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评估一种新方法,该方法用于确定在犬类中采用改良Maquet技术将髌腱-胫骨平台角减小至90°所需的胫骨结节前移距离。

Evaluation of a new method to determine the tibial tuberosity advancement distance required to reduce the patellar tendon-tibial plateau angle to 90° with the modified Maquet technique in dogs.

作者信息

Pillard Paul, Livet Veronique, Cabon Quentin, Bismuth Camille, Sonet Juliette, Remy Denise, Fau Didier, Carozzo Claude, Viguier Eric, Cachon Thibaut

出版信息

Am J Vet Res. 2017 Apr;78(4):517-528. doi: 10.2460/ajvr.78.4.517.

Abstract

OBJECTIVE To assess use of a new radiographic method to determine the distance by which the tibial tuberosity should be advanced to reduce the patellar tendon-tibial plateau angle (PTA) to 90° by means of the modified Maquet technique (MMT) in dogs. SAMPLE 24 pelvic limbs from 12 adult medium-sized to large-breed canine cadavers. PROCEDURES Radiographs of stifle joints at 135° extension in true lateral position were used to determine tibial tuberosity advancement distances for use in the MMT. A method was devised to incorporate the planned osteotomy axis; distal patellar translations of 0, 3, 5, or 10 mm; and advancement cage implant application level along the osteotomy site in advancement planning measurements. Concordance correlation coefficients (CCCs) were calculated to compare these adjusted advancement measurements with true advancement measurements obtained for the same joints in another study after treatment by MMT. Intraobserver, interobserver, and total agreement for selected measurements were determined by assessment of CCCs for results obtained by 3 blinded observers. RESULTS Agreement between true advancement measurements and measurements obtained with osteotomy axis and cage position method calculations that incorporated a 5-mm distal patellar translation distance was excellent (CCC, 0.96). Intraobserver and interobserver agreements for the planning measurements evaluated were good to excellent (CCC, 0.83 to 0.96). CONCLUSIONS AND CLINICAL RELEVANCE Results suggested that the osteotomy axis and cage position method incorporating a 5-mm distal patellar translation distance has the potential to improve success rates for achieving a PTA of 90° in medium-sized to large-breed dogs undergoing MMT for treatment of cranial cruciate ligament rupture. Further research is warranted.

摘要

目的 评估一种新的影像学方法的应用,该方法通过改良Maquet技术(MMT)确定胫骨结节应前移的距离,以使犬的髌腱-胫骨平台角(PTA)减小至90°。样本 来自12只成年中型至大型犬尸体的24个后肢骨盆部肢体。程序 使用在真正侧位135°伸展位时的膝关节X线片来确定MMT中胫骨结节前移距离。设计了一种方法,将计划的截骨轴线、髌骨远端平移0、3、5或10 mm以及沿截骨部位的前移笼植入物应用水平纳入前移规划测量中。计算一致性相关系数(CCC),以将这些调整后的前移测量值与另一项研究中在同一关节经MMT治疗后获得的真实前移测量值进行比较。通过评估3名盲法观察者获得的结果的CCC,确定选定测量值的观察者内、观察者间和总体一致性。结果 真实前移测量值与结合5 mm髌骨远端平移距离的截骨轴线和笼位置方法计算得到的测量值之间的一致性极佳(CCC,0.96)。评估的规划测量值的观察者内和观察者间一致性良好至极佳(CCC,0.83至0.96)。结论及临床意义 结果表明,结合5 mm髌骨远端平移距离的截骨轴线和笼位置方法有可能提高接受MMT治疗颅前交叉韧带断裂的中型至大型犬实现90°PTA的成功率。有必要进行进一步研究。

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