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1.
OBJECTIVE: To evaluate a method for experimental induction of osteoarthritis in the hip joints of dogs. ANIMALS: 12 mixed-breed dogs. PROCEDURE: A unilateral triple pelvic osteotomy was performed. In 6 dogs, the iliac osteotomy was repaired with 45 degrees of internal rotation, reducing coverage of the femoral head by the acetabulum. In the other 6 dogs, the fragments were repaired in anatomic alignment. Radiography, force plate evaluations, and subjective lameness evaluations were performed before and after surgery. Dogs were euthanatized 7 months after surgery, and samples of cartilage and joint capsule were examined histologically. RESULTS: Subjective lameness scores, radiographic appearance of the hip joints, and Norberg angles were not significantly different between groups; however, force plate evaluations did reveal significant differences in vertical ground reaction forces. Femoral head coverage was significantly decreased with rotation of the acetabulum. Mild inflammatory changes were discernible in the joint capsule and articular cartilage of some dogs in both groups. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that 45 degrees internal rotation of the acetabulum does not consistently induce biologically important osteoarthritic changes in the hip joints of dogs.  相似文献   

2.
OBJECTIVE: To determine long-term outcome of distal femoral osteotomy as a component of treatment for distal femoral varus and medial patellar luxation in large-breed dogs. DESIGN:Retrospective case series. ANIMALS: 12 dogs (16 stifle joints). PROCEDURES: Medical records and radiographs were reviewed to identify large-breed dogs with medial patellar luxation (grade > or = 2) and femoral varus angle > or = 12 degrees treated with distal femoral osteotomy, with a minimum follow-up (by a veterinarian) of 18 months. Signalment, weight, medial patellar luxation and lameness grade, pre- and postoperative femoral varus angle, surgical technique, time to radiographic bone union, and complications were recorded. Follow-up with owners via questionnaire was performed > 18 months after surgery. RESULTS: 16 corrective distal femoral osteotomies were performed with ancillary medial patellar luxation procedures in 12 dogs; 4 dogs had staged bilateral procedures. Mean +/- SD preoperative and postoperative femoral varus angles were 16.3 +/- 4.3 degrees and 3.9 +/- 2.5 degrees , respectively. Mean +/- SD time to radiographic union of the distal femoral osteotomy was 52.6 +/- 13 days. One dog had Kirschner wire migration from the tibial tuberosity. Patellar luxation was not detected after surgery in any dog. Mean +/- SD follow-up by a veterinarian was 1,335 +/- 410 days and by use of an owner questionnaire was 1,497 +/- 464 days. All 10 variables of owner-observed patient comfort and function were significantly improved. CONCLUSIONS AND CLINICAL RELEVANCE: Distal femoral osteotomy in combination with traditional treatment provided predictable osteotomy healing, patellar stabilization, and long-term improvement in patient comfort and function when used to treat combined distal femoral varus and medial patellar luxation in large-breed dogs.  相似文献   

3.
OBJECTIVE: To compare long-term outcomes of juvenile pubic symphysiodesis (JPS) and triple pelvic osteotomy (TPO) in dogs with hip dysplasia. DESIGN: Prospective clinical trial. ANIMALS: 18 dogs with hip dysplasia (ie, distraction index > or = 0.5 in at least 1 hip joint and no, mild, or moderate radiographic evidence of degenerative joint disease [DJD]). PROCEDURES: Dogs between 4 and 5.5 months old at enrollment were assigned to undergo JPS, and dogs between 5 and 12 months old were assigned to undergo TPO. All dogs were reexamined at 2 years of age. RESULTS: At 2 years of age, there were no significant differences between groups in regard to lameness scores, angle of extension of the hip joints, distraction index, peak vertical force, acetabular angle, radiographic DJD score, or owner-assigned scores of clinical function. Dorsal acetabular rim angle was significantly higher in dogs that underwent JPS than in dogs that underwent TPO. For dogs that underwent TPO, dorsal acetabular rim angle was significantly decreased and acetabular angle was significantly increased at 2 years of age, compared with values obtained prior to surgery. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that JPS and TPO have similar effects on hip joint conformation in dogs with moderate to severe hip dysplasia but that neither procedure eliminates the hip joint laxity characteristic of hip dysplasia or the progression of degenerative changes.  相似文献   

