Remedios A M, Fries C L
Department of Veterinary Anesthesiology, Radiology and Surgery, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon.
Can Vet J. 1995 Aug;36(8):503-9.
This article discusses the treatment approaches and recommendations for canine hip dysplasia. A search of the literature database MEDLINE (1969-1994) was conducted and relevant journal articles regarding the medical and surgical treatment of hip dysplasia were selected and reviewed. Dysplastic dogs can be divided, for treatment purposes, into those with no or minimal osteoarthrosis, and those with moderate to severe osteoarthrosis. In young animals with joint laxity and pain, but with no or minimal radiographic evidence of osteoarthrosis, the treatment approach is controversial. Conservative management may be effective in the short term, but progressive development of osteoarthrosis occurs and clinical signs may manifest at an older age. Options for surgical treatments in these young dogs include pectineal myectomy, lengthening of the femoral neck, and corrective osteotomies. Corrective osteotomies are advocated to reestablish joint congruency and prevent development of osteoarthrosis. In the mature osteoarthritic dog, effective conservative management depends on the severity of the degenerative joint disease. Proposed surgical treatments for clinically debilitating hip dysplasia include biocompatible osteoconductive/shelf arthroplasty; femoral head and neck excision arthroplasty, with or without muscle sling interposition; and total hip replacement. Although research directly comparing the salvage procedures has not been reported, studies suggest that total hip replacement is more effective in returning large dogs to full functional weight bearing.
本文讨论了犬髋关节发育不良的治疗方法和建议。我们检索了文献数据库MEDLINE(1969 - 1994年),并挑选和审阅了有关髋关节发育不良医学和外科治疗的相关期刊文章。为了治疗目的,发育不良的犬可分为无骨关节炎或仅有轻微骨关节炎的犬,以及患有中度至重度骨关节炎的犬。对于关节松弛且疼痛,但无骨关节炎的影像学证据或仅有轻微证据的幼犬,治疗方法存在争议。保守治疗在短期内可能有效,但骨关节炎会逐渐发展,临床症状可能在犬龄较大时出现。这些幼犬的手术治疗选择包括耻骨肌切除术、股骨颈延长术和矫正截骨术。提倡进行矫正截骨术以重建关节一致性并预防骨关节炎的发展。对于患有成熟骨关节炎的犬,有效的保守治疗取决于退行性关节疾病的严重程度。针对临床上导致衰弱的髋关节发育不良所提议的手术治疗包括生物相容性骨传导/髋臼成形术;股骨头和颈切除关节成形术,有无肌肉吊带插入;以及全髋关节置换术。尽管尚未报道直接比较挽救手术的研究,但研究表明全髋关节置换术在使大型犬恢复到完全功能负重方面更有效。