首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 187 毫秒
1.
Objective— To document the prevalence of femoral medullary infarction associated with the Zurich Cementless Total Hip Replacement (ZCTHR) system in dogs.
Study Design— Case series.
Animals— Dogs (n=35) with 41 ZCTHR implants.
Methods— Medical records (February 1999–December 2002) were reviewed for dogs that had ZCTHR and at least 1 year follow-up with radiographic evaluation. Thirty-five dogs (41 ZCTHR) met the inclusion criteria. Femoral morphologic data, implant to bone relationships, and medullary infarcts were recorded. Data were analyzed for associations between infarct occurrence and morphologic details and dog characteristics.
Results— Eight of 41 femurs had radiographic evidence of infarcts (19.5%). Dogs with infarcts were significantly younger (mean [±SD] age, 18.5±5.2 months) compared with those without infarction (mean age, 44.4±5.6months; P =.027). None of the other variables were significantly different between dogs with and without infarcts. Three femurs with infarcts ultimately developed stem loosening.
Conclusion— A higher prevalence of femoral medullary infarcts was identified with ZCTHR compared with incidence reported for other total hip systems. Younger dogs were more likely to develop infarction.
Clinical Relevance— Femoral infarction appears to be associated with stem loosening. Adjustments in surgical technique or delaying surgery beyond 18 months of age may reduce incidence of infarction but needs further evaluation.  相似文献   

2.
Objective— To describe the surgical technique, early results and complications of tibial tuberosity advancement (TTA) for treatment for cranial cruciate ligament (CrCL)-deficient stifle joints in dogs.
Study Design— Retrospective clinical study.
Animals— Dogs (n=101) with CrCL-deficient stifles (114).
Methods— Medical records of 101 dogs that had TTA were reviewed. Complications were recorded and separated into either major or minor complications based on the need for additional surgery. In-hospital re-evaluation of limb function and time to radiographic healing were reviewed. Further follow-up was obtained by telephone interview of owners.
Results— Complications occurred in 31.5% of the dogs (12.3% major, 19.3% minor). Major complications included subsequent meniscal tear, tibial fracture, implant failure, infection, lick granuloma, incisional trauma, and medial patellar luxation; all major complications were treated with successful outcomes. All but 2 minor complications resolved. The mean time to documented radiographic healing was 11.3 weeks. Final in-hospital re-evaluation of limb function (mean, 13.5 weeks), was recorded for 93 dogs with lameness categorized as none (74.5%), mild (23.5%), moderate (2%), and severe (1%). All but 2 owners interviewed were satisfied with outcome and 83.1% reported a marked improvement or a return to pre-injury status.
Conclusions— TTA is a procedure comparable with alternate methods of CrCL repair with expected good to excellent functional outcome.
Clinical Relevance— TTA procedure can be successfully used to obtain the dynamic stability of a CrCL-deficient stifle joint in dogs.  相似文献   

3.
Objective— To determine the incidence of femoral medullary infarction after modifying the depth of femoral reaming and filing when performing total hip replacement (THR) using the Zurich Cementless Total Hip Replacement system (ZCTHR).
Study Design— Case series.
Animals— Dogs (n=31) that had ZCTHR (34).
Methods— Thirty-one dogs (34 THR) had ZCTHR (May 2003–September 2006) and with >1 year radiographic (craniocaudal, mediolateral views) follow-up after THR were evaluated for the presence of femoral medullary infarcts. Incidence was compared with a previous study performed before the technique modification.
Results— Femoral medullary infarction occurred in 1 femur (2.9%; dog <18 months at THR) compared with 19.5% before the technique change, a significant decrease ( P <.001).
Conclusion— Limiting the depth of reaming and filing of the medullary canal resulted in a significant decrease in the incidence of femoral medullary infarction.
Clinical Relevance— Depth of reaming and filing the medullary canal should be limited when performing THR using the ZCTHR.  相似文献   

