전방 십자인대 결손을 보이는 개에서 TightRope을 이용한 치료방법 평가 Clinical Evaluation of TightRope Cranial Cruciate Ligament Technique for Treatment of Cranial Cruciate Ligament Deficiency in Dogs원문보기
뒷다리 파행 병력을 보이는 아홉 마리 개가 건국대학교 부속 동물병원과 우성 동물병원에 내원하였다. 신체검사에서 아홉 마리 모두 지속적 디딤 파행, 근위축, 통증을 동반한 전방 밀림 증상을 보였다. 경골 압박 자세를 취한 측면 방사선 사진에서 경골 결절의 전방 밀림 증상을 확인하였다. 손상 된 무릎 관절은 각각 오른쪽 7마리, 왼쪽 2 마리에서 확인 되었으며 전방 십자인대 결손 치료를 위해 TightRope 방법이 실시 되었다. 인대 복원을 위한 봉합사로 polyester와 nylon이 각각 3마리와 6마리에서 사용 되었으며 봉합사 두께는 0.8 mm (n = 2), 0.9 mm (n = 4), 1.1 mm (n = 2), and $1.1mm{\times}2$ 가닥 (n = 1)이 사용 되었다. 평균 (${\pm}SD$) 수술 시간, 수술 전 후 전방 밀림 현상은 각각 $48.3{\pm}8.5$ 분 (35-60 분), $8.6{\pm}1.6$ mm (7-12 mm), $1.2{\pm}1.0$ mm (0-3 mm)로 확인 되었다. 수술 직후 방사선 촬영에서 아홉마리 모두 경골 결절 전방 밀림 현상은 확인 되지 않았다. 여덟 마리에서 수술 후 8주 내 정상 보행을 확인할 수 있었으며 1 마리에서 수술 후 2 주 경골 결절 전방 밀림 현상과 디딤 파행 재발을 확인하였다. 재 수술 과정에서 외과용 단추가 부러진 것을 확인 하였고 tibial wedge osteotomy를 실시 하였다. 수술 시간, 부작용, 관절 안정성, 기능 회복 면에서 전방 십자인대 결손 치료를 위한 TightRope 방법이 효과적임을 확인 하였다.
뒷다리 파행 병력을 보이는 아홉 마리 개가 건국대학교 부속 동물병원과 우성 동물병원에 내원하였다. 신체검사에서 아홉 마리 모두 지속적 디딤 파행, 근위축, 통증을 동반한 전방 밀림 증상을 보였다. 경골 압박 자세를 취한 측면 방사선 사진에서 경골 결절의 전방 밀림 증상을 확인하였다. 손상 된 무릎 관절은 각각 오른쪽 7마리, 왼쪽 2 마리에서 확인 되었으며 전방 십자인대 결손 치료를 위해 TightRope 방법이 실시 되었다. 인대 복원을 위한 봉합사로 polyester와 nylon이 각각 3마리와 6마리에서 사용 되었으며 봉합사 두께는 0.8 mm (n = 2), 0.9 mm (n = 4), 1.1 mm (n = 2), and $1.1mm{\times}2$ 가닥 (n = 1)이 사용 되었다. 평균 (${\pm}SD$) 수술 시간, 수술 전 후 전방 밀림 현상은 각각 $48.3{\pm}8.5$ 분 (35-60 분), $8.6{\pm}1.6$ mm (7-12 mm), $1.2{\pm}1.0$ mm (0-3 mm)로 확인 되었다. 수술 직후 방사선 촬영에서 아홉마리 모두 경골 결절 전방 밀림 현상은 확인 되지 않았다. 여덟 마리에서 수술 후 8주 내 정상 보행을 확인할 수 있었으며 1 마리에서 수술 후 2 주 경골 결절 전방 밀림 현상과 디딤 파행 재발을 확인하였다. 재 수술 과정에서 외과용 단추가 부러진 것을 확인 하였고 tibial wedge osteotomy를 실시 하였다. 수술 시간, 부작용, 관절 안정성, 기능 회복 면에서 전방 십자인대 결손 치료를 위한 TightRope 방법이 효과적임을 확인 하였다.
Nine dogs presented to the Veterinary Medical Teaching Hospital of Konkuk University and Woosung Animal Hospital with a history of pelvic limb lameness. On physical examination, 9 dogs all showed a consistent weight bearing lameness and mild muscle atrophy. There was cranial drawer sign with pain in...
