Linney William R, Hammer Douglas L, Shott Susan
Norwood Park Animal Hospital, 4321 N Harlem Ave, Norridge, IL 60706, USA.
J Am Vet Med Assoc. 2011 May 1;238(9):1168-72. doi: 10.2460/javma.238.9.1168.
To assess signalment, outcomes, and complications for dogs surgically treated for medial patellar luxation (MPL) with a combination of lateral retinacular imbrication and tibial crest transposition procedures without femoral trochlear groove deepening techniques, and to determine whether osteoarthritis progressed in these patients during the 8-week period following surgery.
Retrospective case series. Animals-91 dogs.
Medical records were reviewed for information on signalment, clinical history, unilateral versus bilateral disease, preoperative and postoperative MPL grades, duration of follow-up, and perioperative and postoperative complications. Radiographs obtained preoperatively and during 8-week follow-up examinations were reviewed and assigned degenerative joint disease (DJD) scores (range, 0 to 3). Data were analyzed to determine factors influencing outcomes. Kaplan-Meier curves were constructed for recurrence of MPL.
Minor postoperative complications were reported for 31 of 91 (34.1%) dogs. Patellar reluxation occurred in 18 of 91 (19.8%) dogs. Reluxation or complications for which additional surgery was recommended developed in 6 of 91 (6.6%) dogs. At last clinical follow-up, 10 of 91 (11.0%) dogs had at least occasional lameness. No difference was revealed between preoperative and postoperative (8-week follow-up) radiographic DJD scores.
Results of surgical treatment of MPL without femoral trochlear groove deepening procedures were comparable to those in studies of surgical treatment that included groove deepening procedures. Radiographic indices of DJD did not increase during the 8 weeks following surgery. These results suggest that trochlear groove deepening procedures are not always necessary, and patients that undergo these techniques should be carefully selected.
评估采用外侧支持带重叠缝合和胫骨嵴移位术联合治疗内侧髌骨脱位(MPL)且未采用股骨滑车沟加深技术的犬只的体征、治疗结果及并发症,并确定这些患者在术后8周内骨关节炎是否进展。
回顾性病例系列研究。动物:91只犬。
查阅病历以获取有关体征、临床病史、单侧或双侧疾病、术前和术后MPL分级、随访时长以及围手术期和术后并发症的信息。对术前及术后8周随访检查时获得的X光片进行评估,并给出退行性关节病(DJD)评分(范围为0至3)。分析数据以确定影响治疗结果的因素。构建MPL复发的Kaplan-Meier曲线。
91只犬中有31只(34.1%)报告有轻微术后并发症。91只犬中有18只(19.8%)发生髌骨复发。91只犬中有6只(6.6%)出现复发或并发症,建议进行额外手术。在最后一次临床随访时,91只犬中有10只(11.0%)至少偶尔出现跛行。术前和术后(8周随访)X光片的DJD评分无差异。
未采用股骨滑车沟加深术治疗MPL的手术结果与包括滑车沟加深术的手术治疗研究结果相当。术后8周内DJD的X光指标未增加。这些结果表明滑车沟加深术并非总是必要的,应谨慎选择接受这些技术的患者。