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肱骨近端骨软骨病行外科清创术治疗的犬的长期疗效。

Long-term outcome of dogs treated by surgical debridement of proximal humeral osteochondrosis.

机构信息

Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Ohio State University, Columbus, Ohio, USA.

Bark City Veterinary Specialists, Park City, Utah, USA.

出版信息

Vet Surg. 2023 Aug;52(6):810-819. doi: 10.1111/vsu.13866. Epub 2022 Sep 10.

DOI:10.1111/vsu.13866
PMID:36086929
Abstract

OBJECTIVE

To evaluate long-term clinical outcomes of dogs surgically treated for proximal humeral osteochondrosis (OC).

STUDY DESIGN

Cross-sectional study.

SAMPLE POPULATION

Twenty dogs (n = 26 shoulders).

METHODS

Dogs treated with surgical debridement of proximal humeral OC lesions >12 months prior were enrolled. Orthopedic examination (including limb circumference and shoulder goniometry), kinetic gait analysis, shoulder radiographs, shoulder computed tomography (CT), and shoulder arthroscopy were performed. All owners completed a dog mobility questionnaire.

RESULTS

Brachial circumference (P = .003) and maximum shoulder extension (P = .013) were decreased and maximum shoulder flexion (P = .008) was increased (ie less flexion) in the OC limb versus the contralateral limb in unilaterally affected dogs. There were no differences in peak vertical force and vertical impulse between affected and unaffected limbs. Dogs demonstrated a 4.4% decrease in load distributed to the operated limb. Osteoarthritis was present in all shoulders treated for OC lesions. The degree of osteoarthritis in OC-affected shoulders was increased compared to the contralateral limb as evaluated on CT (P = .005) and radiography (P = .0001) in unilaterally affected cases. Moderate-to-severe synovitis was seen in all OC-affected joints. Arthroscopically, all lesions were noted to have patchy, incomplete cartilaginous infilling. Median of aggregate Liverpool Osteoarthritis in Dogs (LOAD) scores was 6.

CONCLUSION

All dogs exhibited ipsilateral muscle atrophy and progressive osteoarthritis, with most dogs exhibiting subtle lameness on the subjective gait examination. Despite this, owner-perceived mobility was satisfactory.

CLINICAL SIGNIFICANCE

Progression of joint disease over time should be expected; however, the abnormalities detected on examination appear to be of questionable clinical relevance.

摘要

目的

评估手术治疗肱骨近端骨软骨病(OC)犬的长期临床疗效。

研究设计

横断面研究。

样本人群

20 只犬(n=26 肩)。

方法

纳入肱骨近端 OC 病变手术清创治疗>12 个月的犬。进行骨科检查(包括肢体周长和肩角测量)、运动步态分析、肩部 X 线片、肩部计算机断层扫描(CT)和肩部关节镜检查。所有主人都完成了犬移动性问卷。

结果

在单侧受影响的犬中,OC 肢体的臂围(P=0.003)和最大肩伸展(P=0.013)减小,最大肩屈曲(P=0.008)增加(即屈曲减少)。受影响和未受影响肢体之间的最大垂直力和垂直冲量没有差异。犬患肢负重减少了 4.4%。所有接受 OC 病变治疗的肩部均存在骨关节炎。与对侧肢体相比,OC 受累肩的 CT(P=0.005)和 X 线(P=0.0001)评估的骨关节炎程度增加。所有 OC 受累关节均可见中度至重度滑膜炎。关节镜下,所有病变均表现为斑片状、不完全的软骨填充。汇总利物浦犬骨关节炎(LOAD)评分中位数为 6。

结论

所有犬均出现同侧肌肉萎缩和进行性骨关节炎,大多数犬在主观步态检查中表现出轻微跛行。尽管如此,主人对犬的移动性仍感到满意。

临床意义

随着时间的推移,应预计关节疾病会进展;然而,检查中发现的异常似乎具有可疑的临床意义。

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