months after the tibial tuberosity advancement procedure. Sixty-five per cent of the owners stated the overall treatment to be excellent, 28 per cent good. CLINICAL SIGNIFICANCE: The six weeks' follow-up examination and the questionnaire revealed results of the tibial tuberosity advancement comparable to previously published studies, stating that the lameness and the activity level of the patients with cranial cruciate ligament disease greatly improved after the tibial tuberosity advancement.
目的:描述采用胫骨结节前移术治疗犬颅交叉韧带损伤病例的围手术期并发症以及六周和八至十二个月的预后情况。 方法:分析包括六周术后复查及接受胫骨结节前移术的犬(70个手术膝关节)X线片在内的病历,以了解短期预后及所记录的并发症情况。向犬主发送一份用于评估八至十二个月预后的问卷,并将答案制成表格。 结果:并发症发生率与先前关于采用胫骨结节前移术或胫骨平台水平截骨术(TPLO)治疗颅交叉韧带断裂的报告相当。最常见的并发症是6例(8.5%)出现有症状的晚期继发性半月板损伤。这些病例在微创过程中通过部分半月板切除术成功治疗。六周复查显示94%的病例胫骨嵴截骨愈合良好,所有犬的跛行明显减轻。83%的犬主报告称,在胫骨结节前移术后八至十二个月,他们的犬从不跛行或仅在剧烈运动后才跛行。65%的犬主表示总体治疗效果极佳,28%表示良好。 临床意义:六周的随访检查和问卷显示,胫骨结节前移术的结果与先前发表的研究相当,表明颅交叉韧带疾病患者在胫骨结节前移术后跛行和活动水平有显著改善。
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