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接受颅交叉韧带疾病手术治疗的犬类半月板损伤的发生率、类型及相关长期临床结果。

Incidence and type of meniscal injury and associated long-term clinical outcomes in dogs treated surgically for cranial cruciate ligament disease.

作者信息

Ritzo Meghan E, Ritzo Brandon A, Siddens Adrienne D, Summerlott Stephanie, Cook James L

机构信息

Veterinary Medical Teaching Hospital, University of Missouri, Columbia, Missouri.

出版信息

Vet Surg. 2014 Nov;43(8):952-8. doi: 10.1111/j.1532-950X.2014.12220.x. Epub 2014 Jun 7.

Abstract

OBJECTIVE

To evaluate factors related to meniscal pathology and their effect on clinical outcome in dogs treated for cranial cruciate ligament (CCL) disease.

STUDY DESIGN

Prospective cross-sectional study.

ANIMALS

Dogs (n = 163) with CCL disease (n = 223 stifles).

METHODS

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.

RESULTS

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).

CONCLUSIONS

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.

摘要

目的

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。

研究设计

前瞻性横断面研究。

动物

患有CCL疾病的犬(n = 163只,患侧膝关节n = 223个)。

方法

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。

结果

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)。

结论

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。

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