4.
OBJECTIVE: To develop a radiographic stress technique to quantify hip joint laxity in dogs. STUDY DESIGN: Prospective study on client-owned dogs presented for hip dysplasia screening. ANIMAL POPULATION: 302 nonselected dogs (63 breeds). METHODS: Dogs were sedated and placed in dorsal recumbency. During pelvic radiography, the femoral heads were displaced manually in a craniodorsal direction. On these stress radiographs, the degree of lateral displacement of the femoral heads was assessed in terms of a subluxation index (SI) and compared with the degree of femoral head subluxation and the severity of hip dysplasia found on conventional extended hindlimb radiographs. RESULTS: The degree of subluxation on stress radiographs was significantly greater than on conventional radiographs. Correlation between the severity of canine hip dysplasia (CHD), graded according to conventional techniques, and the degree of subluxation, induced by radiographic stress technique, was positive (r = .57; P<.0001). Two critical SI values were noted. Of the dogs with an SI value of 0.3 or less, 99% were classified as CHD grade normal, borderline, or mildly dysplastic. In dogs with an SI value between 0.3 and 0.5, CHD grading ranged from normal to severely dysplastic. Of the dogs with an SI value greater than 0.5, 95% had dysplastic hip joints. CONCLUSIONS: Hip joint laxity cannot be quantified precisely on standard position radiographs. The proposed stress technique yields significantly higher degrees of femoral head subluxation than the standard position.  相似文献   

5.
Triple pelvic osteotomy was performed in 15 dogs with bilateral hip dysplasia. Ten dogs were treated bilaterally and five dogs were treated unilaterally. Ten untreated dogs with normal hips served as controls. Force plate analysis, lameness evaluation, and radiography were performed before surgery and at weeks 5, 10, 15, and 28. Three dogs treated unilaterally were euthanatized and the hips were examined grossly and microscopically. Force plate data indicated that young dysplastic dogs transmitted significantly less vertical force through the hip joints than normal dogs. The force transmitted through treated hips reached or approached control levels by week 28 and was significantly greater than the force transmitted through untreated hips. Clinical lameness resolved in 92% of limbs and progression of radiographically detectable degenerative joint disease was minimal. Gross and microscopic degenerative changes in the articular cartilage were similar in the treated and untreated hips. The synovial membrane was less reactive in treated hips.  相似文献   

6.
OBJECTIVE: To determine whether dorsolateral subluxation (DLS) of the femoral head reflects osseous conformation of the coxofemoral (hip) joint and represents a property distinct from maximum passive laxity of the hip joint in dogs. ANIMALS: 14 Labrador Retrievers, 16 Greyhounds, 58 Greyhound-Labrador Retriever mixed-breed dogs, and 1 Rottweiler. PROCEDURES: DLS of the femoral head (DLS score) and passive laxity of the hip joint (distraction index) were determined radiographically in 3 groups of dogs: not treated (167 joints of 84 dogs); before and after injecting 2 ml of hyaluronan into 25 hip joints of 13 dogs; and before and after unilateral triple pelvic osteotomy in 5 dogs. Results of the 2 methods were compared for each group. RESULTS: In untreated dogs, the correlation coefficient (r) of DLS score versus distraction index was -0.73 and -0.69 for 84 left and 83 right hip joints, respectively. Mean coefficient of determination (r2) for both hips was 0.5. Mean DLS score did not differ before and after intra-articular injection of hyaluronan into either hip joint, whereas mean distraction index increased significantly after intra-articular injection. Unilateral triple pelvic osteotomy resulted in a significant increase in DLS score, compared with values obtained before surgery. However, distraction index before and after surgery did not differ significantly. CONCLUSIONS AND CLINICAL RELEVANCE: The DLS test assesses the congruity of the acetabulum and the femoral head in a canine hip joint and thus represents a characteristic distinct from maximum passive laxity. The DLS score and the distraction index evaluate different components of hip joint stability.  相似文献   

