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24只犬矿化和非矿化冈上肌腱病的手术治疗

Surgical treatment of mineralized and nonmineralized supraspinatus tendinopathy in twenty-four dogs.

作者信息

Lafuente M Pilar, Fransson Boel A, Lincoln James D, Martinez Steven A, Gavin Patrick R, Lahmers Kevin K, Gay John M

机构信息

Department of Veterinary Clinical Sciences, Washington State University, Pullman, WA 99164, USA.

出版信息

Vet Surg. 2009 Apr;38(3):380-7. doi: 10.1111/j.1532-950X.2009.00512.x.

DOI:10.1111/j.1532-950X.2009.00512.x
PMID:19573103
Abstract

OBJECTIVE

To report and compare the clinical diagnosis, surgical treatment, histopathologic changes, and outcomes of dogs with mineralized and nonmineralized supraspinatus tendinopathy (ST).

STUDY DESIGN

Case series.

ANIMALS

Dogs (n=24) with ST.

METHODS

Medical records (1995-2006) of dogs with ST that had surgical treatment were reviewed. Results of clinical examination, diagnostic imaging, surgery, histopathology of resected tendon tissue, and outcome were compared between dogs with mineralized and nonmineralized ST.

RESULTS

There were 15 dogs with mineralized ST and 9 with nonmineralized ST. Chronic, unilateral, intermittent or waxing-waning lameness, and pain elicited on palpation of the cranial aspect of the shoulder were the most consistent findings. On ultrasonographic or magnetic resonance imaging (MRI) of 35 shoulders, enlargement of the supraspinatus tendon (54%), increased fluid content (63%), and medial displacement of the biceps tendon (60%) were observed. Eleven of 12 dogs with bilateral abnormalities only had unilateral lameness. Surgery was performed in 30 shoulders. Resected tendon specimens had myxomatous degeneration and/or cartilaginous metaplasia in 11 of 13 dogs in the mineralized group and all 9 dogs in the nonmineralized group. Functional outcome after surgery was poor in 3 dogs and good-to-excellent in 16.

CONCLUSIONS

Mineralized and nonmineralized ST have many similarities. Although lameness is usually unilateral, the supraspinatus tendon may be affected bilaterally.

CLINICAL RELEVANCE

Ultrasonography and MRI are good imaging techniques for detection of ST especially the nonmineralized form. Surgical treatment results in good recovery of limb function. Nonmineralized ST is a recently described disorder in dogs and evaluation of more cases is necessary to determine outcome after surgical or medical treatment.

摘要

目的

报告并比较患矿化性和非矿化性冈上肌腱病(ST)犬的临床诊断、手术治疗、组织病理学变化及预后情况。

研究设计

病例系列研究。

动物

患有ST的犬(n = 24)。

方法

回顾1995年至2006年接受手术治疗的ST犬的病历。比较矿化性和非矿化性ST犬的临床检查结果、诊断性影像学检查结果、手术情况、切除肌腱组织的组织病理学检查结果及预后情况。

结果

15只犬患有矿化性ST,9只患有非矿化性ST。慢性、单侧、间歇性或时轻时重的跛行,以及触诊肩部前方时引发的疼痛是最一致的表现。在对35个肩部进行超声或磁共振成像(MRI)检查时,观察到冈上肌腱增粗(54%)、液体含量增加(63%)以及肱二头肌肌腱向内侧移位(60%)。12只双侧异常的犬中,仅有11只出现单侧跛行。对30个肩部进行了手术。矿化组13只犬中的11只以及非矿化组所有9只犬的切除肌腱标本出现黏液样变性和/或软骨化生。术后3只犬功能预后较差,16只犬功能预后良好至优秀。

结论

矿化性和非矿化性ST有许多相似之处。尽管跛行通常为单侧,但冈上肌腱可能双侧受累。

临床意义

超声和MRI是检测ST尤其是非矿化形式的良好影像学技术。手术治疗可使肢体功能良好恢复。非矿化性ST是犬类最近描述的一种疾病,需要评估更多病例以确定手术或药物治疗后的预后情况。

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