DeSandre-Robinson Dana M, Tano Cheryl A, Fiore Kara L, Prytherch Ben
J Am Vet Med Assoc. 2017 Jan 1;250(1):68-74. doi: 10.2460/javma.250.1.68.
OBJECTIVE To radiographically evaluate and compare changes in the patellar ligament of dogs following tibial plateau leveling osteotomy (TPLO) and tibial tuberosity advancement (TTA). DESIGN Retrospective case series. ANIMALS 106 dogs that underwent TPLO (n = 59) or TTA (n = 47) for unilateral rupture of the cranial cruciate ligament at a private veterinary hospital from August 2009 through September 2012. PROCEDURES Medical records were reviewed to collect information on dog signalment, surgical procedure, whether arthrotomy had been performed, pre- and postoperative measurements of patellar ligament angle (PLA) and tibial plateau angle (TPA), and preoperative and follow-up measurements of patellar ligament thickness. RESULTS For dogs that underwent TTA, thickening of the distal portion of the patellar ligament was identified radiographically in 43 (92%) dogs at the first follow-up examination and 36 (77%) at the second follow-up examination. For dogs that underwent TPLO, these numbers were 57 (97%) and 54 (92%), respectively. A significant decrease in patellar ligament thickness was identified between the first and second follow-up examinations for TTA but not TPLO. Mean ± SD PLA following TTA was 89.46 ± 5.54°, representing a mean difference from the preoperative PLA of 11.86 ± 5.3°; following TPLO, mean TPA was 12.61 ± 4.03°, representing a mean difference from the preoperative TPA of 16.74 ± 7.13°. CONCLUSIONS AND CLINICAL RELEVANCE Patellar ligament thickening occurred following TPLO and TTA in dogs. The clinical relevance of this thickening remains unknown.
目的 通过影像学评估和比较犬胫骨平台水平截骨术(TPLO)和胫骨结节前移术(TTA)后髌韧带的变化。
设计 回顾性病例系列研究。
动物 2009年8月至2012年9月在一家私立兽医医院因单侧前交叉韧带断裂接受TPLO(n = 59)或TTA(n = 47)手术的106只犬。
方法 查阅病历以收集有关犬的特征、手术过程、是否进行了关节切开术、髌韧带角度(PLA)和胫骨平台角度(TPA)的术前和术后测量值,以及髌韧带厚度的术前和随访测量值等信息。
结果 对于接受TTA的犬,在首次随访检查时,43只(92%)犬的髌韧带远端在影像学上显示增厚,第二次随访检查时为36只(77%)。对于接受TPLO的犬,这些数字分别为57只(97%)和54只(92%)。TTA组在首次和第二次随访检查之间髌韧带厚度有显著下降,而TPLO组没有。TTA术后平均±标准差PLA为89.46±5.54°,与术前PLA的平均差值为11.86±5.3°;TPLO术后平均TPA为12.61±4.03°,与术前TPA的平均差值为16.74±7.13°。
结论及临床意义 犬接受TPLO和TTA后均出现髌韧带增厚。这种增厚的临床意义尚不清楚。