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胫骨平台水平截骨术康复期常规影像学检查的临床价值评估

Evaluation of the clinical value of routine radiographic examination during convalescence for tibial plateau-leveling osteotomy.

作者信息

Olivencia-Morell Pedro J, Frederick Steven W, Forbes Jessica N, Cross Alan R

机构信息

BluePearl Specialty and Emergency Pet Hospital, Atlanta, Georgia, USA.

出版信息

Vet Surg. 2021 Nov;50(8):1644-1649. doi: 10.1111/vsu.13726. Epub 2021 Sep 19.

Abstract

OBJECTIVE

To determine how frequently routine follow-up radiographic findings would result in a change to the postoperative plan following tibial plateau-leveling osteotomy (TPLO) in dogs.

STUDY DESIGN

Retrospective study SAMPLE POPULATION: Short-term group: 100 cases; intermediate-term group: 50 cases.

METHODS

Medical records of 100 consecutive cases meeting the inclusion criteria were reviewed (the short-term group). The cases had no owner-perceived issues and underwent routinely prescribed radiographic follow up between 40 and 60 postoperative days after TPLO performed by one experienced surgeon. Complications identified on physical examination (PE) and radiographic examination (RE) were recorded, along with any changes to the postoperative plan. Medical records of 50 consecutive cases that had short-term and intermediate-term (≥180 days) REs and PEs were reviewed similarly (intermediate-term group).

RESULTS

Fifty-one cases in the short-term group had no complications on PE or RE. Forty-nine dogs were diagnosed with minor complications (patellar ligament desmitis, patella or fibula fracture, gait abnormalities): 42 on RE only; 6 on PE and RE; 1 on PE only. Exercise restriction was extended for 2 weeks in 2 cases with radiographic patellar ligament desmitis. Two cases in the intermediate-term group had minor complications at intermediate-term RE. No new PE or RE complications developed between short-term and intermediate-term evaluations.

CONCLUSION

At routine rechecks of dogs with no owner-perceived issues after TPLO, 49% had minor complications but only 2% were deemed significant enough to alter patient management. The likelihood of new radiographic complications developing after short-term evaluation is low.

CLINICAL SIGNIFICANCE

Routine radiographic recheck examinations rarely altered the postoperative plan in TPLO cases with unremarkable clinical recoveries.

摘要

目的

确定犬胫骨平台水平截骨术(TPLO)后,常规随访影像学检查结果导致术后计划改变的频率。

研究设计

回顾性研究

样本量

短期组100例;中期组50例。

方法

回顾了符合纳入标准的100例连续病例的病历(短期组)。这些病例没有主人察觉到的问题,在由一位经验丰富的外科医生进行TPLO术后40至60天接受常规规定的影像学随访。记录体格检查(PE)和影像学检查(RE)中发现的并发症,以及术后计划的任何改变。同样回顾了50例连续病例的病历,这些病例进行了短期和中期(≥180天)的RE和PE检查(中期组)。

结果

短期组中有51例在PE或RE上无并发症。49只犬被诊断为轻微并发症(髌韧带腱炎、髌骨或腓骨骨折、步态异常):仅RE发现42例;PE和RE均发现6例;仅PE发现1例。2例影像学诊断为髌韧带腱炎的病例运动限制延长了2周。中期组中有2例在中期RE时有轻微并发症。短期和中期评估之间未出现新的PE或RE并发症。

结论

在TPLO术后无主人察觉到问题的犬的常规复查中,49%有轻微并发症,但只有2%被认为严重到足以改变患者管理。短期评估后出现新的影像学并发症的可能性较低。

临床意义

在临床恢复情况不明显的TPLO病例中,常规影像学复查很少改变术后计划。

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