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犬前十字韧带断裂行胫骨结节移位和胫骨平台抬高截骨术后的继发半月板撕裂:一项体内实验研究。

Subsequent meniscal tears following tibial tuberosity advancement and tibial plateau leveling osteotomy in dogs with cranial cruciate ligament deficiency: An in vivo experimental study.

机构信息

Department of Veterinary Surgery, College of Veterinary Medicine, Chungnam National University, Daejeon, Republic of Korea.

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, Florida, USA.

出版信息

Vet Surg. 2021 Jul;50(5):966-974. doi: 10.1111/vsu.13648. Epub 2021 Apr 29.

DOI:10.1111/vsu.13648
PMID:33928658
Abstract

OBJECTIVE

To evaluate the short- and mid-term effects of tibial tuberosity advancement (TTA) and tibial plateau leveling osteotomy (TPLO) on subsequent meniscal tears.

STUDY DESIGN

Experimental in vivo study.

ANIMALS

Purpose-bred beagle dogs (n = 15).

METHODS

For each dog, the cranial cruciate ligaments were transected; one limb underwent TTA and the other limb underwent TPLO. Orthopedic and radiographic examinations were performed preoperatively and at 12 and 32 weeks postoperatively. Gross evaluation of the stifle joint was performed after euthanasia at 12 (n = 10) and 32 (n = 5) weeks.

RESULTS

Lameness scores were not different between TTA and TPLO limbs at any time point. Radiographic osteoarthritis scores of TTA stifles (1.33 ± 0.49) were higher than TPLO stifles (0.67 ± 0.49) (p = .002) at 12 weeks postoperatively, but there was no difference between groups at 32 weeks postoperatively. Subsequent medial meniscal tears occurred in 6/10 TTA stifles, and 0/10 TPLO stifles at 12 weeks postoperatively and in 5/5 TTA stifles, and 1/5 TPLO stifles at 32 weeks postoperatively. Subsequent lateral meniscal tears occurred in 4/5 TTA stifles at 32 weeks postoperatively. Medial meniscal total gross pathology score was higher in TTA than TPLO stifles. TTA stifles had more articular cartilage damage when compared with TPLO stifles at 32 weeks postoperatively.

CONCLUSION

In this within-dog experimental comparison, subsequent medial meniscal tears and cartilage injury was more prevalent following TTA when compared to TPLO.

CLINICAL SIGNIFICANCE

In an experimental model, TPLO protects the medial meniscus and articular cartilage better than TTA in stifles with complete cranial cruciate ligament deficiency.

摘要

目的

评估胫骨结节移位术(TTA)和胫骨平台楔形截骨术(TPLO)对随后半月板撕裂的短期和中期效果。

研究设计

体内实验研究。

动物

实验用比格犬(n=15)。

方法

每只狗的前十字韧带均被切断;一条腿接受 TTA,另一条腿接受 TPLO。术前及术后 12 周和 32 周进行矫形和放射学检查。术后 12 周(n=10)和 32 周(n=5)处死时对膝关节进行大体评估。

结果

TTA 组和 TPLO 组在任何时间点的跛行评分均无差异。术后 12 周时,TTA 膝关节的放射学骨关节炎评分(1.33±0.49)高于 TPLO 膝关节(0.67±0.49)(p=0.002),但术后 32 周时两组无差异。术后 12 周时,TTA 组的 10 个膝关节中有 6 个发生内侧半月板撕裂,TPLO 组的 10 个膝关节中无撕裂;术后 32 周时,TTA 组的 5 个膝关节中有 5 个发生内侧半月板撕裂,TPLO 组的 5 个膝关节中有 1 个发生撕裂。术后 32 周时,TTA 组的 5 个膝关节中有 4 个发生外侧半月板撕裂。TTA 组的内侧半月板总大体病理评分高于 TPLO 组。术后 32 周时,TTA 组的关节软骨损伤较 TPLO 组更严重。

结论

在这项同犬实验比较中,与 TPLO 相比,TTA 后更常见内侧半月板撕裂和软骨损伤。

临床意义

在实验模型中,与 TTA 相比,TPLO 更能保护完全前十字韧带缺失的膝关节中的内侧半月板和关节软骨。

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