{"title":"新颖的新月形、内侧闭合、内侧平移、以转角中心为基础的平整截骨术,用于治疗两只狗的外侧室跗关节疾病和头颅十字韧带部分撕裂。","authors":"E J McLean, R G Cashmore","doi":"10.1080/00480169.2024.2308291","DOIUrl":null,"url":null,"abstract":"<p><strong>Case history: </strong>Two mature, large breed dogs presented with chronic lameness and discomfort localised to the stifle.</p><p><strong>Clinical findings: </strong>No hindlimb deformities were present on physical examination or radiographic evaluation. No stifle instability was present. Arthroscopy revealed severe (grade 5/5 modified Outerbridge score) cartilage erosion in the lateral compartment (femorotibial), marked degeneration of the lateral meniscus and early cranial cruciate ligament disease in both patients.</p><p><strong>Treatment and outcome: </strong>Medial-closing, medially translating, centre-of-rotation-of-angulation-based, levelling osteotomy (mcmtCBLO) was performed in both patients. The procedure aims to shift the pelvic limb's mechanical axis medially to reduce pressure in the lateral compartment while also reducing craniocaudal shear forces by lowering the tibial plateau angle.Eight weeks after surgery one patient's lameness had resolved while the other had improved significantly. Second-look arthroscopy performed at this time revealed fibrocartilage formation in the lateral compartment without progression of cruciate disease in both cases. At long-term follow-up (approximately 3 and 5 years), favourable outcomes (no or minimal lameness, mild or moderate osteoarthritis) were identified on the long-term owner survey, lameness examination and radiographs.</p><p><strong>Clinical relevance: </strong>mcmtCBLO reduced or eliminated short- and long-term lameness in these two cases afflicted by concurrent lateral compartment and early cranial cruciate ligament disease.</p>","PeriodicalId":19322,"journal":{"name":"New Zealand veterinary journal","volume":" ","pages":"162-169"},"PeriodicalIF":1.1000,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Novel crescentic, medial-closing, medially translating, centre-of-rotation-of-angulation-based, levelling osteotomy for lateral compartment stifle disease with partial cranial cruciate ligament tear in two dogs.\",\"authors\":\"E J McLean, R G Cashmore\",\"doi\":\"10.1080/00480169.2024.2308291\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Case history: </strong>Two mature, large breed dogs presented with chronic lameness and discomfort localised to the stifle.</p><p><strong>Clinical findings: </strong>No hindlimb deformities were present on physical examination or radiographic evaluation. 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引用次数: 0
摘要
病史两只成年大型犬出现慢性跛行,跗关节局部不适:体格检查和影像学评估均未发现后肢畸形。未发现跗关节不稳定。关节镜检查显示,两名患者的外侧室(股骨胫骨)软骨侵蚀严重(5/5级改良Outerbridge评分),外侧半月板明显退化,头颅十字韧带早期病变:两名患者均接受了内侧闭合、内侧平移、以旋转角度为中心的矫形截骨术(mcmtCBLO)。该手术旨在将骨盆肢体的机械轴向内侧移动,以减少外侧室的压力,同时通过降低胫骨平台角来减少颅尾剪切力。术后八周,一名患者的跛行症状得到缓解,另一名患者的跛行症状则有了明显改善。术后八周,其中一名患者的跛行症状得到缓解,另一名患者的跛行症状也得到明显改善。此时进行的关节镜二维检查显示,两例患者的外侧间室均有纤维软骨形成,但十字韧带病变并未恶化。在长期随访中(约 3 年和 5 年),通过对马主的长期调查、跛行检查和 X 光片检查发现了良好的结果(无跛行或跛行程度轻微、轻度或中度骨关节炎)。临床意义:在这两例同时患有外侧隔和早期头颅十字韧带疾病的病例中,mcmtCBLO 减少或消除了短期和长期跛行。
Novel crescentic, medial-closing, medially translating, centre-of-rotation-of-angulation-based, levelling osteotomy for lateral compartment stifle disease with partial cranial cruciate ligament tear in two dogs.
Case history: Two mature, large breed dogs presented with chronic lameness and discomfort localised to the stifle.
Clinical findings: No hindlimb deformities were present on physical examination or radiographic evaluation. No stifle instability was present. Arthroscopy revealed severe (grade 5/5 modified Outerbridge score) cartilage erosion in the lateral compartment (femorotibial), marked degeneration of the lateral meniscus and early cranial cruciate ligament disease in both patients.
Treatment and outcome: Medial-closing, medially translating, centre-of-rotation-of-angulation-based, levelling osteotomy (mcmtCBLO) was performed in both patients. The procedure aims to shift the pelvic limb's mechanical axis medially to reduce pressure in the lateral compartment while also reducing craniocaudal shear forces by lowering the tibial plateau angle.Eight weeks after surgery one patient's lameness had resolved while the other had improved significantly. Second-look arthroscopy performed at this time revealed fibrocartilage formation in the lateral compartment without progression of cruciate disease in both cases. At long-term follow-up (approximately 3 and 5 years), favourable outcomes (no or minimal lameness, mild or moderate osteoarthritis) were identified on the long-term owner survey, lameness examination and radiographs.
Clinical relevance: mcmtCBLO reduced or eliminated short- and long-term lameness in these two cases afflicted by concurrent lateral compartment and early cranial cruciate ligament disease.
期刊介绍:
The New Zealand Veterinary Journal (NZVJ) is an international journal publishing high quality peer-reviewed articles covering all aspects of veterinary science, including clinical practice, animal welfare and animal health.
The NZVJ publishes original research findings, clinical communications (including novel case reports and case series), rapid communications, correspondence and review articles, originating from New Zealand and internationally.
Topics should be relevant to, but not limited to, New Zealand veterinary and animal science communities, and include the disciplines of infectious disease, medicine, surgery and the health, management and welfare of production and companion animals, horses and New Zealand wildlife.
All submissions are expected to meet the highest ethical and welfare standards, as detailed in the Journal’s instructions for authors.