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胫骨平台水平截骨联合胫骨结节移位治疗十字韧带断裂合并 III 或 IV 级内侧髌骨脱位的并发症和长期结果。

Complications and Long-Term Outcomes after Combined Tibial Plateau Leveling Osteotomy and Tibial Tuberosity Transposition for Treatment of Concurrent Cranial Cruciate Ligament Rupture and Grade III or IV Medial Patellar Luxation.

机构信息

Surgical Department, Centre Hospitalier Vétérinaire Anicura - Aquivet, Eysines, France.

出版信息

Vet Comp Orthop Traumatol. 2024 Jan;37(1):43-49. doi: 10.1055/s-0043-1770740. Epub 2023 Jul 24.

Abstract

OBJECTIVES

This study aims to report complications and long-term outcomes of combined tibial plateau leveling osteotomy and tibial tuberosity transposition (TPLO-TTT) for treatment of concurrent cranial cruciate ligament rupture and medial patellar luxation (MPL).

STUDY DESIGN

This is a retrospective study. Dogs that underwent TPLO-TTT for treatment of combined cranial cruciate ligament rupture and grade III or IV MPL were included. Signalment, fixation method, and complications were recorded. Long-term outcome assessment (minimum 1 year postoperatively) was performed through clinical and radiographic reexamination at the authors' institution.

RESULTS

Twenty-four stifles (22 dogs) were included. Twenty-one stifles had a grade III MPL, and 3 stifles had grade IV MPL. Four major complications consisting of surgical site infection ( = 3) and recurrent grade II MPL ( = 1) were observed. Dogs with surgical site infections were successfully treated with implant removal and oral antibiotics. No additional surgery was performed for the patient with recurrent MPL as no signs of lameness were observed. Minor complications occurred in five cases. At long-term evaluation (median: 27 months; range: 12-67 months), 21/22 dogs were clinically sound and 23/24 stifles had a complete resolution of MPL.

CONCLUSION

TPLO-TTT can be considered as an effective surgical option to treat patients with concurrent cranial cruciate ligament rupture and MPL with a relatively low major complication rate. Owners should be warned of the potential need for implant removal.

摘要

目的

本研究旨在报告胫骨平台平整截骨术联合胫骨结节转移术(TPLO-TTT)治疗十字韧带断裂合并内侧髌骨脱位(MPL)的并发症和长期疗效。

研究设计

这是一项回顾性研究。纳入接受 TPLO-TTT 治疗合并十字韧带断裂和 III 级或 IV 级 MPL 的犬只。记录一般情况、固定方法和并发症。通过在作者机构进行临床和影像学复查,对长期疗效(术后至少 1 年)进行评估。

结果

共纳入 24 个膝关节(22 只犬)。21 个膝关节有 III 级 MPL,3 个膝关节有 IV 级 MPL。观察到 4 种主要并发症,包括手术部位感染( = 3)和复发性 II 级 MPL( = 1)。感染的犬只通过取出植入物和口服抗生素成功治疗。复发性 MPL 的犬只未进行额外手术,因为未观察到跛行迹象。5 例出现轻微并发症。在长期评估时(中位数:27 个月;范围:12-67 个月),22 只犬中有 21 只临床状况良好,24 个膝关节中有 23 个完全解决了 MPL 问题。

结论

TPLO-TTT 可被视为治疗同时患有十字韧带断裂和 MPL 的有效手术选择,其主要并发症发生率相对较低。应警告主人可能需要取出植入物。

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