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改良 Cheli 颅外侧入路微创治疗犬肩骨关节软骨病:技术描述及 164 例疗效分析。

A Modification of the Cheli Craniolateral Approach for Minimally Invasive Treatment of Osteochondritis Dissecans of the Shoulder in Dogs: Description of the Technique and Outcome in 164 Cases.

机构信息

Clinica Veterinaria Vezzoni, Cremona, Italy.

CeDIS Innovet, Innovet Italia, Saccolongo, Padova, Italy.

出版信息

Vet Comp Orthop Traumatol. 2021 Mar;34(2):130-136. doi: 10.1055/s-0040-1719090. Epub 2020 Nov 24.

Abstract

OBJECTIVE

The aim of this study was to describe a novel minimally invasive surgical approach for the treatment of shoulder osteochondritis dissecans (OCD) in dogs and to retrospectively review our clinical cases treated with this approach.

STUDY DESIGN

The study describes a modification of Cheli surgical approach (1985), developed to reduce the degree of invasiveness as well as the incidence of postoperative complications observed in other surgical approaches to the shoulder joint. Medical records of dogs that underwent our minimally invasive approach to the scapulohumeral joint for treatment of OCD from May 2001 to May 2019 were retrospectively reviewed for intraoperative findings and complications. Clinical outcome and complications were also evaluated in the operated dogs with a minimum of a 2-month-follow-up evaluation.

RESULTS

A total of 164 shoulders in 141 dogs (23 bilateral), 103 males and 38 females, were examined and treated with our modified craniolateral approach for the treatment of OCD of the humeral head. In all cases, the modified craniolateral approach allowed visibility and adequate exposure of the caudal humeral head surface. Radiographic and clinical follow-up evaluations were available in 123/164 (75%) cases. The clinical outcome was consistent with other reports using different surgical approaches for OCD lesions of the humeral head in dogs.

CLINICAL SIGNIFICANCE

This technique provided a reliable approach for surgical treatment of canine shoulder OCD and can be considered a valid alternative to other surgical approaches including arthroscopy.

摘要

目的

本研究旨在描述一种治疗犬肩袖骨软骨炎(OCD)的新型微创外科手术方法,并回顾性分析我们采用该方法治疗的临床病例。

研究设计

本研究描述了 Cheli 手术入路(1985 年)的改良,旨在降低肩关节其他手术入路的侵袭程度和术后并发症发生率。回顾性分析 2001 年 5 月至 2019 年 5 月期间采用微创肩胛骨肱骨关节入路治疗 OCD 的犬的术中发现和并发症的医学记录。对至少进行 2 个月随访评估的手术犬进行临床效果和并发症评估。

结果

共检查和治疗了 141 只犬的 164 个肩关节(23 个双侧),103 只为雄性,38 只为雌性,采用改良的颅外侧入路治疗肱骨头 OCD。在所有病例中,改良的颅外侧入路都能清晰地暴露肱骨头的尾侧表面。123/164(75%)例可进行影像学和临床随访评估。临床效果与其他采用不同手术方法治疗犬肱骨头 OCD 病变的报告一致。

临床意义

该技术为犬肩袖 OCD 的手术治疗提供了一种可靠的方法,可作为包括关节镜在内的其他手术方法的有效替代方法。

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