개에서 내측 슬개골 탈구 교정을 위한 경골 조면 이식술과 관련된 수술 후의 합병증: 77 증례 (2007-2011) Postoperative Complications Associated with Tibial Tuberosity Transposition Surgery for Medial Patellar Luxation in Dogs: 77 Cases (2007-2011)원문보기
이 연구는 개에서 내측 슬개골 탈구 수술 후에 발생할 수 있는 합병증을 후향적으로 분석한 연구이다. 4년동안 내측 슬개골 탈구를 교정하기 위해 66마리의 개에서 77건의 수술이 시행되었다. 수술은 내측 연부 조직 이완, 외측 연부 조직 긴장, 활차구 사각 성형술, 경골 조면 이식술을 이용하여 실시되었다. 수술 후 6개월 동안 정기적으로 예후를 평가하였다. 실패율은 처음 수술을 한 경우보다 재수술을 한경우에 더 높았고, 가장 흔한 수술 후 합병증은 경골조면 조각의 변위였다. 경골 조면 변위는 핀이 아래쪽으로 삽입되거나, 핀이 경골 조면 조각의 가장자리에 삽입된 경우 혹은 경골 조면이 둔각인 경우에 발생했다. 따라서 경골 조면 이식술을 주의하여 실시하면 합병증을 최소화 할 수 있으며 좋은 예후를 기대할 수 있을 것으로 사료된다.
이 연구는 개에서 내측 슬개골 탈구 수술 후에 발생할 수 있는 합병증을 후향적으로 분석한 연구이다. 4년동안 내측 슬개골 탈구를 교정하기 위해 66마리의 개에서 77건의 수술이 시행되었다. 수술은 내측 연부 조직 이완, 외측 연부 조직 긴장, 활차구 사각 성형술, 경골 조면 이식술을 이용하여 실시되었다. 수술 후 6개월 동안 정기적으로 예후를 평가하였다. 실패율은 처음 수술을 한 경우보다 재수술을 한경우에 더 높았고, 가장 흔한 수술 후 합병증은 경골조면 조각의 변위였다. 경골 조면 변위는 핀이 아래쪽으로 삽입되거나, 핀이 경골 조면 조각의 가장자리에 삽입된 경우 혹은 경골 조면이 둔각인 경우에 발생했다. 따라서 경골 조면 이식술을 주의하여 실시하면 합병증을 최소화 할 수 있으며 좋은 예후를 기대할 수 있을 것으로 사료된다.
This is a retrospective study describing postoperative complication encountered with surgery performed in dogs with medial patellar luxation (MPL). During the 4-year period, 77 operations had been performed in 66 dogs for correction of MPL. The patients were surgically treated with medial soft tissu...
This is a retrospective study describing postoperative complication encountered with surgery performed in dogs with medial patellar luxation (MPL). During the 4-year period, 77 operations had been performed in 66 dogs for correction of MPL. The patients were surgically treated with medial soft tissue release, lateral soft tissue tightening, trochlear block recession, and/or tibial tuberosity transposition (TTT). Their prognoses were periodically evaluated for 6 months postoperatively. The failure rate was higher in revision surgery than in the first surgery, and the most common postoperative complication was migration of the tibial tuberosity fragment. The causes for the migration of the tibial tuberosity fragment were identified as the downward insertion of a surgical pin, the eccentric position of an inserted pin in the tibial tuberosity fragment, and blunt angle formation of the tibial tuberosity. It is suggested that the appropriate methods for TTT could minimize complications and lead to a good prognosis.
This is a retrospective study describing postoperative complication encountered with surgery performed in dogs with medial patellar luxation (MPL). During the 4-year period, 77 operations had been performed in 66 dogs for correction of MPL. The patients were surgically treated with medial soft tissue release, lateral soft tissue tightening, trochlear block recession, and/or tibial tuberosity transposition (TTT). Their prognoses were periodically evaluated for 6 months postoperatively. The failure rate was higher in revision surgery than in the first surgery, and the most common postoperative complication was migration of the tibial tuberosity fragment. The causes for the migration of the tibial tuberosity fragment were identified as the downward insertion of a surgical pin, the eccentric position of an inserted pin in the tibial tuberosity fragment, and blunt angle formation of the tibial tuberosity. It is suggested that the appropriate methods for TTT could minimize complications and lead to a good prognosis.
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제안 방법
Inclusion criteria required preoperative, postoperative and follow-up (approximate 6 months after surgery) radiographs as well as detailed surgical reports, postoperative treatments, and descriptions of any treatment given for complications. Data obtained from the medical records included breed, age, sex, affected limb (left/right), pre-operative grades of MPL, surgical procedures, and post-operative lameness evaluation.
The dogs were clinically assessed at the 2, 4, 8, 12, 16, and 24 weeks after the stifle surgery. An orthopedic examination was done same as the preoperative evaluation.
Among these techniques, trochleoplasty, tibial tuberosity transposition (TTT), medial soft tissue release and lateral soft tissue tightening have been mainly used for medial patellar luxation (MPL) surgery in toy and small breed dogs (1). The purpose of this study is to investigate the prognosis and the postoperative complication of MPL surgery and to determine more appropriate techniques by analyzing the failure causes in cases.
이론/모형
Subjective weight bearing and lameness were evaluated (Table 1), which were modified from the subjective evaluation score of Bubenik (3).
성능/효과
The full recovery rates for MPL grades 1 to 4 were 100%, 91.7%, 80.6%, and 50.0%, respectively. The partial recovery rates for grades 2 to 4 were 8.
참고문헌 (11)
Alam MR, Lee JI, Kang HS, Kim IS, Park SY, Lee KC, Kim NS. Frequency and distribution of patellar luxation in dogs. 134 cases (2000 to 2005). Vet Comp Orthop Traumatol 2007; 20: 59-64.
Bubenik LJ, Johnson SA, Smith MM, Howard RD, Broadstone RV. Evaluation of lameness associated with arthroscopy and arthrotomy of the normal canine cubital joint. Vet Surg 2002; 31: 23-31.
Campbell CA, Horstman CL, Mason DR, Evans RB. Severity of patellar luxation and frequency of concomitant cranial cruciate ligament rupture in dogs: 162 cases (2004-2007). J Am Vet Med Assoc 2010; 15: 887-891.
Fossum TW, Hedlund CS, Johnson AL, Schulz KS, Seim HB, Willard MD, Bahr A, Carroll GL, Knap K. Diseases of the joint. In: Small animal surgery, 3rd ed. St. Louis: Mosby. 2007; 1289-1297.
Gibbons SE, Macias C, Tonzing MA, Pinchbeck GL, McKee WM. Patellar luxation in 70 large breed dogs. J Small Anim Pract 2006; 47: 3-9.
Linney WR, Hammer DL, Shott S. Surgical treatment of medial patellar luxation without femoral trochlear groove deepening procedures in dogs: 91 cases (1998-2009). J Am Vet Med Assoc 2011; 238: 1168-1172.
Ness MG, Abercromby RH, Turner BM, Carmichael S. A survey of orthopaedic conditions in small animal veterinary practice in Britain. Vet Comp Orthop Traumatol 1996; 9: 43-52.
Talcott KW, Goring RL, de Haan JJ. Rectangular recession trochleoplasty for treatment of patellar luxation in dogs and cats. Vet Comp Orthop Traumatol 2000; 13: 39-43.
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