7.
OBJECTIVE: To investigate factors influencing screw loosening after triple pelvic osteotomy (TPO) and ischial wire stabilization of the acetabular segment. DESIGN: Retrospective case series. Animals-227 dogs with congenital hip dysplasia or subluxated hip joints. PROCEDURES: Medical records and radiographs of 227 dogs that underwent 332 TPO procedures were evaluated, and data pertaining to screw type, plate position, sacral screw engagement, use of ischial interfragmentary wires, and pelvic alignment were assessed for associations with screw loosening. RESULTS: Complications developed in 96 of the 332 (29%) procedures. Cancellous screws without sacral engagement were associated with the lowest frequency (6%) of loosening, compared with cancellous and cortical screws engaging the sacrum and cortical screws that did not engage the sacrum. Frequency of screw loosening increased when cortical or cancellous screws engaged the sacrum and when cortical screws were used. In dogs that had surgery bilaterally, the first limb on which TPO was performed had a higher frequency of screw loosening than the second limb. Pelvic alignment loss was greatest (5.4 degrees ) when the 3 most cranial screws were loosened. Loss of pelvic alignment was significantly different between dogs that underwent surgery and had complications and those that underwent surgery and did not have complications in association with loosening of 1, 2, and 3 screws. CONCLUSIONS AND CLINICAL RELEVANCE: TPO screw loosening was multifactorial and related to stability of the affected ilium, screw type, and screw position. Placing cancellous screws that do not engage the sacrum in pelvic osteotomy plate positions 1 through 3 may decrease the number of screws that loosen.  相似文献   

8.
OBJECTIVE: To compare radiographic and arthroscopic abnormalities in juvenile dogs with clinically apparent hip dysplasia. DESIGN: Case series. ANIMALS: 52 dogs (70 hip joints) with clinical signs of hip dysplasia scheduled to undergo triple pelvic osteotomy. PROCEDURE: A ventrodorsal radiographic projection of the pelvis was evaluated by a radiologist unaware of clinical and arthroscopic findings, and radiographic osteoarthritic abnormalities were judged and scored as absent (0), mild (1), moderate (2), or severe (3). Arthroscopy was performed by a surgeon unaware of clinical and radiographic findings, and arthroscopic abnormalities were graded from 0 (normal) to 5 (exposed, eburnated subchondral bone). RESULTS: In 30 of the 70 (43%) hip joints, no radiographic osteoarthritic abnormalities were seen. Severe, full-thickness articular cartilage lesions (grade 4) of the femoral head or acetabulum were seen arthroscopically in 14 (20%) joints. Lesions > or = grade 2 were seen in 60 (86%) joints. Partial tearing of the ligament of the femoral head was present in 57 (81%) joints, and complete rupture was seen in 5 (7%). Radiographic abnormalities were seen in 13 of the 14 (93%; 95% confidence interval, 66% to 99.8%) joints with grade 4 arthroscopic abnormalities but in only 23 of the 46 (50%; 95% confidence interval, 35% to 65%) joints with grade 2 or 3 arthroscopic abnormalities. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that radiography is not a sensitive method for identifying moderate cartilage lesions in juvenile dogs with hip dysplasia. If moderate cartilage lesions are an important prognostic indicator for the success of triple pelvic osteotomy, then methods other than radiography should be used to detect these lesions.  相似文献   

9.
Objective: To describe a surgical technique, and outcome, for treatment of proximal tibial deformity (varus, valgus, excessive tibial plateau angle [eTPA], tibial torsion and patellar luxation) by combined tibial plateau leveling osteotomy (TPLO) and transverse corrective osteotomy. Study Design: Cases series. Animals: Dogs (n=12; 19 stifle joints). Methods: Medical records of dogs that had combination TPLO and transverse corrective osteotomy, were reviewed. Pre‐ and postoperative tibial angulation, tibial torsion, tibial plateau angle (TPA), corrective osteotomy technique, method of fixation, and complications were recorded. In hospital re‐evaluation of limb function and alignment and length of time to radiographic healing were reviewed. Long‐term outcome was assessed by visual analog scale (VAS) questionnaire and owner telephone interview. Results: Proximal tibial varus or valgus was present in 68.4%; 73.7% had eTPA; and 47.4% had both. Medial patellar luxation (MPL) was present in 57.9%, of which 47.4% had tibial tuberosity displacement. Severe tibial torsion was present in 68.4%. Mean pre‐ and postoperative TPA was 37.5° and 5.7°, respectively. The mean postoperative mechanical medial proximal tibial angle (mMPTA) and mechanical medial distal tibial angle (mMDTA) were 92.2° (range, 88–96°) and 96.1° (range, 94–101°), respectively. Postoperative surgical complications were documented in 21.0%, which included implant loosening or breakage (5.3%), seroma (5.3%), septic arthritis (5.3%), and infection of the proximal tibia (5.3%). All complications were considered major because they required additional surgery. Mean time to document radiographic healing was 10.4 weeks. In‐hospital re‐evaluation of lameness was obtained at the same time; 82.4% were not lame or had a mild lameness, 17.6% had severe lameness (2/3 with infection). The VAS evaluation revealed excellent results and owner satisfaction in all ten dogs in which long‐term follow‐up was obtained. Conclusions: Long‐term clinical outcome of combination TPLO and transverse corrective osteotomy was excellent, and had a high owner satisfaction. Healing times were comparable to standard TPLO with a similar complication rate.  相似文献   

