Cranial Cruciate Ligament Rupture in Dogs - Evaluation of Postoperative Results of the CBLO Technique
DOI:
https://doi.org/10.22456/1679-9216.136446Palavras-chave:
CBLO, Análise da marcha com placa de forçaResumo
Antecedentes: Uma das principais causas de osteoartrite (OA) em cães é a rotura do ligamento cruzado craniano (LCC). Atualmente, são utilizadas muitas técnicas de tratamento intra e extra-articular para cães com rutura do LCC. No entanto, os métodos baseados na biomecânica (Osteotomia de nivelamento do platô tibial-TPLO, Tuberositas Tibia Advancemet - TTA padrão, TTA-Rapid) são frequentemente preferidos. Foi sugerido que pode ser uma técnica alternativa em termos de prevenção de complicações nas TPLO, TTA e TTA-Rapid mais comummente utilizadas. O objetivo do estudo foi investigar os resultados pós-operatórios da técnica Cora Base Levelling Osteotomi (CBLO) em cães com rutura do ligamento cruzado craniano (LCC).
Materiais, Métodos e Resultados: Dez cães de diferentes raças, idades e pesos foram utilizados como material. O ponto CORA foi determinado e uma osteotomia foi realizada considerando o nível CORA. A rotação foi feita antes da osteotomia completa e a placa foi fixada. Registaram-se progressos em 7 casos (70%) nos testes de marcha e corrida em comparação com o período pré-operatório. Observou-se uma ligeira claudicação após o exercício em 3 casos (30%). O tempo de cirurgia nos casos teve uma duração média de 30-40 minutos. Observou-se também que o ângulo da plataforma tibial (TPA) diminuiu individualmente no período pós-operatório. De acordo com os resultados da análise da marcha com placa de força, verifica-se uma melhoria em 5 casos (50%). Não foram observadas alterações no pós-operatório em 5 casos (50%).
Discussão: A técnica CBLO pode ser uma técnica alternativa para a rutura do LCC. Mesmo em raças pequenas, havia uma grande parte óssea para estabilização na área proximal. O parafuso de compressão e o implante proporcionam um excelente contacto ósseo. Isto ajuda a uma fixação correcta e a uma função precoce. A técnica CBLO não danificou a articulação. É necessário um grupo maior de cães para estudos adicionais e avaliação a longo prazo.
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Anderson K.L., O’Neill D.G., Brodbelt D.C., Church D.B., Meeson R.L., Sargan D., Summers J.F., Zulch H. & Collins L.M. 2018. Prevalence, duration and risk factors for appendicular osteoarthritis in a UK dog population under primary veterinary care. Scientific Reports.8: 5641. DOI: 10.1038/s41598-018-23940-z. DOI: https://doi.org/10.1038/s41598-018-23940-z
Andrade M.C., Slunsky P., Klass L.G. & Brunnberg L. 2022. Patellar luxation and concomitant cranial cruciate ligament rupture in dogs- A review. Veterinarni Medicina. 67(04): 163-178. DOI: 10.17221/111/2021-VETMED. DOI: https://doi.org/10.17221/111/2021-VETMED
Arican M. 2020. Kalça displazisi, tedavi seçenekleri ve kalça protezi. In: Kedi ve Köpek Ortopedi ve Travmatoloji. Konya: Anka Promosyon Matbaa Mlz. Ltd. Şti., pp. 229-256.
Arnoczky P.S. 1998. Patellar Tendon Graft for Cranial Cruciate Ligament Repair. In: Current Techniques in Small Animal Surgery, Knee. Bojrab M.J., Ellison G.W. & Slocum B. (Eds). 4th edn. Baltimore: Williams & Wilkins. pp. 1199-1202.
Berg E.E., Pollard M.E. & Kang Q. 2001. Inter articular bone tunnel healing. Arthroscopy.17:189-195. DOI: 10.1007/s11420-008-9096-. DOI: https://doi.org/10.1053/jars.2001.20958
Calvo I., Aisa J., Chase D., Garcia-Fernandez P., San Roman F. & Bennett D. 2014. Tibial tuberosity fracture as a complication of tibial tuberosity advancement. Veterinary and Comparative Orthopaedics and Traumatology. 27: 148-154. DOI: 10.3415/VCOT-13-06-0071. DOI: https://doi.org/10.3415/VCOT-13-06-0071
Dymond N.l., Goldsmid S.E. & Simpson D.J. 2010. Tibial tuberosity advancement in 92 canine stifles: initial results, clinical outcome and owner evaluation. Australian Veterinary Journal. 88: 381-385. DOI: 10.1111/j.1751-0813.2010.00627.x DOI: https://doi.org/10.1111/j.1751-0813.2010.00627.x
Edwards G.A., Hosgood G., Hancock R.B., Preston Stubbs W. & Jackson A.H. 2016. Major complications associated with fork-based and screw-based tibial tuberosity advancement implants: 438 cases. Canadian Veterinary Journal. 57: 415-420.
