犬前十字韧带断裂的自身韧带囊内囊外修复

本文介绍1例前十字韧带断裂患犬病例,通过利用该犬自身韧带对其进行囊内囊外修复,疗效确实;同时避免了使用人工韧带修复所造成的排斥反应、骨损伤及骨关节病的发生,此方法可应用于宠物临床。     

31例犬前十字韧带断裂手术治疗的调查报告

为了了解外侧籽骨胫骨缝合术(LFTS)和胫骨平台水平化截骨术(TPLO)的手术效果,调查统计了2018年11月份—2019年9月份来中国农业大学动物医院接受前十字韧带断裂(CrCLR)治疗的31例发生单侧或双侧CrCLR患犬的相关基础信息及术后治疗效果,记录患犬的就诊日期、品种、性别、年龄、体重、绝育与否、体况评分、手术方法、关节内情况及术后转归,并在术后6周及3个月时电话回访。结果表明：调查的31例CrCLR病例中,最常见的发病品种为迷你贵宾犬,占总病例数的25.8%(8/31);中老年犬(>2岁)占比93.5%;74.2%的患犬属于肥胖体型(9分制体况评分为7～9分);接受LFTS的患犬主要是体重较小的患犬[平均体重为(11.68±9.31)kg],接受TPLO的患犬主要是体重较大的患犬[平均体重为(25.70±6.37)kg];发生前十字韧带(CrCL)完全断裂的病例数(34例)远大于部分断裂的病例数(6例),且双侧发生CrCLR的病例出现CrCL完全断裂的病例数明显高于单侧发病的病例;进行LFTS的病例术后主要并发症的发病率为7.1%,进行TPLO的病例术后主要并发症的发...     

胫骨平台水平化截骨术治疗犬前交叉韧带疾病的手术效果和并发症分析

旨在评估胫骨平台水平化截骨术(tibial plateau leveling osteotomy, TPLO)治疗犬前交叉韧带疾病(cranial cruciate ligament disease, CCLD)的手术效果和并发症,分析影响手术效果和并发症的因素。回顾了在中国农业大学动物医院采用TPLO手术治疗犬CCLD的病历记录,并进行回访。入选病例满足：回访时间大于5个月;病例信息记录完整。结果表明：共纳入85只犬的101例TPLO手术,包含了20个品种的犬,主要有杂种犬(n=17,20.0%)、贵宾犬(n=15,17.7%)、比熊犬(n=11,12.9%)、金毛(n=10,11.8%),拉布拉多(n=8,9.4%)。患犬的体重及年龄的中位数分别是14.4 kg(范围,4～53 kg)和7岁(范围,1～14岁)。整体并发症发生率为37.6%(38/101),其中36例(35.6%, 36/101)发生了轻微并发症(包括创口相关并发症和绷带相关并发症),2例(2.0%)发生严重并发症(包括1例螺钉松脱和1例胫骨结节骨折)。创口相关并发症(23.8%,24/101)中,15只舔舐创口的...     

一例犬前十字韧带断裂的诊疗

前十字韧带断裂（CrCL）是犬（尤其是大型犬）的常见病。表现为膝关节不稳定所引起的持续性跛行。临床上可分为急性和渐进性断裂。渐进性断裂为间歇性跛行,最终发展为完全断裂。前十字韧带断裂的治疗,恢复关节稳定性是治疗重点。     

170例犬前十字韧带疾病囊外固定术的长期效果回顾性调查

为了调查犬膝关节前十字韧带疾病(CCLD)经囊外固定术(ECS)治疗后的长期效果及相关并发症。本试验采用回顾病历记录和电话回访动物主人进行调查的方法,对2015—2021年在中国农业大学教学动物医院诊断为CCLD并接受ECS治疗的犬进行回顾性调查,记录基本信息,通过跛行评分、动物主人满意度和术后并发症评估术后长期效果。结果显示,共收集145只CCLD患犬,有170个膝关节实施了ECS,CCLD最常见品种为贵宾犬和比熊犬,占总病例数的50.8%;平均发病年龄为7.8岁;术后1年跛行评分≤1分的占85.3%;动物主人满意度为90.6%;术后并发症发生率为26.1%,需要二次手术或药物治疗的严重并发症发生率为10.6%。结果表明,ECS对改善CCLD患犬跛行情况的长期效果良好,客户满意度较好。     

犬骨肿瘤的X线摄影诊断

统计资料表明,在犬各组织发生的肿瘤中骨肿瘤约占57%,在犬骨肿瘤中骨肉瘤约占80%,软骨肉瘤约占10%,纤维肉瘤和血管肉瘤约占77%。骨肉瘤是一种原发性恶性骨肿瘤。对其进一步分析表明,骨肉瘤易发生在大体型品种的犬如德国牧羊犬(German Shepherd)、大丹(Great Dane)、拳师犬(Boxer)等,易发生在5—9岁龄(平均7.5(1—1.5岁),公、母犬     

