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