4.
Risk factors for ventral luxation in canine total hip replacement   总被引:1,自引:1,他引:0  
Objective— To identify risk factors associated with ventral luxation (VL) of canine total hip replacement (THR), and outcome.
Study Design— Retrospective study.
Animals— Dogs (n=602) that had THR (563 cemented, 35 cementless, 4 hybrid).
Methods— Dogs (1999–2004) with VL after THR were compared with dogs with uncomplicated THR. Data included signalment, body weight, diagnosis, implant size, acetabular cup orientation, and femoral displacement ratio (FDR).
Results— VL was diagnosed in 11 (1.8%) dogs after primary THR. Including 2 other dogs that had VL after the study period, 10 (77%) of 13 dogs had VL within 7 days of surgery. Risk factors for VL included Saint Bernard-type dogs ( P =.0001), short neck extension ( P =.0005), and high angle of lateral opening in other breeds ( P =.018). There were trends toward higher risk of VL with lower FDR in Saint Bernardtypes ( P =.060), and with cementless implants ( P =.061). Twelve dogs had revision arthroplasty that was successful in all cementless and 2 cemented VL cases. Five dogs had recurrent VL and a poor outcome.
Conclusion— VL is generally an early complication of THR, with no single common risk factor identified.
Clinical Relevance— Saint Bernard types and short neck extensions are associated with increased risk of VL. Poor cup orientation is a determining factor for VL in some dogs, but a protective orientation of the acetabular cup was not found. Revision is successful in most dogs, but recurrent VL merits a guarded prognosis.  相似文献   

5.
OBJECTIVE: To radiographically evaluate the Zurich cementless total hip (ZCTH) cup and correlate lucency with clinical signs of implant instability, time since surgery, and implant generation, using zonal analysis. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs (n = 53). METHODS: Radiographs of dogs that had ZCTH arthroplasty (>1 year) were evaluated using zonal analysis, for lucency surrounding the cup-bone interface (number of zones, length, area). Dogs were examined for clinical signs of implant instability (lameness, hip pain). Lucency was correlated with lameness, time after surgery, and implant generation. RESULTS: Radiographs of 68 implants (18 generation I, 50 generation II) were evaluated. Eight dogs were lame (11.8%). Dogs with lameness were more likely to have lucency in > or =2 zones of analysis (per view), have >2 times the average curvilinear length of lucency, and have >4 times the average area of lucency surrounding the implant compared with non-lame dogs. A weak relationship was observed between time after surgery and implant generation; however, there was no relationship between time after surgery and lucency. CONCLUSIONS: Dogs with lameness after ZCTH arthroplasty were more likely to have lucency at the cup-bone interface. Lucency was better evaluated by radiographic projection than zonal analysis. Temporal progression of lucency was weakly correlated with implant generation. CLINICAL RELEVANCE: Dogs with lucency in > or =2 zones of analysis should be evaluated more frequently for clinical signs of implant loosening. Further investigation of serial radiographs after ZCTH arthroplasty is warranted.  相似文献   

6.
Objective— To evaluate use of a surgical technique commonly used in humans for treatment of cervical spondylotic myelopathy (CSM) in dogs.
Design— Prospective case series.
Animals— Dogs with CSM (n=10).
Methods— Dogs weighing >30 kg that had CSM at 1 vertebral articulation were eligible for inclusion. Dogs had vertebral column distraction/fusion performed using a cortical ring allograft, cancellous autograft, and a spinal locking plate. Dogs were evaluated temporally by repeat neurological examinations and by client perception of postsurgical outcome, determined by telephone interview.
Results— Nine dogs survived the immediate postoperative period. Seven of 8 dogs had moderate to complete improvement without recurrence (mean follow-up, 2.48 years). The most common postsurgical complications were screw loosening (n=4) and plate shifting (2), neither of which required surgical revision. One dog had pseudoarthrosis that may have negatively impacted outcome.
Conclusion— Treatment of single level CSM in dogs with ring allograft and a spinal locking plate system may lead to successful outcomes. The major problems encountered with included cost of the implants and adjusting the system designed for humans to fit the vertebral column of a dog.
Clinical Relevance— For dogs with CSM at a single level, the use of a spinal locking plate in combination with a cortical ring allograft can be an effective surgical treatment. Costs of the implants as well as anatomic differences in dogs make this type of surgery less appealing.  相似文献   