10.
OBJECTIVE: To describe a surgical technique, and outcome, for treatment of cranial cruciate ligament (CrCL) deficient stifle joints with excessive tibial plateau angle (TPA) by combined tibial plateau leveling osteotomy and cranial closing wedge osteotomy (TPLO/CCWO). STUDY DESIGN: Retrospective clinical study. ANIMALS: Fifteen client-owned dogs (18 stifle joints). METHODS: Medical records of dogs that had TPLO/CCWO were reviewed. Pre- and postoperative TPA, CCWO technique, method of fixation and complications were recorded. In-hospital re-evaluation of limb function and length of time to radiographic healing was reviewed. Long-term outcome was assessed by owner telephone interview. RESULTS: Mean pre- and postoperative TPA was 42 degrees and 8 degrees, respectively. The Slocum biradial saw was used to create the CCWO in 4 stifle joints (mean postoperative TPA, 16 degrees) and a sagittal saw was used in 14 stifle joints (mean postoperative TPA, 5 degrees). Postoperative surgical complications were documented in 77.8% of cases; including patellar tendon thickening (61.1%), and implant loosening or breakage (27.8%), seroma formation (11.1%), and local irritation (11.1%). A second surgical procedure was performed in one-third of cases primarily to retrieve implants. Mean time to documented radiographic healing was 18 weeks. Final in-hospital re-evaluation of limb function (mean, 23 weeks postoperatively) was recorded as no lameness in 73.3% and mild lameness in 26.7%. All interviewed owners were satisfied with outcome and 90.9% reported marked improvement or a return to preinjury status. CONCLUSIONS: Long-term clinical outcome of TPLO/CCWO was very good in dogs with excessive TPA, with high owner satisfaction. Longer healing times and a higher complication rate were observed compared with TPLO alone. CLINICAL RELEVANCE: TPLO/CCWO of the tibia in stifle joints with excessive TPA allows for full correction of the TPA to 5 degrees without eliminating buttress support of the tibial tuberosity.  相似文献   

11.
A pelvic radiographic examination was performed on 15 large breed dogs without history and clinical sign of hip dysplasia. The effect of anaesthesia and of two stress-radiographic methods on the coxofemoral subluxation was evaluated. With anaesthesia a mild coxofemoral subluxation was seen in 31 per cent of the dogs, which all appeared radiographically normal when sedated. The Norberg angle was significantly decreased in anaesthetised dogs (P < 0–05). When dogs with a radiographically normal coxofemoral joint conformation were submitted to a stress-radiographic examination there was a shift towards an increased coxofemoral subluxation. Subluxation was seen in 70 per cent of the dogs when the knee fixation method of positioning was applied and in 100 per cent of the dogs when the wedge method was used. Correspondingly the Norberg angle decreased significantly when the coxofermoral joints were stressed (Pkneefix < 0–00003; Pwedge= 0–000008). The study concludes that the currently used procedure for evaluation of the hip joints does not necessarily disclose whether or not a dog has hip dysplasia.  相似文献   

