影像学检查结果对胫骨平台平整化截骨术后犬常规临床再评估时提出的建议的影响。
Influence of radiographic examination findings on recommendations made during routine clinical re-evaluation of dogs with uncomplicated tibial plateau leveling osteotomy.
机构信息
Highcroft Veterinary Referrals, Bristol, England.
Northwest Veterinary Specialists, Runcorn, England.
出版信息
Vet Surg. 2021 Jan;50(1):44-52. doi: 10.1111/vsu.13533. Epub 2020 Oct 21.
OBJECTIVE
To determine the influence of follow-up radiographic examination on recommendations made during routine clinical re-evaluation of dogs that had undergone uncomplicated tibial plateau leveling osteotomy (TPLO).
STUDY DESIGN
Retrospective multi-institutional case series.
ANIMALS
Client-owned dogs (N = 1010) that underwent uncomplicated TPLO.
METHODS
Records from 11 institutions were searched for dogs that had been treated with unilateral TPLO and had no history of postoperative complications before their routine follow-up examination. The frequency of change in further clinical recommendations resulting from client- or clinician-voiced concerns or radiographic abnormalities was investigated.
RESULTS
Follow-up evaluation was performed at a median of 6 (range, 4-15) weeks after TPLO. Radiographic examination findings contributed to a change in recommendations in 4.15% (38/915) of dogs presented without client concerns and without abnormalities at orthopedic examination. Abnormal radiographic findings alone influenced the management of 3.76% (38/1010) of dogs. An association was detected between clinical features and radiological findings leading to a change in recommendations (P < .0001). Administration of analgesia at the time of follow-up was associated with radiographic abnormalities (P = .017) and change in postoperative plans (P = .0007).
CONCLUSION
Radiographic examination findings at follow-up did not influence the management of most dogs with uncomplicated TPLO.
CLINICAL SIGNIFICANCE
Radiographic examination findings are unlikely to influence the treatment of dogs that seem to be recovering uneventfully from an uncomplicated TPLO without concerns from clients, analgesia, or abnormal findings on thorough orthopedic examination by a surgical specialist, at the time of the planned clinical re-evaluation.
目的
确定在对接受过简单胫骨平台平整截骨术(TPLO)的犬进行常规临床再评估时,进行后续影像学检查对建议的影响。
研究设计
回顾性多机构病例系列研究。
动物
接受过简单 TPLO 的患犬(N=1010)。
方法
搜索了 11 个机构的记录,以寻找接受过单侧 TPLO 治疗且在常规随访检查前无术后并发症史的犬。调查了由于患犬或临床医生提出的担忧或影像学异常而导致进一步临床建议改变的频率。
结果
TPLO 后中位 6(范围,4-15)周进行了随访评估。影像学检查结果导致在 4.15%(38/915)无患犬担忧且无骨科检查异常的犬中改变了建议。单独的异常影像学发现影响了 3.76%(38/1010)犬的管理。临床特征与影像学发现之间存在关联,导致了建议的改变(P<.0001)。在随访时给予镇痛与影像学异常(P=.017)和术后计划改变(P=.0007)相关。
结论
随访时的影像学检查结果并未影响大多数接受过简单 TPLO 的犬的管理。
临床意义
在无临床关切、镇痛或外科专家全面骨科检查异常的情况下,对于似乎从简单 TPLO 中恢复顺利且无并发症的犬,在计划的临床再评估时,影像学检查结果不太可能影响其治疗。