Fuchs T.F., Petersen W., Vordemvenne T., Stange R., Raschke M. & Paletta J.R.J. 2007. Influence of synovial fluid on human osteoblasts: an in vitro study. Scientific World Journal. 18: 2012-2020. DOI: 10.1100/tsw.2007.282. DOI: https://doi.org/10.1100/tsw.2007.282
Higuchi H., Shirakura K., Kimura M., Terauchi M., Shinozaki T., Watanabe H. & Takagishi K. 2006. Changes in biochemical parameters after anterior cruciate ligament injury. International Orthopaedics. 30: 43-47. DOI: 10.1007/s00264-005-0023-5. DOI: https://doi.org/10.1007/s00264-005-0023-5
Hirshenson M.S., Krotscheck U., Thompson M.S., Knapp-Hoch H.M., Jay-Silva A.R., McConkey M., Bliss S.P., Todhunter R. & Mohammed H.O. 2012. Evaluation of complications and short-term outcome after unilateral or single-session bilateral tibial tuberosity advancement for cranial cruciate rupture in dogs. Veterinary and Comparative Orthopaedics and Traumatology. 25: 402-409. DOI: 10.3415/VCOT-11-12-0175. DOI: https://doi.org/10.3415/VCOT-11-12-0175
Hulse D., Beale B. & Kerwin S. 2010. Second look arthroscopic findings after tibial plateau leveling osteotomy. Veterinary Surgery. 39: 350-354. DOI: 10.1111/j.1532-950X.2010.00676.x. DOI: https://doi.org/10.1111/j.1532-950X.2010.00676.x
Hulse D., Beale B. & Kowaleski M. 2010. CORA-based leveling osteotomy for the treatment of the CCL deficient stifle. Proceedings of the Association for Veterinary Orthopedic Research and Education, Olympic Valley, CA. pp. 1-5. DOI: 10.1111/j.1532-950X.2013.12035.x.
Kim S.E, Lewis D.D. & Pozzi A. 2012. Effect of tibial plateau leveling osteotomy on femorotibial subluxation: in vivo analysis during standing. Veterinary Surgery. 41: 465-470. DOI: 10.1111/j.1532-950X.2012.00973.x. DOI: https://doi.org/10.1111/j.1532-950X.2012.00973.x
Kowaleski M.P, Boudrieau R.J & Pozzi A. 2017. Stifle joint. In: Johnston S.A. & Tobias K.M. (Eds). Veterinary Surgery: Small Animal. St. Louis: Elsevier Saunders. 2953-2954.
Lafaver S., Miller N.A., Stubbs W.P., Taylor R.A. & Boudrieau R.J. 2007. Tibial tuberosity advancement for stabilization of the canine cranial cruciate ligament-deficient stifle joint: surgical technique, early results and complications in 101 dogs. Veterinary Surgery. 36: 573-586. DOI: 10.1111/j.1532-950X.2007.00307.x. DOI: https://doi.org/10.1111/j.1532-950X.2007.00307.x
Lewis D.D., Kim S.E., Shmalberg J. & MacArthur S.L. 2019. Correction of excessive tibial plateau angle and limb shortening in a juvenile dog using a hinged circular fixator construct and distraction osteogenesis. Case Reports in Veterinary Medicine. 1439237. DOI: 10.1155/2019/1439237 DOI: https://doi.org/10.1155/2019/1439237
Lima D.B, Sul R. & Parkin T. 2016. Incidence of complications associated with tibial tuberosity advancement in Boxer dogs. Veterinary and Comparative Orthopaedics and Traumatology. 29: 39-45. DOI: 10.3415/VCOT-15-02-0036. DOI: https://doi.org/10.3415/VCOT-15-02-0036
Marsolais G.S., Dvorak G. & Conzemius M.G. 2002. Effects of post-operative rehabilitation on limb function after cranial cruciate ligament repair in dogs. Journal of the American Veterinary Medical Association. 220: 1325‐1330. DOI: 10.2460/javma.2002.220.1325. DOI: https://doi.org/10.2460/javma.2002.220.1325
Mazdarani P., Nielsen M.B.M., Gundersen R.S., von Wenck A. & Miles J.E. 2021. Geometric modelling of CORA-based levelling osteotomy in the dog. Reserach Veterinary Science. 135: 127-133. DOI: 10.1016/j.rvsc.2021.01.005. DOI: https://doi.org/10.1016/j.rvsc.2021.01.005
Nutt A.E., Garcia-Fernandez P., San Roman F., Parkin T. & Calvo I. 2015. Risk factors for tibial tuberosity fracture after tibial tuberosity advancement in dogs. Veterinary and Comparative Orthopaedics and Traumatology. 28: 116-123. DOI: 10.3415/VCOT-14-02-0022. DOI: https://doi.org/10.3415/VCOT-14-02-0022
Paley D. 2002. Frontal plane mechanical and anatomic axis planning. Herzenberg J.E. (Ed). Principles of deformity correction. Berlin: Springer-Verlag. Pp: 61-65. DOI: https://doi.org/10.1007/978-3-642-59373-4_4
