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对接受双侧骨盆截骨术治疗的髋关节发育不良幼犬进行中长期影像学证实的结果评估。

Assessment of the medium- to long-term radiographically confirmed outcome for juvenile dogs with hip dysplasia treated with double pelvic osteotomy.

作者信息

Jenkins Paul L, James Daniel R, White Joanna D, Black Anthony P, Fearnside Stephen M, Marchevsky Andrew M, Miller Amanda J, Cashmore Ricky G

机构信息

Surgery Department, Small Animal Specialist Hospital, Sydney, New South Wales, Australia.

Medicine Department, Small Animal Specialist Hospital, Sydney, New South Wales, Australia.

出版信息

Vet Surg. 2020 May;49(4):685-693. doi: 10.1111/vsu.13404. Epub 2020 Mar 14.

Abstract

OBJECTIVE

To assess the medium- to long-term radiographically confirmed outcomes in juvenile dogs with hip dysplasia (HD) that did and did not undergo double pelvic osteotomy (DPO).

STUDY DESIGN

Retrospective case-controlled.

ANIMALS

Twenty-six dogs with HD that were candidates for DPO; 22 dogs underwent DPO (16 bilateral, six unilateral); four dogs did not.

METHODS

Initial and follow-up radiographs of DPO candidates (2011-2017) that did and did not undergo surgery were reviewed, and the British Veterinary Association and Kennel Club Hip Dysplasia Scheme score (BVA-HD), osteoarthritis score (OAS) and laxity index score (LI) were determined. Baseline and follow-up BVA-HD, OAS, and change in radiographically confirmed scores were compared by using analysis of variance for correlated samples.

RESULTS

There was no significant difference in BVA-HD or OAS between surgically treated and nonsurgically treated cohorts at baseline. Follow-up radiographs (median, 49 months) revealed that most (34/38) hips had a BVA-HD ≤10 after DPO, while four of eight hips from the nonsurgical cohort had BVA-HD >10. Follow-up BVA-HD and OAS were lower in hips after surgery (BVA-HD median 2.15, interquartile range [Q1-Q3] 1.3-4.1; OAS median 1.9, Q1-Q3 1.1-4.1) compared with the nonsurgically treated cohort (BVA-HD median 11.4, Q1-Q3 8.1-17.5, P < .01; OAS median 7.0, Q1-Q3 5.1-13.4, P < .01). Seven hips with an LI >1 had no radiographically confirmed progression of osteoarthritis after DPO.

CONCLUSION

Double pelvic osteotomy prevented radiographically confirmed progression of osteoarthritis in the medium- to long-term. Laxity index score > 1 was not a contraindication for DPO in this study.

CLINICAL SIGNIFICANCE

Double pelvic osteotomy prevents progression of radiographically confirmed features of osteoarthritis in juvenile dogs with HD.

摘要

目的

评估接受和未接受双骨盆截骨术(DPO)的患有髋关节发育不良(HD)的幼年犬的中长期影像学确诊结果。

研究设计

回顾性病例对照研究。

动物

26只患有HD且适合进行DPO的犬;22只犬接受了DPO(16只双侧,6只单侧);4只犬未接受。

方法

回顾了2011年至2017年期间适合进行DPO且接受和未接受手术的犬的初始和随访X光片,并确定了英国兽医协会和养犬俱乐部髋关节发育不良评估系统评分(BVA-HD)、骨关节炎评分(OAS)和松弛指数评分(LI)。使用相关样本的方差分析比较基线和随访时的BVA-HD、OAS以及影像学确诊评分的变化。

结果

在基线时,手术治疗组和非手术治疗组之间的BVA-HD或OAS没有显著差异。随访X光片(中位时间为49个月)显示,大多数(34/38)髋关节在DPO后BVA-HD≤10,而非手术组的8个髋关节中有4个BVA-HD>10。与非手术治疗组相比,手术后髋关节的随访BVA-HD和OAS较低(BVA-HD中位值2.15,四分位间距[Q1-Q3] 1.3-4.1;OAS中位值1.9,Q1-Q3 1.1-4.1)(BVA-HD中位值11.4,Q1-Q3 8.1-17.5,P<.01;OAS中位值7.0,Q1-Q3 5.1-13.4,P<.01)。7个LI>1的髋关节在DPO后没有影像学确诊的骨关节炎进展。

结论

双骨盆截骨术在中长期可预防影像学确诊的骨关节炎进展。在本研究中,松弛指数评分>1并非DPO的禁忌证。

临床意义

双骨盆截骨术可预防患有HD的幼年犬影像学确诊的骨关节炎特征的进展。

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