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一项对描述犬髋关节发育不良手术治疗效果的文献的系统综述(1948 - 2012年)

A systematic review of the literature describing the efficacy of surgical treatments for canine hip dysplasia (1948-2012).

作者信息

Bergh Mary Sarah, Budsberg Steven C

机构信息

Department of Veterinary Clinical Sciences, Iowa State University College of Veterinary Medicine, Ames, Iowa.

出版信息

Vet Surg. 2014 Jul;43(5):501-6. doi: 10.1111/j.1532-950X.2014.12208.x. Epub 2014 May 19.

Abstract

OBJECTIVE

To systematically evaluate the literature reporting outcome of surgical treatments for canine hip dysplasia (CHD) and to evaluate whether adequate evidence exists to support a procedure that will allow a consistent return to normal function.

STUDY DESIGN

Systematic literature review.

ANIMALS

Dogs with naturally occurring CHD.

METHODS

An a priori question was defined and a computer-based bibliographic search was performed on PubMed, Medline, CAB Abstracts, and Veterinary Information Network through November 2012. Studies were compared and evaluated with regard to surgical technique, study design, outcome measurements, evidence classification, and evidence quality. Unilateral surgeries with >6 months postoperative follow-up were included.

RESULTS

Manuscripts (n = 477) were identified and reviewed; 17 met the inclusion criteria. One study provided level I evidence, 2 provided level II evidence, 3 provided level III evidence, and 11 provided level IV evidence relative to the study question. The most common outcome measurements were orthopedic examination (70.6%), owner interview (70.6%), and visual gait observation (64.7%). Three studies used objective kinetic gait assessment. Two studies with level III evidence (total hip replacement) and 1 study with level IV evidence (juvenile pubic symphysiodesis) documented a consistent return to normal function after surgery.

CONCLUSIONS

Despite a large number of publications describing clinical outcome after surgical treatments for CHD, few provided strong evidence to allow an adequate assessment of therapeutic efficacy.

摘要

目的

系统评价关于犬髋关节发育不良(CHD)手术治疗结果的文献,并评估是否有充分证据支持能使犬持续恢复正常功能的手术方法。

研究设计

系统文献综述。

动物

患有自然发生的CHD的犬。

方法

确定一个先验问题,并于2012年11月前在PubMed、Medline、CAB文摘和兽医信息网络上进行基于计算机的文献检索。对研究在手术技术、研究设计、结果测量、证据分类和证据质量方面进行比较和评估。纳入术后随访超过6个月的单侧手术。

结果

共识别并审阅了477篇手稿;17篇符合纳入标准。相对于研究问题,1项研究提供了I级证据,2项提供了II级证据,3项提供了III级证据,11项提供了IV级证据。最常见的结果测量方法是骨科检查(70.6%)、主人访谈(70.6%)和视觉步态观察(64.7%)。3项研究使用了客观的动力学步态评估。2项具有III级证据的研究(全髋关节置换)和1项具有IV级证据的研究(青少年耻骨联合固定术)记录了术后持续恢复正常功能的情况。

结论

尽管有大量关于CHD手术治疗后临床结果的出版物,但很少有提供有力证据以充分评估治疗效果的。

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