犬消化道X线造影检查

为探讨犬消化道 Ｘ 线造影检查的最佳途径,以及造影影像与胃肠部分生理功能之间的关系,按照自身循环对照设计法,对 ５ 只本地杂交犬进行了消化道 Ｘ 线造影检查。在试验中进行了不同辅助方法及条件下全消化道常规造影、胃气钡双重造影、全消化道快速造影、结肠钡灌肠常规造影及结肠气钡双重造影。用双盲法进行读片。结果,消化道常规造影检查与其他各项消化道特殊造影检查各具优缺点;一次性注入钡剂进行全消化道常规造影检查、低张造影检查、气钡双重造影检查具有良好的可行性。     

Radiographic and clinical changes of the tibial tuberosity after tibial plateau leveling osteotomy

OBJECTIVE: To investigate radiographic changes of the tibial tuberosity after tibial plateau leveling osteotomy (TPLO) surgery and identify clinical findings and risk factors associated with such changes. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Hundred and eighty-six client-owned dogs (219 stifles) that had TPLO surgery. METHODS: Patient data retrieved included radiographic changes of the tibial tuberosity during re-examination, age, body weight, whether unilateral or single-session bilateral surgery had been performed, location of the anti-rotational pin, approximate tibial tuberosity area, and approximate average tibial tuberosity width. RESULTS: Fracture with resulting caudal displacement of the proximal tibial tuberosity (1.4%; 3 of 219) occurred less frequently than non-displaced tibial tuberosity fractures (7.3%; 16 of 219). Age, weight, average tibial tuberosity width, location of the anti-rotational pin, and single session bilateral surgery were identified as risks factors for non-displaced fracture. Weight divided by the square of the average tibial tuberosity width may be a stronger risk factor than either weight or average tibial tuberosity width alone. CONCLUSIONS: Dogs undergoing single session bilateral TPLO surgery are at greater risk for developing non-displaced tibial tuberosity fractures. The non-displaced tibial tuberosity fracture does not appear to adversely affect outcome or lead to tibial tuberosity avulsion. Significant risk factors for fracture of the proximal tibial tuberosity with caudal displacement were not identified. CLINICAL RELEVANCE: Factors including age, weight, tibial tuberosity thickness, and conditions that may enhance strain on the tibial tuberosity, such as single-session bilateral procedures, may increase risk of fracture.     

Feasibility of utilizing the patellar ligament angle for assessing cranial cruciate ligament rupture in dogs

The patellar ligament angle (PLA) was assessed in 105 normal stifle joints of 79 dogs and 33 stifle joints of 26 dogs with a ruptured cranial cruciate ligament (CrCL). The PLA of stifles with complete CrCL rupture was significantly lower than that of normal stifles, particularly at a flexion angle of 60~80° in both plain and stress views. If the PLA was <90.55° on the stress view with a 60~80° flexion angle, the dog was diagnosed with a complete rupture of the CrCL with a sensitivity of 83.9% and specificity of 100%. In conclusion, measuring the PLA is a quantitative method for diagnosing complete CrCL rupture in canines.     

The effect of tibial plateau leveling osteotomy position on cranial tibial subluxation: an in vitro study

OBJECTIVES: To compare centered versus distal tibial plateau leveling osteotomy (TPLO) position on cranial tibial subluxation, postoperative tibial plateau angle (TPA), and tibial long axis shift (TLAS). STUDY DESIGN: In vitro biomechanical evaluation. ANIMALS: Six pairs of canine cadaveric hind limbs. METHODS: One limb of each pair was randomly assigned to the distal (TPLO-D) or centered (TPLO-C) osteotomy group. Cranial tibial subluxation (CTS) under load was quantified sequentially under 3 conditions: intact, after cranial cruciate ligament transection, and after TPLO; a corrected CTS value was also calculated. Postoperative TPA and TLAS were measured. Comparisons were made using 1-way repeated measures ANOVA with a Tukey's multiple comparison post hoc test for CTS, and a Wilcoxon's sign rank test for TPA and TLAS. Significance was set at P<.05. RESULTS: TPLO-C had a significantly lower mean CTS than TPLO-D (P<.01). Corrected CTS was also significantly lower in TPLO-C than in TPLO-D (P<.001). Postoperative TPA and TLAS were less in TPLO-C than in TPLO-D (P=.0312). CONCLUSION: Our results confirm that distal centering of the TPLO leads to craniodistal translation of the tibial plateau, TLAS, and a postoperative TPA that is greater than expected. This geometric effect has the biomechanical effect expected of inadequate tibial plateau leveling, namely incomplete neutralization of cranial tibial thrust. CLINICAL RELEVANCE: The centered osteotomy position is geometrically more precise, and biomechanically more effective than the distal position.     

