Berger B, Knebel J, Steigmeier-Raith S, Reese S, Meyer-Lindenberg A
Dr. med. vet. Björn Berger, Chirurgische und Gynäkologische Kleintierklinik der Ludwig-Maximilians-Universität München, Veterinärstraße 13, 80539 München, E-Mail:
Tierarztl Prax Ausg K Kleintiere Heimtiere. 2015;43(6):373-80. doi: 10.15654/TPK-150183. Epub 2015 Nov 16.
Cranial cruciate ligament rupture is the most frequently occurring disease of the canine stifle. After introduction of corrective osteotomies of the proximal tibia as surgical treatment option in medium, large and giant breeds, the tibial plateau leveling osteotomy (TPLO) evolved into one of the favorite procedures. In the past small breed dogs have usually been treated by extra-articular stabilization techniques. TPLO has recently become an accepted treatment method in these breeds as well as, and is nowadays used with increasing frequency. The purpose of this study was to evaluate long-term outcomes of TPLO compared to an extra-articular stabilization technique in small breed dogs.
A total of 40 stifles of 30 small breed dogs weighing ≤ 15 kg were treated for cranial cruciate ligament rupture with either TPLO (n = 23) or a lateral capsular-fascial imbrication technique (CFI; n = 17). Dogs were clinically examined before and at least 6 months after surgery by treadmill analysis and radiography. Moreover a questionnaire was provided to the owners to assess postoperative function and overall satisfaction.
Twenty-one of 23 operated limbs (91.3%) treated with TPLO and five of 17 (29.4%) treated with the CFI showed absolute values comparable to healthy dogs when evaluated by peak vertical force, vertical impulse and its symmetry index during objective gait analysis. Both groups showed mild, but continuous progression of osteoarthritis. TPLO led to a significantly faster recovery and a higher degree of owner satisfaction.
Based on clinical examination and objective gait analysis TPLO yielded excellent long-term results and a high degree of owner satisfaction in small breed dogs ≤ 15 kg treated for cranial cruciate ligament rupture.
TPLO seems to be superior to CFI treatment of small breed dogs in this study, although CFI should be considered as treatment option under certain circumstances.
颅交叉韧带断裂是犬膝关节最常见的疾病。在将近端胫骨矫正截骨术作为中、大型和巨型犬种的手术治疗选择引入后，胫骨平台水平截骨术（TPLO）逐渐成为最受欢迎的手术之一。过去，小型犬通常采用关节外稳定技术治疗。TPLO最近在这些犬种中也已成为一种被认可的治疗方法，且如今使用频率越来越高。本研究的目的是评估在小型犬中，与关节外稳定技术相比，TPLO的长期疗效。
对30只体重≤15 kg的小型犬的40个膝关节进行颅交叉韧带断裂治疗，其中23个采用TPLO治疗，17个采用外侧关节囊 - 筋膜重叠缝合技术（CFI）治疗。术前及术后至少6个月对犬进行临床检查，包括跑步机分析和X线摄影。此外，向犬主提供问卷以评估术后功能和总体满意度。
在客观步态分析中，通过峰值垂直力、垂直冲量及其对称指数评估时，TPLO治疗的23个手术肢体中有21个（91.3%）、CFI治疗的17个中有5个（29.4%）显示绝对值与健康犬相当。两组均显示骨关节炎有轻度但持续的进展。TPLO导致恢复明显更快且犬主满意度更高。
基于临床检查和客观步态分析，对于体重≤15 kg的小型犬颅交叉韧带断裂的治疗，TPLO产生了优异的长期效果和高度的犬主满意度。
在本研究中，TPLO似乎优于CFI对小型犬的治疗，尽管在某些情况下CFI应被视为一种治疗选择。