7.
Objective: To describe the surgical technique for the micro total hip replacement (Micro THR) system and report clinical outcomes. Study Design: Prospective study. Animals: Dogs (n=49) and cats (n=8) with coxofemoral arthropathy. Methods: Small breed dogs and cats with coxofemoral arthritis were enrolled for Micro THR. Patient data were recorded. Implant positioning and cement mantle quality were evaluated radiographically. Orthopedic examinations and client interviews were used to assess outcome. Results: Micro THR was performed unilaterally (40 dogs, 8 cats) and staged bilaterally (9 dogs) to resolve pain associated with osteoarthritis or trauma. Mean body weight was 7.2 kg. Postoperative complications included prosthesis luxation (9), cup aseptic loosening (1), and sciatic neurapraxia (1). Mean radiographic follow up was 96.1 weeks; 10 joints were followed for ≥3.0 years. Sixty of the 66 (91%) Micro THRs had excellent outcomes. Two dogs (<2.75 kg) were too small for the prosthesis and 4 dogs with unmanageable luxation had explantation. Conclusions: Micro THR is considered a satisfactory procedure for management of small breed dogs and cats with coxofemoral disease unresponsive to medical management. Clinical Relevance: Micro THR is a viable option to treat disabling disorders of the hip. More than 170 cat and small dog breeds, and many mixed breeds, could benefit from Micro THR surgery.  相似文献   

8.
OBJECTIVE: To determine the practicality and clinical outcome of miniature total hip replacement (THR) in dogs. STUDY DESIGN: Retrospective study. Sample Population- Seventeen client-owned dogs that had miniature THR. METHODS: Patient data surveyed included signalment, body weight, diagnosis, implant size, surgical technique, and intraoperative and postoperative complications. Radiographic evaluation included angle of lateral opening of the acetabular component, implant positioning, cement mantle quality, and femoral displacement measurement and ratio. Client questionnaire and orthopedic examination were used to obtain long-term follow-up information. RESULTS: Miniature THR was performed to address hip dysplasia and secondary osteoarthritis. In 1 dog, a staged bilateral procedure was performed. Mean body weight was 19 kg (range, 12 to 25 kg). Penetration or fissure of the femoral cortex was the most common intraoperative complication and occurred in 3 dogs. In 3 dogs, there was excessive coxofemoral laxity after reduction of the prosthesis. This instability was addressed specifically in 2 dogs by capsulorrhaphy or capsular prosthesis. Postoperative convalescent complications (craniodorsal luxation, 2 dogs; acetabular cup displacement, 1 dog) were related to surgical errors. Aseptic loosening of the femoral implant was diagnosed in 1 dog at 18 months. Mean follow-up time was 17 months (range, 4 to 42 months). Fifteen of 18 (83%) miniature THRs had good or excellent outcomes. CONCLUSIONS: Miniature THR should be considered a satisfactory alternative to femoral head and neck ostectomy in medium-size dogs affected by hip dysplasia and secondary osteoarthritis. The population of medium-size dogs that might derive more benefit from THR than FHO has yet to be defined. CLINICAL RELEVANCE: Miniature THR is a viable treatment option in medium-size dogs with hip dysplasia.  相似文献   

9.
10.
OBJECTIVE: To determine the outcome of total hip arthroplasty in canine hindlimb amputees. STUDY DESIGN: Retrospective evaluation of clinical cases. METHODS: Data recorded from the medical records of nine dogs included patient signalment, indication for amputation and total hip arthroplasty (THA), interval between amputation and THA, and surgical complications. Radiographs were used to assess implant orientation and evidence of complications. Functional outcome was assessed using direct patient evaluation by one of the authors or primary surgeons, or through telephone interview between the primary author and the owner. RESULTS: Seven dogs ultimately had a good or excellent clinical results. Complications occurred in five dogs. Four dogs luxated the prosthetic joint without an obvious traumatic event within 9 weeks of the initial surgery. Revision surgeries resulted in successful coxofemoral reduction in three of four dogs. There were no clinical or radiographic findings suggestive of implant loosening or infection. CONCLUSION: THA can be a successful salvage procedure in the canine hindlimb amputee with disabling, non-neoplastic, noninfectious coxofemoral disease. The risk of luxation in the early postoperative period is high and revision surgery is required for stabilization.  相似文献   

