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影响犬自然发育性髋关节发育不良三联骨盆截骨术长期疗效的术前变量。

Preoperative variables affecting long-term outcome of triple pelvic osteotomy for treatment of naturally developing hip dysplasia in dogs.

作者信息

Rasmussen L M, Kramek B A, Lipowitz A J

机构信息

Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Minnesota, St Paul 55108, USA.

出版信息

J Am Vet Med Assoc. 1998 Jul 1;213(1):80-5.

PMID:9656029
Abstract

OBJECTIVE

To determine whether preoperative radiographic evidence of degenerative joint disease (DJD), hip joint laxity, or age at surgery is associated with long-standing DJD or hip function in dogs with hip dysplasia (HD) that had a triple pelvic osteotomy (TPO).

DESIGN

Prospective study.

ANIMALS

34 dogs with HD.

PROCEDURE

Dogs that had TPO performed during an 8-year period were chosen for long-term follow-up evaluation that included physical examinations, pelvic radiographs, and owner questionnaires. Data on radiographic evidence of DJD, Norberg angle, and percentage of femoral head coverage were retrieved from preoperative records and determined from follow-up radiographs.

RESULTS

Approximately 40% of dogs had progression of DJD. Eighty-seven percent of dogs received excellent or good physical examination scores, and 76% received excellent or good at-home activity scores. Preoperative and long-standing DJD were not associated. The risk of DJD was increased with increased age at surgery, narrower preoperative Norberg angle, and lower percentage of femoral head coverage, but these variables were not associated with clinical hip function.

CLINICAL IMPLICATIONS

TPO for treatment of HD in dogs may slow, rather than stop, radiographic progression of DJD; however, clinical outcome is acceptable for most dogs. Preoperative evidence of DJD may not be a limiting criterion in selecting dogs as suitable TPO candidates. Dogs with extensive hip joint laxity before surgery may be predisposed to developing DJD; thus, the risk-to-benefit ratio for TPO versus salvage procedures should be considered. Younger dogs may develop less severe DJD after TPO; surgery should be considered at the first sign of hip joint laxity and pain.

摘要

目的

确定退行性关节病(DJD)的术前影像学证据、髋关节松弛或手术时的年龄是否与接受三联骨盆截骨术(TPO)的髋关节发育不良(HD)犬的长期DJD或髋关节功能相关。

设计

前瞻性研究。

动物

34只患有HD的犬。

程序

选择在8年期间接受TPO手术的犬进行长期随访评估,包括体格检查、骨盆X光片和主人问卷调查。从术前记录中获取并根据随访X光片确定DJD的影像学证据、诺伯格角和股骨头覆盖百分比的数据。

结果

约40%的犬出现DJD进展。87%的犬体格检查得分优秀或良好,76%的犬在家活动得分优秀或良好。术前和长期DJD不相关。DJD的风险随着手术年龄增加、术前诺伯格角变窄和股骨头覆盖百分比降低而增加,但这些变量与临床髋关节功能无关。

临床意义

TPO治疗犬HD可能会减缓而非阻止DJD的影像学进展;然而,大多数犬的临床结果是可以接受的。DJD的术前证据可能不是选择犬作为合适TPO候选者的限制标准。术前髋关节广泛松弛的犬可能易患DJD;因此,应考虑TPO与挽救手术的风险效益比。年轻犬在TPO后可能发展为较轻的DJD;应在出现髋关节松弛和疼痛的第一迹象时考虑手术。

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