Vasquez Barbara, Hulse Don, Beale Brian, Kerwin Sharon, Andrews Chad, Saunders Brian W
Capital Area Veterinary Specialists, Austin, Texas.
Department Small Animal Medicine and Surgery, College Veterinary Medicine, Texas A&M University, College Station, Texas.
Vet Surg. 2018 Feb;47(2):261-266. doi: 10.1111/vsu.12708. Epub 2017 Sep 8.
To describe the arthroscopic appearance of intra-articular structures mid-term (9 months) and long-term (>12 months) after CORA-based leveling osteotomy (CBLO).
Case series.
Dogs (n = 41) with second-look arthroscopy of the stifle after CBLO for treatment of a cranial cruciate ligament (CCL) deficiency. Both stifles were re-evaluated (stifles n = 42) in 1 dog.
Medical records of dogs that had second-look arthroscopy after CBLO were reviewed. Arthroscopic images of the femoral condyles were independently reviewed. The surgical report documented the integrity of menisci and articular cartilage of the tibial plateaus.
The population included 7 stifles with stable partial CCL tears, 35 stifles with complete CCL tears (n = 28), or incompetent partial CCL tears (n = 7). Median time to second look arthroscopy was 16 months (9-24 months) for stable partial tears. The CCL remained intact in 6 stifles. The Outerbridge score of the articular cartilage of the femoral condyles was as 0 (6) or 1 (1). The articular cartilage of the tibial plateaus appeared normal in all stifles. Median time to second look arthroscopy of stifles with complete tears was 12 months (range, 9-34 months). The caudal cruciate ligament was normal or mildly fibrillated. The appearance of the articular cartilage of the femoral condyles was scored as 0 or near normal (grade 1-2) in all dogs. The articular cartilage of the tibial plateaus appeared normal, except in 1 dog with grade 4 lesion.
CBLO results in minimal to no change in articular cartilage in at a median time of 14 months after surgery. Postoperative clinical lameness is often attributed to late onset meniscal pathology.
描述基于髁上截骨术(CBLO)中期(9个月)和长期(>12个月)后关节内结构的关节镜表现。
病例系列。
因治疗颅侧十字韧带(CCL)缺损而接受CBLO后进行第二次关节镜检查的犬(n = 41)。1只犬的两个 stifle 均进行了重新评估(stifle n = 42)。
回顾了CBLO后进行第二次关节镜检查的犬的病历。对股骨髁的关节镜图像进行独立评估。手术报告记录了半月板和胫骨平台关节软骨的完整性。
该群体包括7个 stifle 有稳定的部分CCL撕裂,35个 stifle 有完全CCL撕裂(n = 28)或不完全部分CCL撕裂(n = 7)。稳定的部分撕裂进行第二次关节镜检查的中位时间为16个月(9 - 24个月)。6个 stifle 的CCL保持完整。股骨髁关节软骨的Outerbridge评分为0(6个)或1(1个)。所有 stifle 的胫骨平台关节软骨外观正常。完全撕裂的 stifle 进行第二次关节镜检查的中位时间为12个月(范围,9 - 34个月)。尾侧十字韧带正常或轻度纤维化。所有犬的股骨髁关节软骨外观评分为0或接近正常(1 - 2级)。除1只患有4级病变的犬外,胫骨平台关节软骨外观正常。
CBLO术后14个月中位时间时关节软骨变化极小或无变化。术后临床跛行常归因于晚期半月板病变。