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关节镜治疗肱骨头滑车骨软骨病伴或不伴内侧冠状突疾病犬的长期疗效:23 例(2012-2020 年)。

Long-term outcomes after arthroscopic treatment of dogs affected by osteochondrosis dissecans of the humeral trochlea, with or without medial coronoid disease: 23 cases (2012-2020).

机构信息

Centre Hospitalier Vétérinaire Frégis, Arcueil, France (Lahiani, Le Boedec, Ragetly); Centre Hospitalier Vétérinaire Languedocia, Montpellier, France (Dunié-Mérigot); Clinique Vétérinaire AniCura TRIOVet, Rennes, France (Caron).

出版信息

Can J Vet Res. 2023 Jul;87(3):202-207.

Abstract

The objective of this study was to report long-term clinical and radiographic outcomes following arthroscopic reparative treatment - flap removal, curettage, and osteostixis of subchondral bone - in dogs with humeral trochlea osteochondritis dissecans (OCD). Dogs were included in this retrospective multicenter case series if they had a computed tomography diagnostic of humeral trochlear OCD, with or without medial coronoid disease, that was treated by arthroscopic reparative technique, and a detailed follow-up at least 6 mo postoperatively. The latter included a clinical examination, assessment of lameness, measurement of the brachial circumference and elbow amplitude, International Elbow Working Group (IEWG) radiographic score, owner-completed canine brief pain inventory (CBPI) score, and visual analogue scale (VAS) rating. A generalized linear model and tests for symmetry and marginal homogeneity were used to compare data. Twenty-three dogs (30 affected elbows) were included. Long-term (median: 22 mo; range: 6 to 98 mo) postoperative lameness, CBPI, VAS, joint distension, and pain scores were significantly improved compared with the preoperative values. Long-term postoperative range of motion and brachial circumference did not reveal any significant difference between OCD-affected and unaffected elbows. Long-term IEWG scores were similar to preoperative values in 56% of elbows and had progressed by 1 grade in 44%. Long-term complications included persistent Grade-1 lameness and occurred in 23% of dogs. Long-term outcomes based on lameness and CBPI scores were considered excellent in 67% of dogs, good in 27%, and intermediate in 6%. Arthroscopic treatment is thus a suitable surgical procedure for OCD of the humeral trochlea in dogs and provides good long-term results.

摘要

本研究的目的是报告关节镜下修复治疗 - 瓣切除、刮除和骨骨钉入骨软骨下骨 - 治疗犬肱桡滑车骨软骨炎(OCD)的长期临床和影像学结果。如果犬具有肱桡滑车 OCD 的计算机断层扫描诊断,无论是否伴有内侧冠状突疾病,都可以通过关节镜下修复技术进行治疗,并在至少 6 个月的术后进行详细随访,那么犬就可以被纳入本回顾性多中心病例系列研究。后者包括临床检查、跛行评估、臂围和肘屈伸幅度测量、国际肘工作组(IEWG)放射评分、主人完成的犬简明疼痛量表(CBPI)评分和视觉模拟评分(VAS)。使用广义线性模型和对称性和边缘同质性检验来比较数据。共纳入 23 只犬(30 个患病肘)。与术前相比,长期(中位数:22 个月;范围:6 至 98 个月)术后跛行、CBPI、VAS、关节肿胀和疼痛评分均显著改善。长期术后运动范围和臂围在 OCD 患病和未患病的肘部之间没有发现任何显著差异。IEWG 评分在 56%的肘部与术前相似,44%的肘部进展了 1 个等级。长期并发症包括持续性 1 级跛行,发生在 23%的犬中。根据跛行和 CBPI 评分,67%的犬长期预后良好,27%的犬预后良好,6%的犬预后中等。因此,关节镜治疗是治疗犬肱桡滑车 OCD 的一种合适的手术方法,可提供良好的长期效果。

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本文引用的文献

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