Moeller E M, Allen D A, Wilson E R, Lineberger J A, Lehenbauer T
Mission MedVet, Mission, Kansas, USA.
Vet Comp Orthop Traumatol. 2010;23(1):37-42. doi: 10.3415/VCOT-09-04-0043. Epub 2009 Dec 8.
Our study evaluated thigh circumference (TC), stifle range of motion (ROM), and lameness in dogs one to five years after unilateral tibial plateau levelling osteotomy (TPLO). We hypothesised that TC, stifle ROM, and lameness would not be different to the unoperated limb (control), one to five years after surgery. Patients that were one to five years post-TPLO were reviewed and were included if they had a unilateral TPLO, and no additional clinical evidence of orthopaedic disease. Standing mid-thigh TC measurements and stifle extension and flexion angles were made in triplicate. Clinical lameness was graded blindly. Data were evaluated statistically using paired t-tests for TC and stifle flexion and extension. Significance was set at p <0.05. Twenty-nine dogs met the inclusion criteria. Mean results for the surgery limbs and control limbs were 39.5 +/- 5.5 cm and 40.1 +/- 5.6 cm for TC, 36.6 +/- 6.8 degrees and 28.6 +/- 4.3 degrees for stifle flexion, and 155.2 +/- 6.6 degrees and 159.8 +/- 4.9 degrees for stifle extension, respectively. The mean TC for the operated limb was 98.5% of the control limb. A significant difference was found between the operated and the control limbs for all measurements. Time after surgery had no apparent affect on outcome. Four of 29 dogs (14%) exhibited some lameness in the TLPO limb during evaluation (one dog was 1 to 2 years postoperative and three dogs were 2 to 3 years postoperative). These results indicate that TC and stifle ROM in the TLPO limb do not return to control-limb measurements one to five years after a TPLO surgery. The clinical significance is unknown as TC returned to 98.5% of control, and the source of lameness in the lame dogs was not identified.
我们的研究评估了单侧胫骨平台水平截骨术(TPLO)术后1至5年犬的大腿周长(TC)、 stifle活动范围(ROM)和跛行情况。我们假设,术后1至5年,患侧的TC、stifle ROM和跛行情况与未手术侧肢体(对照)没有差异。对TPLO术后1至5年的患者进行了复查,纳入标准为接受单侧TPLO手术,且无其他骨科疾病的临床证据。站立位时,在大腿中部测量TC三次,并测量stifle伸展和屈曲角度三次。由不知情的人员对临床跛行进行分级。使用配对t检验对TC以及stifle屈曲和伸展数据进行统计学评估。显著性设定为p <0.05。29只犬符合纳入标准。手术侧肢体和对照侧肢体的平均结果如下:TC分别为39.5±5.5厘米和40.1±5.6厘米;stifle屈曲分别为36.6±6.8度和28.6±4.3度;stifle伸展分别为155.2±6.6度和159.8±4.9度。手术侧肢体的平均TC为对照侧肢体的98.5%。所有测量中,手术侧肢体与对照侧肢体之间均存在显著差异。术后时间对结果没有明显影响。29只犬中有4只(14%)在评估期间,其接受TPLO手术的肢体出现了某种程度的跛行(1只犬术后1至2年,3只犬术后2至几年)。这些结果表明,TPLO手术后1至5年,患侧肢体的TC和stifle ROM并未恢复到对照侧肢体的测量值。由于TC恢复到了对照侧的98.5%,且未确定跛行犬的跛行来源,因此其临床意义尚不清楚。