Peycke L.E., McDougall R., Roca R., Dycus D. & Hulse D.A. 2022. Center of rotation of angulation-based leveling osteotomy for stifle stabilization in skeletally immature dogs. Veterinary Surgery. 51: 528-535. DOI: 10.1111/vsu.13767. DOI: https://doi.org/10.1111/vsu.13767
Putame G., Terzini M., Bignardi C., Beale B., Hulse D., Zanetti E. & Audenino A. 2019. Surgical treatments for Canine Anterior Cruciate Ligament Rupture: Assessing Functional Recovery ThroughMultibody Comparative Analysis. Frontiers in Bioengineering and Biotechnology. 7: 180. DOI: 10.3389/fbioe.2019.00180. DOI: https://doi.org/10.3389/fbioe.2019.00180
Raske M., Hulse D., Beale B., Saunders W.B., Kishi E. & Kunze C. 2013. Stabilization of the CORA- based leveling osteotomy for treatment of cranial cruciate ligament injury using a bone plate augmented with a headless compression screw. Veterinary Surgery. 42: 759-764. DOI: 10.1111/j.1532-950X.2013.12035.x. DOI: https://doi.org/10.1111/j.1532-950X.2013.12035.x
Reif U. & Probst C.W. 2003. Comparison of tibial plateau angles in normal and cranial cruciate deficient stifles of Labrador Retrievers. Veterinary Surgery. 32(4): 385-389. DOI: https://doi.org/10.1053/jvet.2003.50047
Shaw K.K., Alvarez L., Foster S.A., Tomlinson J.E., Shaw A.J. & Pozzi A. 2020. Fundamental principles of rehabilitation and musculoskeletal tissue healing. Veterinary Surgery. 49: 22-32. DOI: 10.1111/vsu.13270. DOI: https://doi.org/10.1111/vsu.13270
Schlag A.N., Peycke L.E. & Hulse D. 2020. Center of rotation of angulation-based leveling osteotomy combined with a coplanar cranial closing wedge ostectomy to manage cranial cruciate ligament insufficiency in dogs with excessive tibial plateau angle. Veterinary Surgery. 49(6):1125-1131. DOI: 10.1111/vsu.13480. DOI: https://doi.org/10.1111/vsu.13480
Stein S. & Schmoekel H. 2008. Short-term and eight to 12 months results of a tibial tuberosity advancement as treatment of canine cranial cruciate ligament damage. Journal of Small Animal Practice. 49:398-404. DOI: 10.1111/j.1748-5827.2008.00592.x. DOI: https://doi.org/10.1111/j.1748-5827.2008.00592.x
Steinberg E.J., Prata R.G., Palazzini K. & Brown D.C. 2011. Tibial tuberosity advancement for treatment of CrCL injury: complications and owner satisfaction. Journal of the American Veterinary Medical Association. 47:250-257. DOI: 10.5326/JAAHA-MS-5574. DOI: https://doi.org/10.5326/JAAHA-MS-5574
Sun L., Zhou X., Wu B., & Tian M. 2012. Inhibitory Effect of Synovial Fluid on Tendon-To-Bone Healing: An experimental study in rabbits. Arthroscopy. 28:1297-1305. DOI: 10.1016/j.arthro.2012.02.017. DOI: https://doi.org/10.1016/j.arthro.2012.02.017
Tinga S., Hughes N., Jones S.C., Park B., Palm L., Desaraju S.S., Banks S.A., MacArthur S.L. & Lewis D.D. 2022. Stifle kinematics in 4 dogs with cranial cruciate ligament insufficiency treated by CORA-based leveling osteotomy. Frontiers in Veterinary Science. 9: 1052327. DOI: 10.3389/fvets.2022.1052327. DOI: https://doi.org/10.3389/fvets.2022.1052327
Vasseur P.M. 2003. Stifle joint. In: Texbook of Small Animal Surgery, Vol: II. Slatter D. Philadelphia: W.B. Saunders. 2090-2143.
Von Pfeil D.J., Kowaleski M.P., Glassman M. & Dejardin L.M. 2018. Results of a survey of Veterinary Orthopedic Society members on the preferred method for treating cranial cruciate ligament rupture in dogs weighing more than 15 kilograms (33 pounds). Journal of the American Veterinary Medical Association. 253:586-597. DOI: 10.2460/javma.253.5.586. DOI: https://doi.org/10.2460/javma.253.5.586
Whitney M.E., Butler J.R., Dycus D.L., Teer L.B., Elder S.H., Priddy L.B. & Wills R.W. 2022. Ex vivo biomechanical comparison of four Center of Rotation Angulation Based Leveling Osteotomy fixation methods.Veterinary Surgery. 51:157-162. DOI: 10.1111/vsu.13696. DOI: https://doi.org/10.1111/vsu.13696
Wolf R.E., Scavelli T.D., Hoelzler M.G., Fulcher R.P. & Bastian R.P. 2012. Surgical and postoperative complications associated with tibial tuberosity advancement for cranial cruciate ligament rupture in dogs: 458 cases (2007-2009). Journal of the American Veterinary Medical Association. 240:1481-1487. DOI: 10.2460/javma.240.12.1481. DOI: https://doi.org/10.2460/javma.240.12.1481
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