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评估一种用于治疗犬颅交叉韧带疾病的关节内合成韧带:一项为期六个月的前瞻性临床试验。

Evaluation of an intra-articular synthetic ligament for treatment of cranial cruciate ligament disease in dogs: a six-month prospective clinical trial.

作者信息

Barnhart Matthew D, Maritato Karl, Schankereli Kemal, Wotton Harry, Naber Steven

机构信息

Matthew D. Barnhart, DVM, MS, Diplomate ACVS, MedVet Medical & Cancer Centers, 300 E. Wilson Bridge Rd, Worthington, OH 43085, United States, E-mail:

出版信息

Vet Comp Orthop Traumatol. 2016 Nov 23;29(6):491-498. doi: 10.3415/VCOT-15-12-0206. Epub 2016 Oct 6.

DOI:10.3415/VCOT-15-12-0206
PMID:27709221
Abstract

OBJECTIVE

Evaluate the short-term outcomes of a novel synthetic ligament for treatment of naturally occurring canine cranial cruciate ligament disease.

STUDY DESIGN

Prospective clinical study.

ANIMALS

Dogs with unilateral cranial cruciate ligament disease (n = 50).

METHODS

Patient parameters evaluated included a five-point lameness score, evaluation of craniocaudal stifle instability, and radiographic findings over 24 weeks. Any postoperative complications were recorded.

RESULTS

Thirty-four out of 42 dogs experienced significant improvements in lameness between the preoperative and 24 week time points. Lameness scores in those dogs improved significantly at all measured time intervals after postoperative week 2. Recurrence of stifle instability increased significantly over the study period from immediate postoperative measurements. Cranial drawer recurred in seven out of 42 of dogs by week 4 and 18/42 by week 24. Implant changes were not noted between the immediate and six-month postoperative radiographs except where complications occurred. Overall, 25 dogs experienced a total of 32 complications (22 major and 10 minor). Sixteen dogs had major complications, and nine had minor complications.

CONCLUSION

The procedure was generally effective at improving lameness scores, but did not consistently maintain postoperative stifle stability and had an unacceptably high complication rate. This synthetic ligament procedure cannot be recommended for use in its current form.

摘要

目的

评估一种新型合成韧带治疗犬自然发生的颅交叉韧带疾病的短期疗效。

研究设计

前瞻性临床研究。

动物

单侧颅交叉韧带疾病的犬(n = 50)。

方法

评估的患者参数包括五分制跛行评分、颅尾关节不稳定评估以及24周内的影像学检查结果。记录任何术后并发症。

结果

42只犬中有34只在术前和24周时间点之间跛行有显著改善。这些犬的跛行评分在术后第2周后的所有测量时间间隔均有显著改善。在研究期间,从术后立即测量开始,关节不稳定的复发显著增加。到第4周时,42只犬中有7只出现颅侧抽屉试验复发,到第24周时为18/42。除出现并发症外,术后即刻和术后6个月的X线片之间未发现植入物变化。总体而言,25只犬共出现32例并发症(22例严重并发症和10例轻微并发症)。16只犬出现严重并发症,9只出现轻微并发症。

结论

该手术在改善跛行评分方面总体有效,但不能持续维持术后关节稳定性,且并发症发生率高得令人无法接受。目前形式的这种合成韧带手术不建议使用。

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