Flesher Kathryn, Beale Brian S, Hudson Caleb C
Department of Surgery, Veterinary Specialists and Emergency Services, Rochester, New York, United States.
Department of Surgery, Gulf Coast Veterinary Specialists, Houston, Texas, United States.
Vet Comp Orthop Traumatol. 2019 Jan;32(1):26-32. doi: 10.1055/s-0038-1676296. Epub 2019 Jan 15.
The main aim of this article is to describe the technique and outcome of a modified tibial plateau levelling osteotomy (TPLO) that simultaneously levels the tibial plateau and realigns the quadriceps mechanism through medial translation of the proximal tibial segment in dogs less than 15 kg.
A retrospective medical records search identified dogs with concurrent cranial cruciate ligament rupture (CCLR) and medial patellar luxation (MPL). A study group (76 stifles) treated with a modified TPLO was compared with a non-tibial translation group (45 stifles) corrected with traditional surgical technique. Signalment, arthroscopic findings, adjunctive surgical procedures, osteotomy healing time and complications were recorded. Tibial plateau angle, proximal tibial segment medialization, width of the tibial osteotomy, mechanical medial proximal tibial angle and mechanical medial distal tibial angle were measured and recorded on preoperative and postoperative radiographs.
Overall complication rate was 18.4% in the treatment group and 28.9% in the non-tibial translation group. Reluxation occurred in 6.6% of cases in the study group and in 8.8% of cases in the non-tibial translation group. There was no statistical difference in healing time between groups.
A modified TPLO can be used to treat patients with concurrent MPL and CCLR with good clinical outcome. Complication rates are comparable to traditional repairs for MPL. No major differences were appreciated between study and a non-tibial translation groups for variables compared.
本文的主要目的是描述一种改良的胫骨平台水平截骨术(TPLO)的技术和结果,该手术通过对体重小于15kg犬的胫骨近端进行内侧移位,同时使胫骨平台水平并重新调整股四头肌机制。
通过回顾性医疗记录搜索,确定患有同时性颅交叉韧带断裂(CCLR)和内侧髌骨脱位(MPL)的犬。将接受改良TPLO治疗的研究组(76个 stifles)与采用传统手术技术矫正的非胫骨移位组(45个 stifles)进行比较。记录品种、关节镜检查结果、辅助手术程序、截骨愈合时间和并发症。在术前和术后X线片上测量并记录胫骨平台角、胫骨近端段内移、胫骨截骨宽度、机械性胫骨近端内侧角和机械性胫骨远端内侧角。
治疗组的总体并发症发生率为18.4%,非胫骨移位组为28.9%。研究组6.6%的病例发生再脱位,非胫骨移位组为8.8%。两组之间的愈合时间无统计学差异。
改良的TPLO可用于治疗同时患有MPL和CCLR的患者,临床效果良好。并发症发生率与MPL的传统修复相当。在比较的变量方面,研究组和非胫骨移位组之间未发现重大差异。