Franklin Samuel P, Stoker Aaron M, Murphy Sean M, Kowaleski Michael P, Gillick Mitchell, Kim Stanley E, Karlin Michael, Cross Alan, Cook James L
Colorado Canine Orthopedics and Rehab, Colorado Springs, CO, United States.
Thompson Laboratory for Regenerative Orthopaedics, University of Missouri, Columbia, MO, United States.
Front Vet Sci. 2021 Dec 24;8:759610. doi: 10.3389/fvets.2021.759610. eCollection 2021.
The purpose of this study was to retrospectively characterize outcomes and complications associated with osteochondral allograft transplantation for treating chondral and osteochondral lesions in a group of client-owned dogs with naturally-occurring disease. Records were reviewed for information on signalment, treated joint, underlying pathology (e.g., osteochondritis dissecans; OCD), and type, size, and number of grafts used. Complications were classified as "trivial" if no treatment was provided, "non-surgical" if non-surgical treatment were needed, "minor surgical" if a minor surgical procedure such as pin removal were needed but the graft survived and function was acceptable, or "major" if the graft failed and revision surgery were needed. Outcomes were classified as unacceptable, acceptable, or full function. Thirty-five joints in 33 dogs were treated including nine stifles with lateral femoral condyle (LFC) OCD and 10 stifles with medial femoral condyle (MFC) OCD treated with osteochondral cylinders or "plugs." There were 16 "complex" procedures of the shoulder, elbow, hip, stifle, and tarsus using custom-cut grafts. In total there were eight trivial complications, one non-surgical complication, two minor surgical complications, and five major complications for a total of 16/35 cases with complications. Accordingly, there were five cases with unacceptable outcomes, all of whom had major complications while the other 30 cases had successful outcomes. Of the 30 cases with successful outcomes, 15 had full function and 15 had acceptable function. Based on these subjective outcome assessments, it appears osteochondral allograft transplantation is a viable treatment option in dogs with focal or complex cartilage defects. However, no conclusions can be made regarding the inferiority or superiority of allograft transplantation in comparison to other treatment options based upon these data.
本研究的目的是回顾性地描述在一组患有自然发生疾病的客户拥有的犬中,同种异体骨软骨移植治疗软骨和骨软骨损伤的结果及并发症。回顾记录以获取有关信号、治疗关节、潜在病理(如剥脱性骨软骨炎;OCD)以及所用移植物的类型、大小和数量的信息。如果未进行治疗,并发症被分类为“轻微”;如果需要非手术治疗,则为“非手术”;如果需要诸如取出钢针等小手术,但移植物存活且功能可接受,则为“小手术”;如果移植物失败且需要翻修手术,则为“重大”。结果被分类为不可接受、可接受或完全功能。对33只犬的35个关节进行了治疗,其中包括9个外侧股骨髁(LFC)OCD的 stifles关节和10个内侧股骨髁(MFC)OCD的 stifles关节,采用骨软骨圆柱体或“栓子”进行治疗。使用定制切割移植物对肩部、肘部、髋部、 stifles关节和跗关节进行了16例“复杂”手术。总共有8例轻微并发症、1例非手术并发症、2例小手术并发症和5例重大并发症,总共16/35例出现并发症。因此,有5例结果不可接受,所有这些病例都有重大并发症,而其他30例结果成功。在30例成功的病例中,15例具有完全功能,15例功能可接受。基于这些主观结果评估,同种异体骨软骨移植似乎是患有局灶性或复杂性软骨缺损的犬的一种可行治疗选择。然而,根据这些数据,无法就同种异体移植与其他治疗选择相比的劣势或优势得出结论。