Long-term radiographic comparison of tibial plateau leveling osteotomy versus extracapsular stabilization for cranial cruciate ligament rupture in the dog

OBJECTIVE: Comparison of 2 methods of surgical management of cranial cruciate ligament (CCL) injury in large-breed dogs using a radiographic osteoarthrosis (OA) scoring system. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs (n=66). METHODS: Radiographs were evaluated from dogs weighing >/=22.7 kg, with surgical management of CCL rupture using extracapsular repair (ECR) or tibial plateau leveling osteotomy (TPLO). Radiographs were taken immediately before surgery and >/=12 months later. An OA score was assigned to each set of radiographs taken at the preoperative and final examinations by evaluating 32 specific features of stifle OA. The difference between preoperative and final OA scores were subtracted and 2 final score categories of a change 5 were created. A logistic regression model was used to evaluate the effect of right versus left pelvic limb, age, preoperative weight, postoperative weight, days from surgery until final radiographic recheck, cranial cruciate status at surgery, medial meniscus status at surgery, and ECR versus TPLO. RESULTS: The ECR group had 27 stifles (22 dogs) and the TPLO group had 52 stifles (44 dogs). ECR dogs had a preoperative weight of 33.4+/-9.3 kg (range 22.7-54.1 kg) and a preoperative OA score of 13.0+/-8.4 (range 1-34) compared with TPLO dogs that had a preoperative weight of 38.9+/-9.1 kg (range 25-63.9 kg) and preoperative OA score of 15.9+/-8.4 (range 4-44). Postoperative weights for ECR and TPLO dogs were 33.6+/-9 kg (range 21.8-54.6 kg) and 39.4+/-10.1 kg (range 24-72 kg), respectively. Final OA scores were: ECR dogs, 26.3+/-10.8 (range, 10-54); TPLO dogs, 23.3+/-9.5 (range, 12-50). Dogs with a final change in OA score of >/=6 were 5.78 times more likely to have had ECR compared with those that had TPLO as stabilization procedure (odds ratio=5.78; Log-likelihood test P-value=.025). Other dependent variables were not significant. CONCLUSIONS: Based on logistic regression analysis, dogs with larger OA score differences were 5.78 times more likely to have had ECR than TPLO. CLINICAL RELEVANCE: Prospective, randomized surgical trials with pre-defined objective measures would be required to further evaluate the clinical importance of these preliminary findings which suggest that TPLO may help stabilize the cranial tibial thrust as originally proposed.     

Age, Tibial Plateau Angle, Sex, and Weight as Risk Factors for Contralateral Rupture of the Cranial Cruciate Ligament in Labradors

Objective— To compare rates of contralateral cranial cruciate ligament rupture (CCLR) in Labradors based on age and weight at initial rupture, sex, and tibial plateau angle (TPA) and to determine whether Labradors that rupture their initial cranial cruciate ligament (CCL) at an earlier age (<4 years) are more likely to rupture their contralateral side within a certain period of time. Study Design— Case series. Animals— Labradors (n=94) that had tibial plateau leveling osteotomy (TPLO). Methods— Two groups: no contralateral rupture (NR) and contralateral rupture (CR) were compared for significant (P<.05) differences in percentage of subsequent cruciate tears using a Wilcoxon's rank‐sum tests for continuous variables and Fisher's exact test for sex. Adjusted odds ratios for likelihood of subsequent cruciate tears (yes/no) were estimated using logistic regression. Associations of these characteristics with time to subsequent rupture were assessed using Kaplan–Meier survival analysis estimation. Predictors of presentation with bilateral ruptures (BR) versus single rupture were also evaluated using Wilcoxon's rank‐sum tests and a generalized Fisher's exact test. Results— Subsequent CCLR occurred in 45 dogs (48%), and BR on admission were identified in 10 dogs (10.6%). Comparing NR and CR dogs, there were no significant differences between age or weight at initial rupture, sex or TPA; however there were associations toward longer time to CR for dogs older than the median age and female dogs (intact and spayed). There were no significant differences in age, sex, weight, or TPA of dogs with bilateral CCL ruptures compared with initial unilateral ruptures; however, there was a trend toward dogs presenting at an older age and with lower TPA's in the BR group. Among the 84 NR/CR dogs, the median time to rupture of the contralateral CCL was 5.5 months (95% CI 5.2–5.7). Conclusions— Age and weight at initial rupture, sex, and TPA does not affect likelihood or rate of contralateral CCL rupture or presentation with bilateral CCL ruptures. Clinical Relevance— Approximately 50% of Labradors will rupture the contralateral CCL within 5.5 months of the initial rupture but age, weight, sex, and TPA cannot be used as predictive features.