Department of Equine and Small Animal Medicine, Faculty of Veterinary Medicine, University of Helsinki, Helsinki, Finland.
Lahti Veterinary Hospital, IVC Evidensia, Lahti, Finland.
Vet Comp Orthop Traumatol. 2024 Nov;37(6):286-296. doi: 10.1055/s-0044-1788726. Epub 2024 Jul 24.
The aim of our study was to investigate a degradable polylactide-collagen scaffold (COPLA) in the treatment of shoulder osteochondritis dissecans (OCD) in dogs.
The study was a controlled, randomized, blinded clinical trial with a parallel group design with a 1.5-year follow-up. Twenty dogs with uni- or bilateral shoulder OCD (29 shoulders) were randomized to receive a COPLA or arthroscopic debridement only (Control). The outcome of treatment was assessed with gait and stance analysis, passive range of motion measurement, pain and lameness evaluation, Helsinki Chronic Pain Index, and computed tomography (CT).
Eighteen dogs (25 shoulders) completed the study. The clinical outcome variables improved significantly from baseline in COPLA and Control groups after treatment but no significant differences emerged between groups. Significantly fewer COPLA than Control shoulders had osteoarthritis (OA) in CT at 6 months ( = 0.019) but the difference was not significant at 1.5 years. At 1.5 years, all dogs were sound and pain-free in joint palpation, but OA was diagnosed in 13/18 dogs (18/25 shoulders) with CT.
The results suggest that COPLA scaffold slowed down the development of OA at 6 months but it did not improve the clinical recovery or prevent OA in dogs with shoulder OCD in long-term follow-up at 1.5 years compared with arthroscopic debridement only. Regardless of the treatment method, clinical recovery was good, but OA developed in the majority of dogs.
本研究旨在探讨可降解聚乳酸-胶原支架(COPLA)在犬肩袖骨软骨炎(OCD)治疗中的作用。
这是一项具有 1.5 年随访期的对照、随机、双盲临床试验,采用平行组设计。20 只单或双侧肩袖 OCD 的犬(29 个肩)被随机分为 COPLA 或关节镜下清创术(对照组)。采用步态和站立分析、被动活动范围测量、疼痛和跛行评估、赫尔辛基慢性疼痛指数和 CT 评估治疗效果。
18 只犬(25 个肩)完成了研究。COPLA 和对照组治疗后临床结局变量均较基线显著改善,但组间无显著差异。6 个月时,COPLA 组较对照组发生骨关节炎(OA)的肩明显减少( = 0.019),但 1.5 年后无显著差异。1.5 年后,所有犬在关节触诊时均无痛且无跛行,但 CT 诊断 18/25 个肩中有 13 个(18/18 只)存在 OA。
结果表明,COPLA 支架在 6 个月时减缓了 OA 的发展,但与关节镜下清创术相比,在 1.5 年的长期随访中,COPLA 并不能改善临床恢复或预防肩袖 OCD 犬的 OA。无论治疗方法如何,临床恢复都很好,但大多数犬都发展为 OA。