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11 例全髋关节假体颅向背侧脱位行双骨盆切开术效果不佳。

Poor success rates with double pelvic osteotomy for craniodorsal luxation of total hip prosthesis in 11 dogs.

机构信息

VetRef-Anicura, Referral Veterinary Clinic, Angers-Beaucouzé, France.

出版信息

Vet Surg. 2023 Nov;52(8):1219-1227. doi: 10.1111/vsu.14024. Epub 2023 Sep 12.

DOI:10.1111/vsu.14024
PMID:37700514
Abstract

OBJECTIVE

To report the outcome of double pelvic osteotomy (DPO) for craniodorsal luxation of total hip replacement (THR).

STUDY DESIGN

Retrospective case series.

ANIMALS

Eleven client-owned animals.

METHODS

Dogs with craniodorsal luxation of THR and high angle of lateral opening (ALO) were considered candidates for DPO. The ALO and the version angle (VA) were measured on pre- and post-DPO radiographs. Pre- and post-DPO ALO and VA were compared using a Wilcoxon signed-rank test. Clinical and radiographic outcomes were assessed at 2 and 6 months post-DPO.

RESULTS

Eleven DPOs were performed on 11 dogs after THR luxation. The ALO was reduced from a median of 66.2° (range 37.3-73.1°) to 55.9° (range 13.2-60.0°) (p ≤ .001), and VA increased from a median of 25.6° (range 6.8-51.9°) to 35.3° (range 15.1-51.7°) (p ≤ .03). Craniodorsal luxation recurred in five dogs and was managed with closed reduction (one dog), capsulorrhaphy (one dog), or repositioning of the acetabular cup (three dogs). The median clinical follow-up duration was 19.7 months (range 3.4-73.0). In the long term, seven dogs required explantation (five aseptic loosenings, two infections) (median 8.2 months, range 2.6-50.6).

CONCLUSION

Reluxation was frequent after DPO, 5/11 dogs requiring additional procedures, including three cup revisions. The long-term outcome was considered to be poor due to frequent explantation.

CLINICAL SIGNIFICANCE

Double pelvic osteotomy may be considered to avoid cup replacement when managing craniodorsal THR luxations in dogs but is not recommended due to high complication rates.

摘要

目的

报告全髋关节置换术(THR)颅顶背侧脱位行双盆骨截骨术(DPO)的结果。

研究设计

回顾性病例系列。

动物

11 只患犬。

方法

患有 THR 颅顶背侧脱位和高外侧开口角(ALO)的犬被认为是 DPO 的候选者。在 DPO 前后拍摄的 X 光片上测量 ALO 和矢状角(VA)。使用 Wilcoxon 符号秩检验比较 DPO 前后的 ALO 和 VA。在 DPO 后 2 个月和 6 个月时评估临床和影像学结果。

结果

11 只 THR 脱位的犬接受了 11 次 DPO。ALO 从中位数 66.2°(范围 37.3°-73.1°)减少到 55.9°(范围 13.2°-60.0°)(p≤0.001),VA 从中位数 25.6°(范围 6.8°-51.9°)增加到 35.3°(范围 15.1°-51.7°)(p≤0.03)。5 只犬发生颅顶背侧再脱位,经闭合复位(1 只犬)、囊切开术(1 只犬)或髋臼杯重新定位(3 只犬)治疗。中位临床随访时间为 19.7 个月(范围 3.4-73.0)。长期随访中,7 只犬需要取出(5 只无菌性松动,2 只感染)(中位数 8.2 个月,范围 2.6-50.6)。

结论

DPO 后再脱位很常见,11 只犬中有 5 只需要额外手术,包括 3 次杯修复。由于频繁取出,长期预后被认为较差。

临床意义

当犬全髋关节置换术颅顶背侧脱位时,可考虑行双盆骨截骨术以避免更换髋臼杯,但由于并发症发生率较高,不建议使用。

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