12.
OBJECTIVES: To describe surgical arthrodesis of the scapulohumeral joint and to evaluate its efficacy in reducing morbidity associated with severe shoulder dysfunction in miniature horses. STUDY DESIGN: Retrospective study. ANIMALS: Four miniature horses. METHODS: Medical records and radiographs were reviewed for history, physical examination findings, lameness evaluation, radiographic evaluation, surgical techniques, postoperative complications, and outcome. A 10- or 11-hole, 4.5-mm narrow dynamic compression plate and 4.5-mm cortical screws were applied to the cranial surface of the scapula and cranial surface of the humerus after osteotomy of the intermediate tubercle. In most horses, 1 or 2 screws were inserted in lag fashion across the joint, through holes in the plate. RESULTS: Scapulohumeral osteoarthritis was diagnosed radiographically in 4 horses, and 3 horses had concurrent shoulder luxation or subluxation. All horses had grade 3 or 4 lameness before surgery, and most improved by 1 to 2 grades after surgery. Despite complications of implant failure (2 horses), infection (2 horses), scapular fracture (1 horse), and atrophy of the shoulder muscles (1 horse), functional arthrodesis reduced morbidity in all horses. CONCLUSIONS: Scapulohumeral arthrodesis facilitates early return to weight bearing in miniature horses with severe scapulohumeral joint osteoarthrosis. Despite functional gait abnormality, the horses ambulated quite well after surgery. CLINICAL RELEVANCE: Scapulohumeral arthrodesis should be considered for debilitating conditions of the shoulder joint in miniature horses, especially when the intended outcome is breeding or pasture soundness.  相似文献   

13.
OBJECTIVE: To determine the radiographic methods that best predict the development of osteoarthritis in the hip joints of a cohort of dogs with hip dysplasia and unaffected dogs. ANIMALS: 205 Labrador Retrievers, Greyhounds, and Labrador Retriever-Greyhound crossbred dogs. PROCEDURE: Pelvic radiography was performed when the dogs were 8 months old. Ventrodorsal extended-hip, distraction, and dorsolateral subluxation (DLS) radiographs were obtained. An Orthopedic Foundation for Animals-like hip score, distraction index, dorsolateral subluxation score, and Norberg angle were derived from examination of radiographs. Osteoarthritis was diagnosed at the time of necropsy in dogs > or = 8 months of age on the basis of detection of articular cartilage lesions. Multiple logistic regression was used to determine the radiographic technique or techniques that best predicted development of osteoarthritis. RESULTS: A combination of 2 radiographic methods was better than any single method in predicting a cartilage lesion or a normal joint, but adding a third radiographic method did not improve that prediction. A combination of the DLS score and Norberg angle best predicted osteoarthritis of the hip joint or an unaffected hip joint. All models that excluded the DLS score were inferior to those that included it. CONCLUSIONS AND CLINICAL RELEVANCE: A combination of the DLS score and Norberg angle was the best predictor of radiographic measures in 8-month-old dogs to determine whether a dog would have normal or osteoarthritic hip joints.  相似文献   

14.
Triple osteotomy of the pelvis with transplantation of the greater trochanter was performed in 41 immature dogs (77 hips) with hip dysplasia. Before surgery, all hips were moderately to severely subluxated and unstable on palpation. The juxta-acetabular location of the ilial, ischial, and pubic osteotomies allowed repositioning of the acetabulum over the femoral head even when subluxation was severe. The acetabular fragment was rotated 70 degrees to 90 degrees in all hips. After surgery, craniodorsal coverage of the femoral head was increased and each hip was stable on palpation. Bilateral procedures were performed 4 to 7 weeks apart. The functional status of the limb was assessed and physical examination and radiography were performed in 71% (55) of the hips 1.0 to 5.5 years (mean, 2.7 years) after surgery. Functional ability was considered satisfactory in 93% (51) of the limbs, though few dogs had a normal gait. On palpation, all hips were stable and all but one were evaluated as nonpainful. In most instances, contact between the femoral neck and the repositioned acetabular rim resulted in a variable amount of crepitus and restriction of motion when the hip was abducted and rotated externally and internally. Eighty-two percent (45) of the hips had little or no evidence of degenerative joint disease. A satisfactory functional, physical, and radiographic result was obtained in 73% (40) of the hips.  相似文献   

