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20kg 以上犬只的滑车成形术治疗高位髌骨和髌骨脱位

Dome trochleoplasty for correction of patella alta and patella luxation in dogs > 20 kg.

机构信息

1NorthStar VETS, Robbinsville, NJ.

2Department of Psychology, College of Science and Mathematics, Rowan University, Glassboro, NJ.

出版信息

J Am Vet Med Assoc. 2023 Aug 15;261(11):1-6. doi: 10.2460/javma.23.06.0307. Print 2023 Nov 1.

Abstract

OBJECTIVE

To describe the dome trochleoplasty procedure and report the short-term outcomes and complications associated with a novel technique to correct patellar luxation and patella alta.

ANIMALS

13 dogs (16 stifle joints) diagnosed with medial patellar luxation with concurrent patella alta in dogs > 20 kg.

CLINICAL PRESENTATION

Medical records of dogs weighing > 20 kg that underwent a dome trochleoplasty for correction of a medial luxating patella were prospectively evaluated. The procedure described involves an osteotomy of the femoral trochlea, which is then translated and/or rotated to correct patellar luxation. Clinical results were assessed using subjective lameness scoring, radiographic evaluation, and the Canine Brief Pain Inventory (CBPI) tool.

RESULTS

16 stifle joints were included in this study. The overall complication rate was 50%. Major complications occurred in 43.8% of stifle joints due to pin migration and recurrent luxation of the patella. One dog experienced a catastrophic complication 4 months postoperatively. Uncomplicated osteotomy healing was present in 94% of dogs. The median initial lameness score was 2 (mean, 1.81; range, 0 to 4) and at the final recheck was 0 (mean, 0.31; range, 0 to 2). The CBPI scores were available for 50% of stifle joints. The median initial CBPI score was 45.5 (mean, 48.8; range, 32 to 74) and at the final recheck was 17.5 (mean, 20.5; range, 0 to 43).

CLINICAL RELEVANCE

The dome trochleoplasty procedure offers an alternative technique for surgical correction of patellar luxation secondary to patella alta in large-breed dogs, but due to its higher complication and reluxation rates, it should be used cautiously and probably in combination with other corrective procedures, such as tibial tuberosity transposition, soft tissue imbrication, and/or soft tissue release rather than as a stand-alone procedure.

摘要

目的

描述穹顶滑车成形术,并报告一种用于矫正髌骨脱位和髌骨高位的新型技术的短期结果和并发症。

动物

13 只体重 > 20kg 的犬(16 个膝关节),诊断为内侧髌骨脱位伴并发髌骨高位。

临床症状

对接受穹顶滑车成形术以矫正内侧髌骨脱位的 > 20kg 犬的医疗记录进行前瞻性评估。该手术涉及股骨滑车的截骨术,然后对其进行平移和/或旋转以矫正髌骨脱位。临床结果通过主观跛行评分、影像学评估和犬简明疼痛量表(CBPI)进行评估。

结果

本研究纳入 16 个膝关节。总体并发症发生率为 50%。由于针迁移和髌骨再次脱位,43.8%的膝关节发生重大并发症。1 只狗术后 4 个月发生灾难性并发症。94%的犬出现无并发症的骨切开愈合。初始跛行评分中位数为 2 分(平均 1.81 分;范围 0 至 4 分),最终复查时为 0 分(平均 0.31 分;范围 0 至 2 分)。50%的膝关节可获得 CBPI 评分。初始 CBPI 评分为 45.5 分(平均 48.8 分;范围 32 至 74 分),最终复查时为 17.5 分(平均 20.5 分;范围 0 至 43 分)。

临床意义

穹顶滑车成形术为大型犬因髌骨高位导致的髌骨脱位提供了一种替代的手术矫正技术,但由于其较高的并发症和再脱位率,应谨慎使用,可能与胫骨结节移位、软组织叠瓦状切开和/或软组织松解等其他矫正术式联合使用,而不是作为单一术式。

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