通过计算机断层扫描评估，比较自体松质骨移植和未移植自体松质骨的犬胫骨结节前移后的骨愈合情况。

Comparison of bone healing, as assessed by computed tomography, following tibial tuberosity advancement in dogs with and without autogenous cancellous bone grafts.

作者信息

James D R, Webster N, White J D, Marchevsky A M, Cashmore R G, Havlicek M, Fearnside S, Black A P

机构信息

a Surgery Department , Small Animal Specialist Hospital , Level 1/1 Richardson Place, North Ryde , NSW , Australia.

b Darkroom Veterinary Imaging , St Georges Crescent , Heatherton , Vic , Australia.

出版信息

N Z Vet J. 2017 Sep;65(5):270-276. doi: 10.1080/00480169.2017.1345336. Epub 2017 Jul 5.

DOI:10.1080/00480169.2017.1345336

PMID:28637394

Abstract

AIMS

To objectively compare measures of bone healing, using computed tomography (CT) in dogs following bilateral tibial tuberosity advancement (TTA), between tibiae treated with and without autogenous cancellous bone grafts.

METHODS

Ten dogs with bilateral cranial cruciate ligament disease requiring surgical stabilisation were prospectively recruited to undergo single-session bilateral TTA, with only one, randomly assigned, tibia receiving bone graft in the osteotomy deficit. Bone healing at the osteotomy site was assessed using CT performed 38-70 days post-operatively. CT images were evaluated using both objective measurements of osseous bridging and subjective evaluation by six radiologists. Repeated measures ANOVA was used to compare the objective outcomes between the grafted and non-grafted tibiae.

RESULTS

The mean percentage of the osteotomy deficit bridged at the lateral cortex was greater in grafted (77.6, SD 35.2%) compared to non-grafted (63.0, SD 36.5%) tibiae (p=0.001), but did not differ at the medial cortex (p=0.1). The mean minimum callus width was greater in grafted (7.2, SD 3.3 mm) compared to non-grafted (3.6, SD 2.9 mm) tibiae (p<0.001). There was no difference in mean attenuation (measured in Hounsfield units) of the callus between grafted and non-grafted tibiae (p=0.5). The grafted tibia was deemed to have superior bone healing in 50/60 subjective assessments made by radiologists.

CONCLUSIONS

Superior osseous bridging was detected by CT analysis following TTA using autogenous cancellous bone grafts compared with no graft. This was shown by greater bridging percentage at the lateral cortex and formation of a broader callus. Qualitative assessments made by six radiologists also supported the conclusion that bone healing was improved by use of autogenous cancellous bone graft. CT was a useful method for assessing evidence of bone healing following TTA.

CLINICAL RELEVANCE

These findings justify the application of autogenous cancellous bone graft to augment healing following TTA in dogs.

摘要

目的

使用计算机断层扫描（CT）客观比较双侧胫骨结节前移术（TTA）后犬只胫骨在使用和未使用自体松质骨移植情况下的骨愈合情况。

方法

前瞻性招募10只患有双侧颅交叉韧带疾病需要手术稳定的犬只，进行单次双侧TTA，仅一侧胫骨（随机分配）在截骨缺损处接受骨移植。术后38 - 70天使用CT评估截骨部位的骨愈合情况。CT图像通过骨桥接的客观测量以及6位放射科医生的主观评估进行评价。采用重复测量方差分析比较移植和未移植胫骨之间的客观结果。

结果

与未移植胫骨（63.0，标准差36.5%）相比，移植胫骨外侧皮质截骨缺损处的骨桥接平均百分比更高（77.6，标准差35.2%）（p = 0.001），但在内侧皮质无差异（p = 0.1）。与未移植胫骨（3.6，标准差2.9 mm）相比，移植胫骨的平均最小骨痂宽度更大（7.2，标准差3.3 mm）（p < 0.001）。移植和未移植胫骨的骨痂平均衰减（以亨氏单位测量）无差异（p = 0.5）。在放射科医生进行的60次主观评估中，50次认为移植胫骨的骨愈合更好。