15.
OBJECTIVE: To determine the prevalence of cranial cruciate ligament rupture (CCLR) in dogs with lameness previously attributed to canine hip dysplasia (CHD). DESIGN: Retrospective study. ANIMALS: 369 client-owned dogs. PROCEDURES: Hospital medical records from 1994 to 2003 were reviewed for dogs in which the referring veterinarian had diagnosed hip dysplasia or hip pain. Dogs were designated as having hind limb lameness because of partial or complete CCLR or CHD. RESULTS: 8% of dogs were sexually intact females, 43% were spayed females, 14% were sexually intact males, and 35% were castrated males. Mean age was 3.8 years (range, 3 months to 15 years). The most common breeds were the Labrador Retriever (21%), German Shepherd Dog (13%), and Golden Retriever (11%). The prevalence of CCLR as the cause of hind limb lameness was 32% (95% confidence interval, 27.2% to 36.8%). The distribution of CCLR among hind limbs was left (29%), right (28%), and bilateral (43%). Of 119 dogs with CCLR, 94% had concurrent radiographic signs of CHD, 92% had stifle joint effusion, and 81% had a cranial drawer sign. CONCLUSIONS AND CLINICAL RELEVANCE: On the basis of the high prevalence of CCLR in dogs referred for lameness because of CHD, it is important to exclude other sources of stifle joint disease before making recommendations for treatment of CHD.  相似文献   

16.
OBJECTIVE: To evaluate the thresholds of 2 radiographic methods used to determine coxofemoral joint laxity in 7 breeds of dogs. ANIMALS: Three hundred and fifty clinically normal dogs. STUDY DESIGN: Retrospective study. METHODS: Hip radiographs from 7 breeds of dogs were randomly selected from a database. None of the dogs had radiographic evidence of degenerative joint disease (DJD). Distraction index (DI) and Norberg angle (NA) were measured on these radiographs and compared with DI and NA thresholds for diagnosing DJD susceptibility derived from the literature and from evaluated Borzois. Dogs with a NA<105 degrees and a DI of < or =0.32 were considered false-positives and dogs with a NA> or =105 degrees and a DI of >0.32 were considered false-negatives. RESULTS: Mean age of all dogs was 22.9 months. Mean NA for all dogs was 99.37 degrees, and mean DI for all dogs was 0.44. Borzoi mean DI of was significantly less than the mean DI of the other 6 breeds. The highest (most hip laxity) Borzoi DI was 0.32, and the lowest (most hip laxity) Borzoi NA was 99 degrees. False-positive and false-negative diagnoses were identified in 6 of the 7 breeds. CONCLUSIONS: Using the NA threshold of 105 degrees (literature established threshold of susceptibility to DJD) resulted in a high percentage of false-negative and false-positive diagnoses. Breeds like the Labrador Retriever and Rottweiler would have large numbers of hip dysplasia susceptible dogs remain in the breeding population based on this NA threshold. False-positive diagnoses were common in breeds like the Australian Shepherd, Borzoi, and German Shepherd effectively eliminating hip dysplasia nonsusceptible dogs from the breeding population. CLINICAL RELEVANCE: The NA was not an accurate predictor of DJD susceptibility in these 7 breeds of dogs when using a NA threshold of 105 degrees.  相似文献   

17.
Objective: To compare the resulting complications, short-term results, and client satisfaction for treatment of cranial cruciate ligament rupture using either unilateral or bilateral single-session tibial tuberosity advancement (TTA) in dogs. Methods: Medical records of 68 dogs (101 stifles) undergoing unilateral or bilateral single-session TTA were evaluated. Data gathered included signalment, history, physical examination findings, anaesthesia and surgical time, type of cranial cruciate ligament rupture and meniscal injury, implants, and intra-operative and postoperative complications. A mixed effect logistic regression analysis was performed to determine if complications were grouped by surgical procedure. Linear regression was performed to determine the influence of the variables on the occurrence of complications. Values of p <0.05 were considered significant. Results: No major intra-operative complications occurred. Twenty stifles (20%) developed a complication after surgery (11 minor, 9 major). There was no significant difference in occurrence of complications between dogs undergoing unilateral (n = 8) or bilateral single-session (n = 12) TTA (p = 0.69). The only risk factor found to be associated with complication occurrence was age. Clinical significance: This is the first report evaluating the use of bilateral simultaneous TTA. There was no significant difference in complication rates between unilateral and bilateral single-session TTA. Additional evaluation is needed to fully determine the extent of complications and long-term outcome of bilateral single-session TTA.  相似文献   