Nine dogs presented to the Veterinary Medical Teaching Hospital of Konkuk University and Woosung Animal Hospital with a history of pelvic limb lameness. On physical examination, 9 dogs all showed a consistent weight bearing lameness and mild muscle atrophy. There was cranial drawer sign with pain in 9 dogs. Mediolateral radiographic projection revealed cranial subluxation of the tibial tuberosity in a tibial compression view. The right and left stifle joints were affected in 7 dogs and 2 dogs respectively. TightRope cranial cruciate ligament (CCL) technique for treatment of CCL deficiency was performed. Polyester and nylon were used to stabilize the stifle in 3 dogs and 6 dogs respectively. Suture sizes were 0.8 mm (n = 2), 0.9 mm (n = 4), 1.1 mm (n = 2), and $1.1mm{\times}2$ strands (n = 1) in diameter. Mean (${\pm}SD$) surgical duration was $48.3{\pm}8.5$ minutes (range 35 to 60 minutes). Preoperative and postoperative mean (${\pm}SD$) cranial drawer signs were $8.6{\pm}1.6$ mm (rage 7 to 12 mm) and $1.2{\pm}1.0$ mm (rage 0 to 3 mm) respectively. Immediate postoperative radiographs of the affected limb revealed no evidence of cranial subluxation of the tibial tuberosity in a tibial compression view of 9 dogs. Normal limb function was regained in 8 dogs within 8 weeks postoperatively. A consistent weight bearing lameness resolved in all dogs after TightRope CCL technique, but reoccurred in one dog (case No. 6) 2 weeks after surgery. Cranial subluxation of the tibial tuberosity was identified in a tibial compression test. During the second surgery, breakage of surgical button was identified and a tibial wedge osteotomy was performed. Based on surgical time, complication, stifle stability, and functional recovery, the present study indicated that TightRope CCL technique is effective treatment for the dogs with CCL deficiency.
Nine dogs presented to the Veterinary Medical Teaching Hospital of Konkuk University and Woosung Animal Hospital with a history of pelvic limb lameness. On physical examination, 9 dogs all showed a consistent weight bearing lameness and mild muscle atrophy. There was cranial drawer sign with pain in 9 dogs. Mediolateral radiographic projection revealed cranial subluxation of the tibial tuberosity in a tibial compression view. The right and left stifle joints were affected in 7 dogs and 2 dogs respectively. TightRope cranial cruciate ligament (CCL) technique for treatment of CCL deficiency was performed. Polyester and nylon were used to stabilize the stifle in 3 dogs and 6 dogs respectively. Suture sizes were 0.8 mm (n = 2), 0.9 mm (n = 4), 1.1 mm (n = 2), and $1.1mm{\times}2$ strands (n = 1) in diameter. Mean (${\pm}SD$) surgical duration was $48.3{\pm}8.5$ minutes (range 35 to 60 minutes). Preoperative and postoperative mean (${\pm}SD$) cranial drawer signs were $8.6{\pm}1.6$ mm (rage 7 to 12 mm) and $1.2{\pm}1.0$ mm (rage 0 to 3 mm) respectively. Immediate postoperative radiographs of the affected limb revealed no evidence of cranial subluxation of the tibial tuberosity in a tibial compression view of 9 dogs. Normal limb function was regained in 8 dogs within 8 weeks postoperatively. A consistent weight bearing lameness resolved in all dogs after TightRope CCL technique, but reoccurred in one dog (case No. 6) 2 weeks after surgery. Cranial subluxation of the tibial tuberosity was identified in a tibial compression test. During the second surgery, breakage of surgical button was identified and a tibial wedge osteotomy was performed. Based on surgical time, complication, stifle stability, and functional recovery, the present study indicated that TightRope CCL technique is effective treatment for the dogs with CCL deficiency.
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문제 정의
TightRope CCL technique has been recently investigated to provide successful functional outcomes with low overall and major complication rates in a cost effective manner; however, the results of such a technique have been described in only two reports (3,12). The purpose of our study is to evaluate the clinical outcome of TightRope CCL technique for treatment of cranial cruciate ligament deficiency in nine dogs.
This study described the surgical treatment using TightRope CCL technique in 9 dogs with CCL deficiency. Based on surgical time, complication, stifle stability, and functional recovery, the present study indicated that TightRope CCL technique is effective treatment for the dogs with CCL deficiency.
제안 방법
The distance between the line b and a caudal part of the tibial condyle was estimated as cranial drawer. Function was evaluated 6 months postoperatively, based on physical examination by a veterinarian (HY) and telephone interview with owners. The owners were asked if there was lameness and pain when walking.
Owners were instructed to administer firocoxib (5 mg/kg orally once daily; Previcox®; Merial, Frence) for 14 days and tramadol (3 mg/kg orally twice daily; Tridol®; Yuhan. Co., Ltd, Korea) for 3 days postoperatively.
대상 데이터
Five male and 4 female dogs underwent TightRope CCL technique for treatment of cranial cruciate ligament deficiency. Breeds were Cocker Spaniel (n = 3), Jin-do dog (n = 2), Poodle (n = 2), Beagle (n = 1), and Alaskan Malamute (n = 1). Mean (± SD) body weight for dogs was 18.
참고문헌 (13)
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Tonks CA, Pozzi A, Ling H, Lewis DD. The effects of extraarticular suture tension on contact mechanics of the lateral compartment of cadaveric stifles treated with the TightRope $CCL^{(R)}$ or lateral suture technique. Vet Surg 2010; 39: 343-349.
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