犬双侧髋关节置换术后外侧髌骨脱位

VCOT Open Pub Date : 2022-07-01 DOI:10.1055/s-0042-1750035
Angharad B Simlett-Moss, G. Arthurs, F. Schiborra, E. Comerford
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引用次数: 0

摘要

一个2岁的雄性绝育杂交提出了7个月的历史左骨盆肢体跛行。诊断为双侧髋关节发育不良后,分期混合型全髋关节置换术(THR)间隔16个月进行。每次THR后24小时内发生同侧II级外侧髌骨脱位(LPL)。两例LPLs均采用块状凹陷成形术成功治疗。主观步态分析显示每次THR后骨盆肢体步态异常。临床检查发现两肢均有II级LPL。计算机断层扫描显示轻度滑车沟发育不全,但没有其他骨骼异常。THR术后10周和4周分别行滑车块缩沟成形术。最后一次手术后12个月的长期随访发现,两名PLs患者的跛行程度最小(0-1/10),临床检查无疼痛,基于客户的测量仪器活动能力评分总体较低,为2分(犬利物浦骨关节炎)。本病例报告文件表明,易感犬滑车嵴发育不全,LPL可继发于THR,可通过标准技术成功处理脱位。此外,尽管坊间有传闻称狗的内侧髌骨脱位继发于THR,但这是首次发表的关于THR后任何髌骨脱位处理的报告。
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Lateral Patellar Luxations following Bilateral Hip Joint Replacement in a Dog
A 2-year-old male neutered crossbreed was presented with a 7-month history of left pelvic limb lameness. Following a diagnosis of bilateral hip dysplasia, staged hybrid total hip replacements (THR) were performed 16 months apart. An ipsilateral grade II lateral patellar luxation (LPL) developed within 24 hours after each THR. Both LPLs were successfully treated by block recession sulcoplasty. Subjective gait analysis showed an abnormal pelvic limb gait following each THR. Clinical examination detected a grade II LPL on each operated limb. Computed tomography of both pelvic limbs revealed mild trochlear sulcus hypoplasia but no other skeletal abnormalities. Trochlear block recession sulcoplasty was performed 10 and 4 weeks respectively after THR. Long-term follow-up 12 months after the last surgery found minimal (0–1/10) lameness, no pain on clinical examination in both PLs and an overall low client-based metrology instrument mobility score of 2 (Liverpool Osteoarthritis in Dogs). This case report documents that in predisposed dogs, with hypoplastic trochlear ridges, LPL can occur secondary to THR and can be successfully managed by standard techniques to address the luxation. Furthermore, despite anecdotal verbal reports of medial patellar luxation occurring secondary to THR in dogs, this is the first published report of the management of any patellar luxation subsequent to THR.
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