Department of Veterinary Medical Sciences, School of Agriculture and Veterinary Medicine, Alma Mater Studiorum, University of Bologna, Ozzano Emilia, Bologna, Italy.
PLoS One. 2019 Aug 6;14(8):e0219849. doi: 10.1371/journal.pone.0219849. eCollection 2019.
The present retrospective study evaluated the progression of osteoarthritis in stifle joints based on the radiographic grade of osteoarthritis (OA) scored in dogs with cranial cruciate ligament rupture. The aim of the study was to search for a correlation between the stage of radiographic osteoarthritis prior to surgery and the osteoarthritis progression occurring after the tibial tuberosity advancement (TTA) procedure. It was hypothesized that the procedure carried out in dogs in the early stages of OA could reduce the OA changes. A total of 190 X-ray images obtained from the medical records of 38 dogs were evaluated. The radiographic signs of osteoarthritis of 38 stifle joints were scored from 0 to 3 in 10 specific anatomic locations. The radiographs were divided into 4 groups based on the global scores: A) no-OA, B) mild-OA, C) moderate-OA, D) severe-OA; they were assessed prior to surgery, and 1, 2, 3 and 6 months post-operatively (T0, T1, T2, T3 and T6). There were no differences in osteoarthritis progression in Groups A and C at any time. Osteoarthritis changes from T0 to T6 were statistically significant in Group B. The OA changes in the anatomic locations were investigated. The most common anatomic sites for OA changes were the patella apex, the proximal and distal trochlear ridges, and the caudal aspect of the tibial plateau assessed before surgery. After surgery, the score increased in the first three locations in 10, 9 and 11 joints, respectively; instead, the progression of osteoarthritis in the caudal aspect of the tibial plateau occurred in 23 out of 38 stifle joints. The results indicated that the TTA procedure could be effective in slowing down the OA progression when carried out in the absence of or in the early stages of disease. Therefore, an early intervention may be suggested in clinical practice to obtain minimal or no progression 6 months postoperatively.
本回顾性研究基于患有十字韧带断裂犬的放射学关节炎（OA）分级评估膝关节的骨关节炎进展。研究目的是寻找术前放射学 OA 分期与胫骨结节前移（TTA）术后骨关节炎进展之间的相关性。假设在 OA 早期阶段对犬进行手术可以减少 OA 变化。共评估了 38 只犬的病历中的 190 张 X 射线图像。38 个膝关节的 OA 放射学征象在 10 个特定解剖部位从 0 到 3 分级。根据整体评分将 X 射线分为 4 组：A）无 OA、B）轻度 OA、C）中度 OA、D）重度 OA；在术前以及术后 1、2、3 和 6 个月（T0、T1、T2、T3 和 T6）评估。在任何时间，A 组和 C 组的 OA 进展均无差异。B 组从 T0 到 T6 的 OA 变化具有统计学意义。研究了各解剖部位的 OA 变化。术前最常见的 OA 变化解剖部位是髌骨尖、滑车嵴近端和远端以及胫骨平台的后侧面。手术后，10、9 和 11 个关节中前三个部位的评分分别增加；相反，38 个膝关节中有 23 个出现胫骨平台后侧面的 OA 进展。结果表明，当在无疾病或疾病早期进行 TTA 手术时，该手术可能会有效减缓 OA 进展。因此，在临床实践中可能建议早期干预，以获得术后 6 个月最小或无进展。
