Tikekar A, De Vicente F, McCormack A, Thomson D, Farrell M, Carmichael S, Chase D
Veterinary Specialists Auckland, Auckland, New Zealand.
Pride Veterinary Specialists, Derby, UK.
N Z Vet J. 2022 Jul;70(4):218-227. doi: 10.1080/00480169.2022.2052992. Epub 2022 Mar 30.
To compare short and long-term outcomes after tibial plateau levelling osteotomy (TPLO) and lateral fabello-tibial suture (LFTS) techniques for the management of cranial cruciate ligament disease in small dogs with high tibial plateau angles (TPA).
In this retrospective study, the medical records of two veterinary specialist practices in the United Kingdom were searched for dogs (<20 kg) that underwent TPLO or LFTS between 2000 and 2010, and had a preoperative radiographic TPA >30° with either short-term (6 weeks) and/or long-term (>3 months) follow-up data. Data collected at a 6-week post-surgical re-examination was derived from orthopaedic examination and radiographic assessment and included the incidence of major and minor complications and scoring of the short-term outcome. Long-term outcome was scored based on results of a subjective owner questionnaire and veterinary orthopaedic examination.
A total of 61 (84 stifles) dogs were included in the study: 24 (30 stilfes) and 37 (54 stifles) dogs underwent LFTS and TPLO, respectively. Long-term clinical outcome was different (p = 0.017) between groups; 15/15 stifles in the TPLO group had a good or excellent long-term clinical outcome, compared to 4/8 (50%) in the LFTS group. There was no evidence of a difference in short-term post-operative outcome or owner subjective long-term outcome between treatment groups.Stifles in the LFTS group were more likely (p = 0.027) to have palpable stifle pain at long-term follow-up. Owners reported that 5/16 (31.3%) dogs in the LFTS group required oral non-steroidal anti-inflammatory drug (NSAID) treatment at least monthly (4/5 required daily treatment), whereas no dogs in the TPLO group required treatment with NSAID more frequently than three times per year (p = 0.011).No correlation was found between short-term outcome and owner subjective long-term outcome but there was a positive correlation between short-term outcome and long-term clinical outcome.There was no evidence of a difference in overall major complication rates between treatment groups. The occurrence of complications was associated with heavier body weight at the time of surgery. No other variables were shown to be risk factors for complications.
Small breed dogs with high TPA that underwent TPLO had better long-term clinical outcomes and were less likely to require NSAID administration than those that underwent LFTS. The risk of complication increased with the weight of the dog at surgery. There was a positive correlation between short-term outcome and long-term clinical outcome.
比较胫骨平台水平截骨术（TPLO）和外侧腓肠肌-胫骨缝合术（LFTS）治疗高胫骨平台角（TPA）小型犬颅交叉韧带疾病的短期和长期疗效。
在这项回顾性研究中，检索了英国两家兽医专科诊所2000年至2010年间接受TPLO或LFTS治疗、术前放射学TPA>30°且有短期（6周）和/或长期（>3个月）随访数据的犬（<20 kg）的病历。术后6周复查收集的数据来自骨科检查和放射学评估，包括主要和次要并发症的发生率以及短期疗效评分。长期疗效根据主人主观问卷和兽医骨科检查结果进行评分。
共有61只（84个 stifles）犬纳入研究：分别有24只（30个 stifles）和37只（54个 stifles）犬接受了LFTS和TPLO。两组之间的长期临床疗效不同（p = 0.017）；TPLO组15/15个 stifles具有良好或优异的长期临床疗效，而LFTS组为4/8（50%）。治疗组之间术后短期疗效或主人主观长期疗效无差异证据。LFTS组的 stifles在长期随访时更有可能（p = 0.027）出现可触及的 stifle疼痛。主人报告LFTS组5/16（31.3%）的犬至少每月需要口服非甾体抗炎药（NSAID）治疗（4/5需要每日治疗），而TPLO组没有犬需要比每年三次更频繁的NSAID治疗（p = 0.011）。短期疗效与主人主观长期疗效之间未发现相关性，但短期疗效与长期临床疗效之间存在正相关。治疗组之间总体主要并发症发生率无差异证据。并发症的发生与手术时体重较重有关。未发现其他变量是并发症的危险因素。
接受TPLO治疗的高TPA小型犬比接受LFTS治疗的犬具有更好的长期临床疗效，且不太可能需要使用NSAID。并发症的风险随着手术时犬的体重增加而增加。短期疗效与长期临床疗效之间存在正相关。
