Dueland R T, Adams W M, Patricelli A J, Linn K A, Crump P M
Department of Surgical Sciences, University of Wisconsin, Madison, Wisconsin, USA.
Vet Comp Orthop Traumatol. 2010;23(5):306-17. doi: 10.3415/VCOT-09-04-0045. Epub 2010 Aug 25.
To measure one and two year effects of juvenile pubic symphysiodesis (JPS) in puppies defined as 'at-risk' for canine hip dysplasia (CHD) using the following objective hip conformation criteria: Acetabular angle (AA), dorsal acetabular rim angle (DARA) and hip laxity (PennHIP© distraction index (DI).
Controlled clinical case study.
Thirty-nine dysplastic puppies (six controls).
The dogs were anaesthetised and acetabular angle, DARA, and DI values were obtained by computed tomography and radiography preoperatively. Electro-cautery fusion of the pubic symphysis was performed between 12 - 24 weeks of age. The imaging was repeated at one and two years of age.
Significant hip improvements were seen at the two-year follow-up appointments for: AA (JPS dogs 31% increase, control 3%), DARA (JPS 38% decrease, control 15%) and DI (JPS 41% decrease in laxity, controls 20%) for all postoperative versus preoperative values. Pubic fusion occurred with minor morbidity.
Juvenile pubic symphysiodesis resulted in significant improvements in hip conformation (AA and DARA), especially in mild to moderately lax hips (DI = 0.40-0.69). Most dogs with DI≥0.70 increased in osteoarthritis grade by two years of age.
Juvenile pubic symphysiodesis surgery at 12-24 weeks of age significantly improved hip conformation and decreased laxity in at-risk CHD dogs. Early-age (12 to 16 week) recognition of hip laxity offered greater JPS benefits than surgery performed at 19- to 24-weeks-old. Dogs with severe laxity (DI≥0.70) continued to increase in osteoarthritis. An early (12-16 weeks) positive laxity test (Ortolani) should alert one to obtain objective laxity determinations (PennHIP© DI).
使用以下客观髋关节形态学标准，测量幼年耻骨联合固定术（JPS）对被定义为患犬髋关节发育不良（CHD）“风险”幼犬的1年和2年影响：髋臼角（AA）、髋臼背侧缘角（DARA）和髋关节松弛度（PennHIP© 牵引指数（DI））。
对照临床病例研究。
39只发育不良幼犬（6只对照）。
对犬只进行麻醉，并在术前通过计算机断层扫描和X线摄影获得髋臼角、DARA和DI值。在12至24周龄之间进行耻骨联合的电灼融合。在1岁和2岁时重复成像。
在两年的随访检查中，所有术后与术前值相比，在以下方面均观察到髋关节有显著改善：AA（JPS犬增加31%，对照增加3%）、DARA（JPS降低38%，对照降低15%）和DI（JPS松弛度降低41%，对照降低20%）。耻骨联合融合发生时并发症轻微。
幼年耻骨联合固定术使髋关节形态（AA和DARA）有显著改善，尤其是在轻度至中度松弛的髋关节（DI = 0.40 - 0.69）中。大多数DI≥0.70的犬只在2岁时骨关节炎等级增加。
12至24周龄的幼年耻骨联合固定术显著改善了有CHD风险犬只的髋关节形态并降低了松弛度。早期（12至16周）识别髋关节松弛比在19至24周龄时进行手术能带来更大的JPS益处。严重松弛（DI≥0.70）的犬只骨关节炎持续加重。早期（12 - 16周）阳性松弛试验（奥托拉尼试验）应提醒人们进行客观的松弛度测定（PennHIP© DI）。
