P Garnier, B Dekerle, J Vial, E Maurice, M Manassero, V Viateau
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引用次数: 0
摘要
病例史:在2021年9月至2022年5月期间,因肘关节发育不良相关的跛行被送到一家兽医教学医院,并根据影像学结果确定需要进行关节镜检查的狗(n = 15)被前瞻性招募到研究中。跛行时间中位数为4个月(最小1个月,最大24个月)。临床表现:不同品种的平均体重为31.6公斤(最小15公斤,最大46.4公斤),出生时平均年龄为14个月(最小8个月,最大83个月)。影像学结果(CT)与所有犬的内冠突裂裂或破碎的内冠突疾病一致。关节镜检查结果:首先在前肢(n = 10)的初步尸体研究中评估了针关节镜(NA)手术的可行性,该研究收集了10只因与研究无关的原因而被安乐死的成年狗。肘关节探查通过内侧入路进行,首先是NA (1.9 mm 0°角镜),然后是标准关节镜(SA;2.4 mm 30°角度范围)。记录可视化的质量和程度(通过可视化的解剖结构数量评分)并进行统计比较。由于尸体研究表明,NA允许安全检查内侧/尾侧室的所有结构,因此该程序随后用于需要治疗的狗。在临床环境中,所有犬的肘部探查均成功,治疗(去除骨软骨碎片)无需转化为SA。手术后一个月,所有狗的跛行评分(0-5)都有所改善,12/15的狗不再跛行。与术前49天(IQR 46.5-57)相比,术后24天(IQR 19.5-31.5)的犬骨科指数评分中位数为99天(最短47天,最长180天);p临床相关性:所有犬均行关节镜辅助下骨软骨碎片去除术,短期临床结果满意。NA是诊断和评估冠突裂裂犬病变的一种可行技术。需要更大的临床研究和更长的随访时间来验证NanoScope手术关节镜系统作为SA视频辅助治疗内侧冠状突疾病的替代策略。
Evaluation of a small-bore needle arthroscope for diagnosis and treatment of medial coronoid disease in dogs: a pilot study with short-term assessment.
Case history: Dogs (n = 15) that were presented to a single veterinary teaching hospital with elbow dysplasia-associated lameness between September 2021 and May 2022, and were determined to require arthroscopy based on imaging results, were prospectively recruited into the study. The median duration of lameness was 4 (min 1, max 24) months.
Clinical findings: Various breeds were represented with a median body weight of 31.6 (min 15, max 46.4) kg and median age at presentation of 14 (min 8, max 83) months. Results of imaging modalities (CT) were consistent with medial coronoid disease with fissured or fragmented medial coronoid process in all dogs.
Arthroscopic findings: Feasibility of the needle arthroscopy (NA) procedure was firstly assessed in a preliminary cadaveric study in forelimbs (n = 10) collected from 10 adult dogs euthanised for reasons unrelated to the study. Elbow exploration was performed through a medial approach beginning with NA (1.9 mm 0° angle scope) followed by standard arthroscopy (SA; 2.4 mm 30° angle scope). The quality and extent of visualisation (scored through the number of anatomical structures visualised) were recorded and statistically compared. As the cadaver study indicated that NA allowed safe inspection of all structures in medial/caudal compartments, this procedure was then used in the dogs requiring treatment. In the clinical setting, elbow exploration was successful in all dogs and the treatment (removal of osteochondral fragments) was performed without requiring conversion into SA. One month after surgery, all dogs had an improvement in their lameness score (0-5) and 12/15 dogs were no longer lame. There was a reduction in Canine Orthopaedic Index scores measured a median of 99 (min 47, max 180) days after surgery (24 (IQR 19.5-31.5)) compared to the pre-operative period (49 (IQR 46.5-57); p < 0.001).
Clinical relevance: Needle arthroscopy-assisted removal of osteochondral fragments was performed in all dogs with satisfactory short-term clinical outcome. NA is a feasible technique for diagnosis and lesion assessment in dogs with a fissured or fragmented coronoid process. Larger clinical studies with longer follow-up are necessary to validate the NanoScope operative arthroscopy system as an alternative strategy to SA for video-assisted treatment of medial coronoid 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.