Renwick S Michelle, Renwick Alasdair I, Brodbelt David C, Ferguson John, Abreu Humberto
East Neuk Veterinary Clinic, St Monans, United Kingdom.
Royal Veterinary College, North Mymms, United Kingdom.
Vet Surg. 2018 May;47(4):507-515. doi: 10.1111/vsu.12794. Epub 2018 Apr 26.
To determine the effects of low-level laser therapy (LLLT) on clinical outcomes in dogs with cranial cruciate ligament disease treated with tibial plateau leveling osteotomy (TPLO).
Randomized, placebo-controlled clinical trial. Owners and surgeons (care providers and assessors) were masked.
Ninety-five dogs were admitted for TPLO and assigned to 1 of 2 groups, laser group (LG; n = 51) or placebo group (PG; n = 44).
Three treatments (laser or placebo) were administered within a 4-day perioperative period. A fourth treatment was recommended and was accepted in 28.4% of cases (LG, n = 14; PG, n = 13). Dogs in the LG group received laser at wavelengths 660 nm red (100 mW) and at 800, 905 and 970 nm infrared (maximum 15 W continuous wave, 20 W peak pulsed wave), administered simultaneously. Dogs in the PG group received placebo laser (660 nm, 4 mW). Other treatments were identical. Outcomes were measured by difference in clinical metrology instruments (Liverpool Osteoarthritis in Dogs and adjusted Canine Orthopedic Index [COI]), osteotomy healing on a radiographic scale, time to cessation of nonsteroidal anti-inflammatory drug administration, and wound healing by owner questionnaire.
The only difference detected between groups consisted of a greater improvement in the gait section of the adjusted COI (ACOI) in the LG group (median [interquartile range; IQR] = 6 [4-7.5]) compared with the PG group (median [IQR] = 4 [2-6]; P < .05).
The laser protocol used in this study was associated with a greater improvement in ACOI gait in dogs treated with TPLO but did not improve any other clinical metrology instrument scores or bone healing.
This study provides some evidence that LLLT may improve the gait of dogs recovering from a TPLO, as assessed by owners.
确定低强度激光疗法(LLLT)对接受胫骨平台水平截骨术(TPLO)治疗的颅交叉韧带疾病犬临床结局的影响。
随机、安慰剂对照临床试验。主人和外科医生(护理提供者和评估者)均处于盲态。
95只犬因TPLO入院,并被分配到2组中的1组,激光组(LG;n = 51)或安慰剂组(PG;n = 44)。
在围手术期4天内进行3次治疗(激光或安慰剂)。推荐进行第4次治疗,28.4%的病例接受了该治疗(LG组,n = 14;PG组,n = 13)。LG组的犬同时接受波长660 nm红色激光(100 mW)以及800、905和970 nm红外激光(最大连续波15 W,峰值脉冲波20 W)。PG组的犬接受安慰剂激光(660 nm,4 mW)。其他治疗相同。通过临床计量仪器(犬类利物浦骨关节炎和调整后的犬类骨科指数[COI])的差异、X线片评估截骨愈合情况、停止使用非甾体抗炎药的时间以及通过主人问卷评估伤口愈合情况来衡量结局。
两组之间检测到的唯一差异是,与PG组(中位数[四分位间距;IQR] = 4 [2 - 6])相比,LG组调整后的COI(ACOI)步态部分改善更大(中位数[IQR] = 6 [4 - 7.5];P <.05)。
本研究中使用的激光方案与接受TPLO治疗的犬ACOI步态改善更大有关,但未改善任何其他临床计量仪器评分或骨愈合情况。
本研究提供了一些证据,表明经主人评估,LLLT可能改善从TPLO恢复的犬的步态。