Ritzo Meghan E, Ritzo Brandon A, Siddens Adrienne D, Summerlott Stephanie, Cook James L
Veterinary Medical Teaching Hospital, University of Missouri, Columbia, Missouri.
Vet Surg. 2014 Nov;43(8):952-8. doi: 10.1111/j.1532-950X.2014.12220.x. Epub 2014 Jun 7.
To evaluate factors related to meniscal pathology and their effect on clinical outcome in dogs treated for cranial cruciate ligament (CCL) disease.
Prospective cross-sectional study.
Dogs (n = 163) with CCL disease (n = 223 stifles).
CCL disease was treated by (1) arthroscopy and TightRope (TR) stabilization; (2) arthroscopy and tibial plateau leveling osteotomy (TPLO); or (3) open arthrotomy and TPLO. Incidences of concurrent and subsequent meniscal tears, meniscal treatments, mid-(6 months) and long-(>1 year) term outcomes by owner assessment were compared among surgical treatment groups.
Concurrent meniscal tears were diagnosed in 83% of stifles assessed by arthroscopy and 44% of stifles assessed by arthrotomy, with concurrent tear diagnosis being 1.9 times more likely by arthroscopy than arthrotomy (P < .001). Incidence of diagnosis of subsequent meniscal tears was 6.7% with median time to diagnosis of 5.8 months. Differences in proportion of subsequent meniscal tears among treatment groups were not significant (P = .69). Subsequent meniscal tears were diagnosed in 21% of cases without concurrent meniscal tears, but only 1.3% of cases with concurrent meniscal tears (P < .001). Cases treated with meniscal release did not have subsequent meniscal tears, whereas dogs not treated with meniscal release had a subsequent meniscal tear rate of 11% (P = .0013). Cases diagnosed and treated for concurrent meniscal tears were 1.3 times more likely to have a successful long-term outcome (P = .007).
CCL surgical technique did not affect subsequent meniscal tear rate or mid-term or long-term functional outcomes, whereas diagnosis and treatment of concurrent meniscal tears did significantly affect both.
评估与半月板病变相关的因素及其对治疗颅交叉韧带(CCL)疾病犬临床结局的影响。
前瞻性横断面研究。
患有CCL疾病的犬(n = 163只,患侧膝关节n = 223个)。
CCL疾病采用以下方法治疗:(1)关节镜检查和TightRope(TR)稳定术;(2)关节镜检查和胫骨平台水平截骨术(TPLO);或(3)开放性关节切开术和TPLO。比较手术治疗组之间并发和继发半月板撕裂的发生率、半月板治疗情况、主人评估的中期(6个月)和长期(>1年)结局。
通过关节镜检查评估的膝关节中,83%诊断为并发半月板撕裂;通过关节切开术评估的膝关节中,44%诊断为并发半月板撕裂。关节镜检查诊断并发撕裂的可能性比关节切开术高1.9倍(P <.001)。继发半月板撕裂的诊断发生率为6.7%,诊断的中位时间为5.8个月。治疗组之间继发半月板撕裂比例的差异不显著(P =.69)。在无并发半月板撕裂的病例中,21%诊断为继发半月板撕裂,但在有并发半月板撕裂的病例中仅为1.3%(P <.001)。接受半月板松解治疗的病例未发生继发半月板撕裂,而未接受半月板松解治疗的犬继发半月板撕裂率为11%(P =.0013)。诊断并治疗并发半月板撕裂的病例长期成功结局的可能性高1.3倍(P =.007)。
CCL手术技术不影响继发半月板撕裂率或中期或长期功能结局,而并发半月板撕裂的诊断和治疗对两者均有显著影响。