18.
OBJECTIVE--To determine the long-term effects of juvenile pubic symphysiodesis (JPS) in dysplastic puppies. STUDY DESIGN--Prospective, randomized, clinical trial. ANIMALS--Seven dysplastic Chesapeake Bay retrievers and 2 beagle-crosses (BX1 and 2). METHODS--Five puppies had JPS performed with electrocauterization at 12, 16, 20, 22, and 24 weeks of age, respectively. Two puppies served as controls. BX1 and BX2 were used to obtain biopsies of the symphysis. Hips were evaluated for: pelvic development (transverse computerized tomography for acetabular angle [AA] and dorsal acetabular rim angle [DARA]); laxity [hip extended and stress radiography [distraction index (DI)]); Ortolani maneuver with reduction angles; acetabular coverage (Norberg angles); and function (coxofemoral range of motion, hip pain, and gait analysis by force-plate technique at 44 and 137 weeks of age). RESULTS--The pubis fused prematurely in every puppy that was operated on with the JPS technique. Greater acetabular responses were related to younger ages at surgery. The final mean AA in dogs that had JPS was 25 degrees greater than preoperative values; 40% increased over control. The DARA final mean was 10 degrees, 52% less than preoperative values and 46% less than control. The final mean DI in dogs having JPS was 0.28, 47% improved over preoperative values and 58% better than control. Mean pelvic dimensions in dogs that had JPS were 18% less than control. Gait analyses were normal for all dogs at 137 weeks. No urinary or bowel complications occurred. CONCLUSIONS--Significant ventrolateral acetabular rotation, increased hip coverage, diminished hip laxity, normal pain-free gait, and insignificantly reduced pelvic size occurred after JPS. CLINICAL SIGNIFICANCE--Dysplastic hips in young dogs were significantly improved by JPS.  相似文献   

19.
OBJECTIVE: To detect early screw loosening in triple pelvic osteotomy (TPO) and to evaluate the efficacy of retightening using fluoroscopic guidance and minimally invasive surgery to maintain acetabular alignment and achieve bone healing. STUDY DESIGN: Prospective clinical study. SAMPLE POPULATION: Sixteen dogs that had TPO. METHODS: Dogs (16) had TPO (21) by using pre-angled plates secured with 3.5 and 4.0 mm screws, with ischiatic or iliac cerclage, for osteosynthesis. In all but 1 TPO at least 1 screw was inserted into the sacral body (43 screws). The mean radiographic screw length inserted in the sacrum was 10.2 mm, and the mean percent sacral engagement was 22%. Dogs were examined clinically and radiographically immediately postoperatively, and at 10, 30, 60, and 90 days to evaluate screw position. Loose screws were retightened through stab incisions using fluoroscopy to locate the screw. RESULTS: TPO was performed without operative complications. At 10 days, 12 TPOs (57%; 11 dogs) had loose screws primarily located in the cranial aspect of the plate. This represented 20% (25) of the inserted screws. In 5 dogs, screw loosening resulted in medial rotation of the acetabular segment. All loose screws were retightened; 3 screws loosened again in 2 dogs and were detected at 60 days. However, the osteotomies healed with the planned acetabular rotation without further intervention. Screw tightening corrected the acetabular segment displacement. Screws correctly seated at 10 days did not subsequently loosen. Clinical and radiographic outcome was judged excellent in all dogs. CONCLUSION: Loose screws in TPO plates can be identified by 10 days postoperatively and retightened using fluoroscopic guidance to achieve acetabular realignment and healing without need for further surgery. CLINICAL RELEVANCE: Postoperative radiographic evaluation of screw position at 10 days after TPO is recommended to detect loose screws. Retightening loose screws should be considered as an alternative to TPO revision or confinement, especially in immature dogs.  相似文献   

20.
Humeroulnar subluxation was treated surgically in 13 dogs with 18 affected elbows using a proximal osteotomy of the ulna that allowed the ulna to elongate dynamically. Distal humeroulnar subluxation was secondary to premature closure of the distal ulnar physis in 16 elbows. One distal subluxation was secondary to a radioulnar synostosis, and one proximal subluxation developed after premature closure of the distal radial physis. The mean follow-up time was 22 months. Twenty-eight percent of the elbows were judged to have excellent results, 22% good results, 50% fair results, and none was judged to have a poor outcome. The presenting lameness grade and the severity of preoperative and postoperative humeroulnar subluxation had significant correlations with the prognosis. Associated orthopedic abnormalities and complications of concurrent surgical procedures affected the outcome in several dogs. Overall, the dynamic proximal ulnar osteotomy was a simple and effective technique for the treatment of uncomplicated humeroulnar subluxation.  相似文献   

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