11.
Objective— To describe augmentation of primary Achilles tendon repair using suture with a semitendinosus muscle flap and report outcome in 5 dogs.
Study Design— Prospective clinical study.
Animals— Dogs (n=5) with Achilles tendon rupture (n=6).
Methods— After tendon repair with #2 polypropylene in a 3-loop pulley suture pattern, the lateral one-half of the semitendinosus muscle was transected from the ischium, rotated distally then sutured with #2 polypropylene to the calcaneus in a 3-loop pulley pattern. The epitenon was sutured to the muscle flap fascia with interrupted sutures. All dogs had a bivalved cast for 2 weeks then a cranial splint for 2–6 weeks. Lameness scores (0=stands and walks normally to 4=non-weight-bearing lameness, plantigrade stance on affected pelvic limb) were determined every 2–3 weeks postoperatively for 12 weeks. Outcome was determined from telephone questionnaire of owners.
Results— Four had lameness scores of 0, the 5th had a score of 1 at 12 weeks. Three owners were very satisfied with outcome. Minor complications included cast sores (2 dogs), infection (2), and acute swelling (1); 1 major complication occurred (infection resulting in reoperation).
Conclusions— Semitendinosus flap augmentation resulted in early return to function without prolonged postoperative immobilization. Three dogs returned to full work/activity after repair.
Clinical Relevance— Augmentation of primary Achilles tendon repair with a semitendinosus flap can be considered in dogs with chronic rupture but further investigation of the long-term outcome using this technique is needed.  相似文献   

12.
Objective— To describe indirect decompression by means of cervical spine locking plate (CSLP) fixation with vertebral distraction, discectomy, and cancellous block bone grafting in large breed dogs with single caudal cervical dynamic spondylotic lesions diagnosed by myelography with linear traction to the cervical spine, and contrast-enhanced computed tomography.
Study Design— Prospective clinical study.
Animals— Dogs (n=12) with caudal cervical spondylotic myelopathy because of a single dynamic, traction-responsive lesion.
Methods— Single, traction-responsive, caudal cervical spondylotic lesions were treated by vertebral distraction, discectomy, cancellous block bone grafting, and CSLP fixation. Follow-up was obtained by sequential recheck examination by the author or referring veterinarian or by telephone inquiries.
Results— Ten dogs had neurologic improvement after surgery. Indirect decompression by maintained distraction with cancellous block grafting and CSLP fixation was readily accomplished with less risk of blood loss or iatrogenic spinal cord injury than that associated with direct (ventral) decompression. There were no complications of graft intrusion, extrusion or subsidence, implant loosening, foraminal impingement, or end-plate failure. Two dogs that had satisfactory short-term recoveries developed clinical signs associated with adjacent segment disease and were euthanatized. At long-term follow-up, 8 dogs had satisfactory function, either a normal gait or one with slight to moderate proprioceptive deficits.
Conclusions— CSLP fixation with cancellous block interbody grafting is an effective and perhaps safer method of treating single-level, traction-responsive cervical spondylosis in large breed dogs.
Clinical Relevance— CSLP fixation with interbody bone grafting is a viable alternative to other techniques for treatment of single-level, traction-responsive cervical spondylosis.  相似文献   

13.
14.
OBJECTIVE: To report the use of dorsal acetabular augmentation (DAA) in canine total hip arthroplasty (THA) and to evaluate the clinical and radiographic outcome after a minimum of 1 year follow-up. STUDY DESIGN: Clinical study. ANIMALS: Nine dogs that had THA. METHODS: Ten hips requiring acetabular augmentation for optimum acetabular cup implantation for THA were evaluated retrospectively. The excised femoral head and neck was used as the corticocancellous bone graft for index THA surgeries, and the dorsal crest of the ipsilateral ilial wing was used as the bone graft in 1 dog that had a revision surgery. Clinical and radiographic follow-up examinations were performed at approximately 8 weeks and 1 year postoperatively. Long-term radiographic examinations included use of a standing dorsal acetabular rim (DAR) projection for assessment of graft-recipient boundary. Functional clinical outcome was assessed using direct patient evaluation and telephone interview. RESULTS: One dog failed to regain limb function after surgery. Suspected aseptic loosening of the acetabular cup was observed on radiographs approximately 12 weeks postoperatively. Excluding this single explantation, follow-up physical and radiographic examinations indicated good implant and graft positioning and normal function for all dogs. CONCLUSIONS: Acetabular augmentation permitted implantation of an appropriately sized acetabular cup while maintaining complete DAR coverage of the prosthesis. Nine out of 10 hips had a successful outcome with minimal radiographic and no functional abnormalities. Further follow-up is necessary to determine the long-term outcome of DAR augmentation in canine THA. CLINICAL RELEVANCE: Acetabular augmentation with an autogenous corticocancellous bone graft constructed from the femoral head and neck can provide complete DAR coverage to permit use of an appropriately sized acetabular cup in THA.  相似文献   

