Costa Mario, Craig Diane, Cambridge Tony, Sebestyen Peter, Su Yuhua, Fahie Maria A
Western University of Health Sciences, College of Veterinary Medicine, Pomona, California.
Veterinary Surgical Specialists, Tustin, California.
Vet Surg. 2017 May;46(4):494-500. doi: 10.1111/vsu.12649. Epub 2017 Mar 31.
To report major postoperative complications in 1613 dogs with tibial tuberosity advancement (TTA).
Retrospective case series.
Dogs (n = 1613) with cranial cruciate ligament deficiency treated with TTA.
Medical records of TTAs performed between December 2007-2013 were reviewed for age, sex, weight, contralateral stifle surgery, surgical approach, duration of preoperative lameness, presence of meniscal damage, concurrent patellar luxation and simultaneous bilateral TTA. Major postoperative complications were defined as surgical site infection (SSI) (superficial, deep, or organ/space), implant failure, fracture, patellar luxation, and meniscal tear.
Major complications were recorded in 13.4% of cases. Superficial SSI (incisional irritation) was diagnosed in 6.9% cases, requiring only antimicrobial therapy. Other complications included postliminary medial meniscal tear (2% incidence), deep SSI (incisional dehiscence, 1.1%), implant failure (1%), patellar luxation (1.2%), fracture (0.9%), and organ/space SSI (septic arthritis, 0.4%). Dogs with normal menisci were less likely to develop postliminary meniscal tears if the medial meniscus was released at the time of TTA (P < .0001). No association was detected between recorded parameters and complications, although dogs >8 years old approached significance (P = .05) in terms of predisposition to major complications.
Major complications after TTA are uncommon, even in dogs with concurrent patellar luxation or bilateral simultaneous procedures. In spite of its morbidity, medial meniscal release may prevent postliminary meniscal tears.
报告1613例接受胫骨结节前移术（TTA）的犬术后主要并发症情况。
回顾性病例系列研究。
接受TTA治疗的前交叉韧带损伤犬（n = 1613）。
回顾2007年12月至2013年期间进行TTA手术的病历，记录动物的年龄、性别、体重、对侧膝关节手术情况、手术入路、术前跛行持续时间、半月板损伤情况、并发髌骨脱位以及同期双侧TTA情况。术后主要并发症定义为手术部位感染（SSI）（浅表、深部或器官/腔隙感染）、植入物失败、骨折、髌骨脱位和半月板撕裂。
13.4%的病例出现主要并发症。6.9%的病例诊断为浅表SSI（切口刺激），仅需抗菌治疗。其他并发症包括术后内侧半月板撕裂（发生率2%）、深部SSI（切口裂开，1.1%）、植入物失败（1%）、髌骨脱位（1.2%）、骨折（0.9%）和器官/腔隙SSI（化脓性关节炎, 0.4%）。如果在TTA手术时松解内侧半月板，半月板正常的犬发生术后半月板撕裂的可能性较小（P < 0.0001）。尽管8岁以上犬在发生主要并发症的易感性方面接近显著性水平（P = 0.05），但未发现记录的参数与并发症之间存在关联。
TTA术后主要并发症并不常见，即使是并发髌骨脱位或同期进行双侧手术的犬。尽管内侧半月板松解存在一定发病率，但可能预防术后半月板撕裂。
