Tibial Plateau Leveling Osteotomy for Cranial Cruciate Ligament Rupture in Canines: Patient Selection and Reported Outcomes.

IF 1.7 Q2 VETERINARY SCIENCES Veterinary medicine (Auckland, N.Z.) Pub Date : 2019-12-27 eCollection Date: 2019-01-01 DOI:10.2147/VMRR.S204321
Andy Nanda, Eric C Hans
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引用次数: 12

Abstract

Cranial cruciate ligament (CCL) rupture is one of the most common causes of pelvic limb lameness in dogs. In a CCL deficient stifle, joint lameness develops from cranial tibial translation in relation to the distal femoral condyles. The tibial plateau leveling osteotomy (TPLO) is a well-described surgical procedure that neutralizes tibiofemoral shear force by altering the tibial plateau via a proximal tibial osteotomy, and subsequently restores normal limb function. Current literature for the TPLO was reviewed and used to describe the optimal patient selection and to report clinical outcome with the TPLO in comparison to other surgical options for CCL rupture. The clinical outcomes reported to date, particularly those utilizing objective outcome data, support the TPLO as being able to consistently return dogs to normal limb function with a low risk for long-term morbidity. The TPLO procedure was found to be widely applicable to dogs ranging from small breed to large and giant breed, and does not appear to have some of the limitations that exist with alternative surgical options. This review concludes that the TPLO is an excellent treatment option for any dog with CCL rupture due to the excellent long-term outcome and high rate of owner satisfaction previously reported. Despite these conclusions, it is important to remember that treatment selection for CCL rupture remains dependent on multiple considerations including patient factors, surgeon experience, and costs.

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胫骨平台水平截骨治疗犬颅十字韧带断裂:患者选择和报道的结果。
颅十字韧带(CCL)断裂是狗骨盆肢体跛行最常见的原因之一。在CCL缺失的膝关节中,与股骨远端髁相关的颅胫骨平移导致关节跛行。胫骨平台平截骨术(TPLO)是一种被广泛描述的外科手术,通过胫骨近端截骨改变胫骨平台来中和胫骨股侧剪切力,随后恢复正常的肢体功能。我们回顾了目前关于TPLO的文献,并将其用于描述最佳患者选择,并报告TPLO与其他CCL破裂手术选择的临床结果。迄今为止报告的临床结果,特别是那些利用客观结果数据的临床结果,支持TPLO能够持续地使狗恢复正常的肢体功能,并且长期发病的风险很低。TPLO手术被发现广泛适用于从小型犬到大型犬和巨型犬,并且似乎没有其他手术选择存在的一些局限性。这篇综述的结论是,TPLO对于任何患有CCL破裂的狗来说都是一个很好的治疗选择,因为以前报道过的长期结果很好,而且主人满意度很高。尽管有这些结论,但重要的是要记住,CCL破裂的治疗选择仍然取决于多种因素,包括患者因素、外科医生经验和费用。
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