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体重50公斤及以上的超大型和巨型犬胫骨结节前移术与胫骨平台平整截骨术后并发症的比较

Comparison of complications following tibial tuberosity advancement and tibial plateau levelling osteotomy in very large and giant dogs 50 kg or more in body weight.

作者信息

Hans Eric C, Barnhart Matthew D, Kennedy Shawn C, Naber Steven J

机构信息

Eric C. Hans DVM, MedVet Medical and Cancer Center for Pets, 300 E. Wilson Bridge Rd, Worthington, OH, 43035, United States, Phone: +1 614 846 5800, Fax: +1 614 846 5803, E-mail:

出版信息

Vet Comp Orthop Traumatol. 2017 Jul 20;30(4):299-305. doi: 10.3415/VCOT-16-07-0106. Epub 2017 Jun 21.

Abstract

OBJECTIVES

To analyse and compare major complications in dogs ≥50 kg undergoing tibial tuberosity advancement (TTA) or tibial plateau levelling osteotomy (TPLO) for treatment of cranial cruciate ligament disease.

METHODS

Medical records and radiographs of client-owned dogs (≥50 kg) treated for cranial cruciate ligament disease with either TTA or TPLO between January 2011 and November 2015 were reviewed. Ninety-one TTA cases and 54 TPLO cases met the study inclusion criteria. All complications within one year of surgery were recorded. Major complications were those requiring surgical revision or intervening medical therapy to resolve. Logistic regression analysis evaluated for associations with major complication occurrence. Major complications were statistically compared between TTA and TPLO treatment groups.

RESULTS

Incidence of major complications following TTA and TPLO surgery were 19.8% and 27.8%, respectively. Surgical site infection (SSI) was the single most common major complication following both TTA (15.4%) and TPLO (25.9%) surgery. There were no significant differences between TTA and TPLO treatment regarding the rate of SSI, surgical revision, or overall occurrence of major complications. Postoperative antibiotic therapy significantly reduced the risk of a major complication in all dogs ≥50 kg (p = 0.015; OR: 0.201: 95%CI: 0.055-0.737).

CLINICAL SIGNIFICANCE

Major complications occurred frequently following TTA and TPLO treatment of cranial cruciate ligament disease in dogs ≥50 kg. The increased chance for SSI should be considered and postoperative antibiotic therapy is recommended.

摘要

目的

分析并比较体重≥50 kg的犬接受胫骨结节前移术(TTA)或胫骨平台水平截骨术(TPLO)治疗前交叉韧带疾病的主要并发症。

方法

回顾2011年1月至2015年11月期间接受TTA或TPLO治疗前交叉韧带疾病的客户拥有犬(体重≥50 kg)的病历和X光片。91例TTA病例和54例TPLO病例符合研究纳入标准。记录手术一年内的所有并发症。主要并发症是那些需要手术翻修或介入性药物治疗才能解决的并发症。逻辑回归分析评估与主要并发症发生的关联。对TTA和TPLO治疗组之间的主要并发症进行统计学比较。

结果

TTA和TPLO手术后主要并发症的发生率分别为19.8%和27.8%。手术部位感染(SSI)是TTA(15.4%)和TPLO(25.9%)手术后最常见的单一主要并发症。TTA和TPLO治疗在SSI发生率、手术翻修率或主要并发症的总体发生率方面没有显著差异。术后抗生素治疗显著降低了所有体重≥50 kg犬发生主要并发症的风险(p = 0.015;OR:0.201:95%CI:0.055 - 0.737)。

临床意义

体重≥50 kg的犬接受TTA和TPLO治疗前交叉韧带疾病后主要并发症频繁发生。应考虑SSI增加的可能性,并建议术后使用抗生素治疗。

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