Chuang Connie, Ramaker Megan A, Kaur Sirjaut, Csomos Rebecca A, Kroner Kevin T, Bleedorn Jason A, Schaefer Susan L, Muir Peter
Comparative Orthopaedic Research Laboratory, and the Department of Surgical Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin, United States of America.
PLoS One. 2014 Sep 25;9(9):e106389. doi: 10.1371/journal.pone.0106389. eCollection 2014.
Complete cranial cruciate ligament rupture (CR) is a common cause of pelvic limb lameness in dogs. Dogs with unilateral CR often develop contralateral CR over time. Although radiographic signs of contralateral stifle joint osteoarthritis (OA) influence risk of subsequent contralateral CR, this risk has not been studied in detail.
METHODOLOGY/PRINCIPAL FINDINGS: We conducted a retrospective longitudinal cohort study of client-owned dogs with unilateral CR to determine how severity of radiographic stifle synovial effusion and osteophytosis influence risk of contralateral CR over time. Detailed survival analysis was performed for a cohort of 85 dogs after case filtering of an initial sample population of 513 dogs. This population was stratified based on radiographic severity of synovial effusion (graded on a scale of 0, 1, and 2) and severity of osteophytosis (graded on a scale of 0, 1, 2, and 3) of both index and contralateral stifle joints using a reproducible scoring method. Severity of osteophytosis in the index and contralateral stifles was significantly correlated. Rupture of the contralateral cranial cruciate ligament was significantly influenced by radiographic OA in both the index and contralateral stifles at diagnosis. Odds ratio for development of contralateral CR in dogs with severe contralateral radiographic stifle effusion was 13.4 at one year after diagnosis and 11.4 at two years. Odds ratio for development of contralateral CR in dogs with severe contralateral osteophytosis was 9.9 at one year after diagnosis. These odds ratios were associated with decreased time to contralateral CR. Breed, age, body weight, gender, and tibial plateau angle did not significantly influence time to contralateral CR.
Subsequent contralateral CR is significantly influenced by severity of radiographic stifle effusion and osteophytosis in the contralateral stifle, suggesting that synovitis and arthritic joint degeneration are significant factors in the disease mechanism underlying the arthropathy.
犬完全性颅交叉韧带断裂（CR）是犬后肢跛行的常见原因。单侧CR的犬随着时间推移常发生对侧CR。尽管对侧膝关节骨关节炎（OA）的影像学表现会影响随后对侧CR的风险，但尚未对此风险进行详细研究。
方法/主要发现：我们对单侧CR的宠物犬进行了一项回顾性纵向队列研究，以确定影像学上膝关节滑膜积液和骨赘形成的严重程度如何随时间影响对侧CR的风险。在对最初的513只犬样本进行病例筛选后，对85只犬的队列进行了详细的生存分析。使用可重复的评分方法，根据患侧和对侧膝关节滑膜积液的影像学严重程度（按0、1、2级评分）和骨赘形成的严重程度（按0、1、2、3级评分）对该群体进行分层。患侧和对侧骨赘形成的严重程度显著相关。诊断时，患侧和对侧膝关节的影像学OA对侧颅交叉韧带断裂有显著影响。诊断后1年，对侧膝关节影像学严重积液的犬发生对侧CR的比值比为13.4，2年时为11.4。诊断后1年，对侧严重骨赘形成的犬发生对侧CR的比值比为9.9。这些比值比与对侧CR发生时间缩短相关。品种、年龄、体重、性别和胫骨平台角对侧CR发生时间无显著影响。
随后的对侧CR受对侧膝关节影像学滑膜积液和骨赘形成严重程度的显著影响，提示滑膜炎和关节炎性关节退变是关节病发病机制中的重要因素。
