Morgan Joe P, Voss Katja, Damur Daniel M, Guerrero Tomás, Haessig Michael, Montavon Pierre M
Section of Diagnostic Imaging and Radio-Oncology, Vetsuisse Faculty University of Zurich, Zurich, Switzerland.
Vet Surg. 2010 Jun;39(4):425-32. doi: 10.1111/j.1532-950X.2010.00669.x. Epub 2010 Mar 25.
To (1) evaluate radiographic changes associated with osteoarthrosis (OA) before and after tibial tuberosity advancement (TTA) and (2) determine if these changes are indicative of limb function as determined by kinetic gait analysis.
Prospective clinical study.
Dogs (n=35) with cranial cruciate ligament (CCL) deficient stifles (38).
Variables recorded were: complete or partial CCL rupture, meniscal lesions, arthroscopically graded cartilage lesions, complications, and revision surgeries. Radiographic evaluation and kinetic gait analysis (vertical ground reaction forces [GRFs]) were conducted pre- and 4-16 months postoperatively (mean, 5.9 months). Radiographs were evaluated without knowledge of operative findings and functional outcome. A score (0-3) based on new bone production at 11 specific sites was used to grade OA. Soft tissue changes were classified separately as normal or excessive. Preoperative scores were correlated with clinical variables. Postoperative scores and progression of OA scores were correlated with clinical variables and GRFs.
OA remained unchanged in 17 joints and progressed in 21 (55%). Dogs with meniscal lesions had higher OA scores preoperatively, but not at follow-up. Dogs with severe cartilage lesions at surgery had more progression of OA. GRFs improved after surgery and were not correlated with any of the radiographic OA scores.
Progression of OA was greater in the presence of severe cartilage lesions at surgery. OA scores were not correlated with GRFs.
Progression of OA is generally expected to occur after TTA despite improvement of limb function.
（1）评估胫骨结节前移（TTA）前后与骨关节炎（OA）相关的影像学变化；（2）确定这些变化是否可通过动态步态分析反映肢体功能。
前瞻性临床研究。
患有颅交叉韧带（CCL）损伤 stifles 的犬（n = 35）（38 个 stifles）。
记录的变量包括：CCL 完全或部分断裂、半月板损伤、关节镜分级的软骨损伤、并发症及翻修手术。在术前及术后 4 - 16 个月（平均 5.9 个月）进行影像学评估和动态步态分析（垂直地面反作用力 [GRFs]）。在不了解手术结果和功能结局的情况下评估 X 光片。基于 11 个特定部位的新骨生成情况使用评分（0 - 3 分）对 OA 进行分级。软组织变化单独分类为正常或过度。术前评分与临床变量相关。术后评分及 OA 评分进展与临床变量和 GRFs 相关。
17 个关节的 OA 保持不变，21 个关节（55%）进展。有半月板损伤的犬术前 OA 评分较高，但随访时无差异。手术时软骨损伤严重的犬 OA 进展更多。术后 GRFs 改善，且与任何影像学 OA 评分均无相关性。
手术时存在严重软骨损伤时 OA 进展更大。OA 评分与 GRFs 无相关性。
尽管肢体功能有所改善，但 TTA 后通常预期会发生 OA 进展。
