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犬颅交叉韧带断裂胫骨结节前移术的手术及术后并发症:458例(2007 - 2009年)

Surgical and postoperative complications associated with tibial tuberosity advancement for cranial cruciate ligament rupture in dogs: 458 cases (2007-2009).

作者信息

Wolf Rebecca E, Scavelli Thomas D, Hoelzler Michael G, Fulcher Ryan P, Bastian Richard P

机构信息

Garden State Veterinary Specialists, 1 Pine St, Tinton Falls, NJ 07753, USA.

出版信息

J Am Vet Med Assoc. 2012 Jun 15;240(12):1481-7. doi: 10.2460/javma.240.12.1481.

DOI:10.2460/javma.240.12.1481
PMID:22657932
Abstract

OBJECTIVE

To describe the surgical and postoperative complications encountered with tibial tuberosity advancement (TTA) performed in dogs with cranial cruciate ligament-deficient stifle joints.

DESIGN

Retrospective case series.

ANIMALS

458 dogs (TTA performed on 501 stifle joints).

PROCEDURES

During the 2-year period, 624 TTA procedures had been performed in dogs for correction of cranial cruciate ligament deficiency. Five hundred one stifle joints in 458 dogs fit the criteria for inclusion; 43 dogs had had TTAs performed on both stifle joints. Historical data and complications reported were analyzed.

RESULTS

Following 501 TTA surgeries, there were 95 instances of complications reported. In 7 stifle joints, 2 complications occurred. The most common complication was incisional infection and inflammation. Stifle joints with medial menisci that did not undergo medial meniscal release had a high incidence of subsequent injury, and meniscal tear was the most common complication treated by a second surgery. A partially torn cranial cruciate ligament left in situ at the time of TTA did not protect against subsequent injury of an intact, unreleased medial meniscus. Most fractures were identified on routine follow-up radiography and were rarely treated. In terms of preoperative factors, high body weight (> 40 kg [88 lb]) and a high preoperative patellar tendon angle were significantly associated with complications.

CONCLUSIONS AND CLINICAL RELEVANCE

High body weight and preoperative patellar tendon angle were significantly associated with complications following TTA in dogs. Subsequent meniscal tear was the most common reason for second surgery, suggesting that medial meniscal release of intact menisci should be considered when performing TTA in dogs.

摘要

目的

描述在患有前十字韧带损伤的膝关节的犬只中进行胫骨结节前移术(TTA)时遇到的手术及术后并发症。

设计

回顾性病例系列。

动物

458只犬(对501个膝关节进行了TTA手术)。

步骤

在2年期间,对犬只进行了624例TTA手术以纠正前十字韧带损伤。458只犬的501个膝关节符合纳入标准;43只犬的两个膝关节均接受了TTA手术。对报告的历史数据和并发症进行了分析。

结果

在501例TTA手术后,报告了95例并发症。在7个膝关节中发生了2种并发症。最常见的并发症是切口感染和炎症。未进行内侧半月板松解的内侧半月板所在的膝关节随后受伤的发生率较高,半月板撕裂是二次手术治疗的最常见并发症。TTA时原位保留的部分撕裂的前十字韧带并不能防止完整、未松解的内侧半月板随后受伤。大多数骨折在常规随访X线检查中被发现,很少进行治疗。在术前因素方面,高体重(>40 kg [88 lb])和术前髌腱角与并发症显著相关。

结论及临床意义

高体重和术前髌腱角与犬只TTA术后的并发症显著相关。随后的半月板撕裂是二次手术的最常见原因,这表明在对犬只进行TTA时应考虑对完整半月板进行内侧半月板松解。

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