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关节内同种异体移植技术治疗犬自发性颅交叉韧带断裂的长期疗效

Long-term outcome of an intra-articular allograft technique for treatment of spontaneous cranial cruciate ligament rupture in the dog.

作者信息

Biskup Jeffery J, Balogh Daniel G, Scott Ruth M, Conzemius Michael G

机构信息

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, Tennessee.

Department of Veterinary Clinical Sciences and Clinical Investigation Center, University of Minnesota, St. Paul, Minnesota.

出版信息

Vet Surg. 2017 Jul;46(5):691-699. doi: 10.1111/vsu.12653. Epub 2017 Mar 31.

Abstract

OBJECTIVE

To determine the 12-month outcome in dogs with spontaneous cranial cruciate ligament (CCL) rupture after repair with an intra-articular decellularized allograft.

STUDY DESIGN

Prospective pilot case series.

ANIMALS

Ten client-owned dogs with unilateral CCL rupture.

METHODS

An intra-articular, decellularized, deep digital flexor tendon allograft was secured in the stifle with a femoral cross pin and tibial spiked washers and screws. An interference screw was placed in the tibial tunnel. Dogs were evaluated with an owner questionnaire, radiographs, and force platform gait analysis before and 2, 6, and 12 months after surgery.

RESULTS

Owners reported improvement in level of pain and mobility throughout the study, especially over the first 6 months. Peak vertical force and vertical impulse improved across all time points. Ground reaction force asymmetry index for peak vertical force and vertical impulse at 12 months showed 3 dogs within a normal index (<6%), 4 dogs as nonvisibly lame (6-20%), and 3 dogs as visibly lame (≥20%). For most dogs, osteoarthritis scoring did not change over the 12-month period and some femoral-tibial translation was detected on standing horizontal beam radiographs.

CONCLUSION

Intra-articular repair using a decellularized allograft can provide functional clinical outcomes in dogs with CCL disease. A better understanding of long-term engraftment after this procedure is needed.

摘要

目的

确定采用关节内脱细胞同种异体移植物修复的自发性颅交叉韧带(CCL)断裂犬的12个月预后情况。

研究设计

前瞻性试验病例系列。

动物

10只单侧CCL断裂的客户-owned犬。

方法

将关节内脱细胞的趾深屈肌腱同种异体移植物用股骨交叉销钉和胫骨带尖垫圈及螺钉固定在膝关节。在胫骨隧道内放置一枚干涉螺钉。在手术前以及术后2个月、6个月和12个月,通过主人问卷、X线片和测力平台步态分析对犬进行评估。

结果

主人报告在整个研究过程中,疼痛程度和活动能力有所改善,尤其是在最初的6个月。所有时间点的垂直峰值力和垂直冲量均有所改善。12个月时垂直峰值力和垂直冲量的地面反作用力不对称指数显示,3只犬的指数正常(<6%),4只犬为不可见跛行(6 - 20%),3只犬为可见跛行(≥20%)。对于大多数犬,骨关节炎评分在12个月期间没有变化,并且在站立水平梁X线片上检测到一些股胫平移。

结论

使用脱细胞同种异体移植物进行关节内修复可为患有CCL疾病的犬提供功能性临床结果。需要更好地了解该手术后的长期植入情况。

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