15.
OBJECTIVE: To evaluate the long-term clinical and radiographic results of a canine uncemented porous-coated anatomic (PCA) total hip arthroplasty (THA). STUDY DESIGN: Prospective study of consecutive clinical patients using survival analysis. ANIMALS: Forty-one dogs that underwent PCA THA; nine had bilateral PCA THA (50 prostheses). METHODS: Gait observation, orthopedic examination, and radiographic assessment were conducted before THA, 6 months after THA, and yearly thereafter. A zonal analysis system was used to document osseous changes in the femur and the acetabulum. Acetabular cup and femoral stem subsidence and migration, femoral canal fill, and implant orientation were measured. Survival analysis of the procedure was conducted. RESULTS: Long-term follow-up was available for 37 dogs (46 prostheses). The median follow-up was 63 months. Limb function was normal for 37 limbs and abnormal for 9 limbs because of dislocation (n = 3), lumbosacral disease (n = 2), degenerative myelopathy (n = 1), autoimmune disease (n = 1), brain tumor (n = 1), or osteosarcoma of the femur (n = 1). All prosthetic stems and cups were fixed by bone ingrowth fixation. Osteolysis was not observed. Bone infarction occurred in five femoral canals (four dogs). The 6-year survival rate for the procedure was 87% (95% confidence interval, 72%-96%). CONCLUSIONS: Long-term fixation of the uncemented PCA acetabular cup and stem is successful in dogs, and long-term clinical function is excellent.  相似文献   

16.
Objective— To (1) report a technique for repair of feline ilial fractures using a dorsally applied bone plate and (2) compare outcome with cats treated by a lateral plate.
Study Design— Prospective study.
Animals— Cats (n=10) with iliac fractures.
Methods— Cats with ilial fractures (January 2005–December 2006) were treated by application of a dorsally applied bone plate. Immediate postoperative radiographs were compared with those taken 4–6 weeks later to assess screw loosening, screw purchase, and pelvic canal narrowing. Owners were contacted for medium-term (>3 month) follow-up. Data were compared with a report of outcome after lateral plating (LP) in 21 cats.
Results— Mean (± SD) screw purchase (89 ± 11 mm) was significantly greater ( P <.01) with a dorsal plate compared with a lateral plate (33 ± 8 mm). Significantly more screws ( P <.01) were used with a dorsal plate (median, 7) compared with a lateral plate (median, 6). Significantly less postoperative pelvic canal narrowing developed in the dorsal plating group between postoperative and 4–6-week follow-up radiography compared with the LP group (2% versus 15%, P <.01).
Conclusion— Dorsal plating of feline ilial fractures results in significantly less screw loosening and pelvic canal narrowing at 4–6 weeks after surgery compared with LP.
Clinical Relevance— Dorsal plating of feline iliac fractures may reduce complications associated with pelvic canal narrowing such as constipation and megacolon.  相似文献   

17.
Objective— To describe a surgical technique for total knee replacement (TKR) in dogs with severe osteoarthritis (OA) and report 1-year outcome.
Study Design— Prospective clinical case study.
Animals— Dogs (n=6) with severe stifle OA.
Methods— Preoperative and postoperative evaluations were compared after 6 dogs had TKR. Data gathered included radiographs, goniometric measures of passive range of motion, ground reaction forces, and girth measurements of the thigh before surgery and at 6 weeks, 3 months, 6 months, and 1 year.
Results— Stifle extension and excursion angles were significantly improved by 3 months after TKR. Mean peak vertical force and impulse were significantly improved by 6 months.
Conclusions— TKR is a viable treatment option for dogs with severe stifle OA.
Clinical Relevance— With continued refinement of surgical technique, instrumentation, and implants, TKR could become a reliable treatment for dogs with disabling, painful nonseptic stifle OA.  相似文献   

