Mölsä Sari H, Hielm-Björkman Anna K, Laitinen-Vapaavuori Outi M
Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Finland.
J Am Vet Med Assoc. 2013 Sep 1;243(5):689-95. doi: 10.2460/javma.243.5.689.
To evaluate, by means of an owner questionnaire, long-term outcome and prevalence of chronic pain after cranial cruciate ligament (CCL) surgery in dogs.
Retrospective case series.
253 dogs with surgically treated CCL rupture.
Data from surgical records of dogs that underwent surgical repair of CCL between 2004 and 2006 were reviewed. An owner questionnaire, including the validated Helsinki chronic pain index (HCPI), served to evaluate long-term outcome and prevalence of chronic pain after surgical repair by means of intracapsular, extracapsular, or osteotomy techniques. Additional questions inquired about recovery and rehabilitation after surgery, current well-being, medications, and adjunct treatments.
Of 507 questionnaires, 272 (53.6%) were returned; 19 were excluded because of incomplete answers. Mean ± SD follow-up time was 2.7 ± 0.8 years (range, 1.3 to 4.5 years). Owners considered surgical outcome as excellent in 122 of 226 (54.0%) dogs, good in 97 (42.9%), fair in 0 (0%), and poor in 7 (3.1%). At follow-up, the mean ± SD HCPI for 206 dogs was 8.9 ± 6.3 (range, 0 to 24). Of these 206 dogs, 64 (31.1%) had an HCPI ≥ 12, indicating chronic pain. Mean HCPI in dogs with a good outcome (11.8 ± 5.4; 95% confidence interval, 10.6 to 12.9) was significantly higher than that for dogs with an excellent outcome (6.2 ± 5.7; 95% confidence interval, 5.1 to 7.2). Owner-reported postoperative lameness was significantly shorter after osteotomy techniques, compared with lameness duration after the intracapsular technique.
On the basis of owner assessment, long-term chronic pain was found in approximately 30% of dogs after CCL repair.
通过主人问卷调查，评估犬颅交叉韧带（CCL）手术后的长期预后及慢性疼痛的发生率。
回顾性病例系列研究。
253只接受CCL破裂手术治疗的犬。
回顾2004年至2006年间接受CCL手术修复的犬的手术记录数据。一份主人问卷，包括经过验证的赫尔辛基慢性疼痛指数（HCPI），用于通过囊内、囊外或截骨技术评估手术修复后的长期预后及慢性疼痛的发生率。其他问题询问了术后的恢复和康复情况、当前的健康状况、用药情况及辅助治疗。
在507份问卷中，272份（53.6%）被返还；19份因回答不完整被排除。平均随访时间±标准差为2.7±0.8年（范围1.3至4.5年）。在226只犬中，主人认为手术结果优秀的有122只（54.0%），良好的有97只（42.9%），一般的有0只（0%），差的有7只（3.1%）。随访时，206只犬的平均HCPI±标准差为8.9±6.3（范围0至24）。在这206只犬中，64只（31.1%）的HCPI≥12，表明存在慢性疼痛。手术结果良好的犬的平均HCPI（11.8±5.4；95%置信区间，10.6至12.9）显著高于手术结果优秀的犬（6.2±5.7；95%置信区间，5.1至7.2）。与囊内技术后的跛行持续时间相比，主人报告的截骨技术后的术后跛行时间明显更短。
基于主人评估，约30%的犬在CCL修复后存在长期慢性疼痛。
