Kim Stanley E, Lewis Daniel D, Pozzi Antonio
Department of Small Animal Clinical Sciences, University of Florida, Gainesville, FL, USA.
Vet Surg. 2012 May;41(4):465-70. doi: 10.1111/j.1532-950X.2012.00973.x. Epub 2012 Mar 1.
To assess the effect of tibial plateau leveling osteotomy (TPLO) on femorotibial subluxation during standing in dogs with cranial cruciate ligament (CrCL) insufficiency.
Prospective clinical study.
Fifteen dogs weighing 20-45 kg with unilateral complete CrCL insufficiency.
Force-platform analysis, and lateral weight-bearing radiographs of the affected stifle were acquired preoperatively, 1, 3, and 6 months postoperatively. The distance between the origin and insertion of the CrCL (CrCL(d) ) was measured on each radiograph and compared between time points using ANOVA. Lateral radiographs of the non-weight-bearing affected stifle and weight-bearing contralateral normal stifle were acquired preoperatively, and CrCL(d) was compared with a paired t-test. Dogs were grouped according to medial meniscal status (intact or hemimeniscectomy) and CrCL(d) was compared within each group using ANOVA.
No difference was observed in CrCL(d) between the non-weight-bearing affected stifle and the contralateral stifle (P = .994). That is, femorotibial joint alignment in the affected stifle when non-weight-bearing was considered normal. Preoperatively in the affected stifle, CrCL(d) during weight-bearing was 6.3 ± 2.4 mm longer than normal (P < .001). Postoperative weight-bearing CrCL(d) in dogs with intact menisci at all time points was not statistically different from normal; CrCL(d) at 1 (P = .014) and 6 months (P = .005) postoperatively was longer than normal in dogs with hemimeniscectomy.
TPLO does not consistently resolve femorotibial subluxation during standing in dogs with CrCL insufficiency. The medial meniscus appears to be an important contributor to stability in stifles treated by TPLO.
评估胫骨平台水平截骨术（TPLO）对患有前交叉韧带（CrCL）功能不全的犬站立时股胫半脱位的影响。
前瞻性临床研究。
15只体重20 - 45千克、单侧完全性CrCL功能不全的犬。
在术前、术后1个月、3个月和6个月获取患侧膝关节的力平台分析结果以及负重位外侧X线片。在每张X线片上测量CrCL起点与止点之间的距离（CrCL(d)），并使用方差分析比较不同时间点的测量结果。术前获取患侧膝关节非负重位和对侧正常膝关节负重位的外侧X线片，采用配对t检验比较CrCL(d)。根据内侧半月板状态（完整或半半月板切除术）对犬进行分组，并使用方差分析比较每组内的CrCL(d)。
患侧膝关节非负重位与对侧膝关节的CrCL(d)无差异（P = 0.994）。也就是说，患侧膝关节非负重时的股胫关节对线被认为是正常的。术前患侧膝关节负重时，CrCL(d)比正常长6.3±2.4毫米（P < 0.001）。半月板完整的犬在所有时间点的术后负重CrCL(d)与正常无统计学差异；半月板切除术的犬在术后1个月（P = 0.014）和6个月（P = 0.005）时的CrCL(d)比正常长。
TPLO并不能始终解决患有CrCL功能不全的犬站立时的股胫半脱位问题。内侧半月板似乎是TPLO治疗膝关节稳定性的重要因素。