18.
Objective- To assess the clinical results in dogs with acetabular fractures stabilized using a screw-wire-polymethylmethacrylate (SWP) composite fixation.
Study Design- A retrospective study of client-owned dogs with acetabular fractures.
Animals- Fourteen dogs ranging in age from 4 to 95 months (mean, 34 ±25 months; median, 25 months) and body weight from 8 to 39 kg (mean, 25 ±6 kg; median, 27 kg).
Methods- Medical records and radiographs were retrospectively evaluated to determine location of the fracture, presence of preexisting degenerative joint disease, accuracy of fracture reduction and complications associated with surgery. Long-term results were evaluated by subjective assessment of lameness, elicitation of pain and/or crepitus on manipulation of the coxofemoral joint, measurements of pelvic limb circumference, coxofemoral joint goniometric measurements, and radiographic evaluation.
Results- Fracture reduction was considered anatomic in 13 dogs. At the time of the last follow-up evaluation (mean, 347 ±261 days; median, 380 days) 10 dogs were sound on the affected limb, three dogs had a subtle weight-bearing lameness of the affected limb, and the remaining dog had a consistent non-weight-bearing lameness of the affected limb. Mild (n = 10) or moderate (n = 1) degenerative changes of the affected coxofemoral joint attributed to the acetabular fracture and its repair were noted on the follow-up radiographs in 11 dogs. Limb circumference of the affected limb ranged from -8.2% to +10.8% (mean, -0.8 ±4.2%; median, -0.7%) of the contralateral limb.
Conclusions- The SWP composite fixation consistently maintained anatomic reduction, was associated with few complications, and yielded satisfactory clinical results.
Clinical Relevance- The SWP composite fixation technique would seem to be an acceptable means of stabilizing acetabular fractures in dogs.  相似文献   

19.
This study reports the long-term clinical outcome after partial ligation of single extrahepatic vascular anomalies in 20 dogs. Outcome was classified as successful or complicated based on review of follow-up evaluations that consisted of telephone contacts with owners and veterinarians (n = 20), in hospital reevaluation (n = 15), and per-rectal portal nuclear scintigraphy (n = 12). Partial ligation was initially effective in resolving clinical signs in all 20 dogs. Long-term outcome was completely satisfactory in 50% of the cases. The mean time interval between surgery and onset of signs, or diagnosis of complications in the 10 dogs with a complicated outcome, was approximately 3 years. Central nervous system, gastrointestinal, and complications related to the urinary tract were most common. Acquired multiple extrahepatic venous communications occurred in at least 3 of 10 dogs (30%) with a complicated outcome. Long-term survival occurred in 13 of 20 dogs (65%) with partial ligation. The mean survival time for the seven dogs that died or were euthanatized was 3.6 years and the mean survival time for the 13 dogs still alive at the last follow-up was 5.0 years.  相似文献   

20.
Objective— To describe a novel reconstructive technique after nasal planum and premaxilla resection.
Study Design— Case report.
Animals— Dogs (n=2) with squamous cell carcinoma (SCC) of the nasal planum.
Methods— A 9-year-old neutered female Labrador retriever (dog 1) and an 11–year-old neutered male Golden retriever (dog 2) had resection of the nasal planum and premaxilla for treatment of locally invasive SCC. Reconstruction of a nasal planum facsimile was based on use of the nonhaired pigmented margins of bilateral labial mucocutaneous rotation-advancement flaps.
Results— Reconstruction of the premaxilla by construction of a nasal planum facsimile resulted in uncomplicated wound healing and improved cosmesis. There was no tumor recurrence at 1290 (dog 1) and 210 (dog 2) days after surgery.
Conclusion— Reconstruction of a nasal planum facsimile was successfully performed without complications in 2 dogs with high owner satisfaction with cosmetic appearance.
Clinical Relevance— This technique represents a significant advancement in surgical cosmetic outcome, may potentially reduce postoperative complications, and should be considered for dogs requiring nasal reconstruction after nasal planum resection with premaxillectomy.  相似文献   

设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号