한국임상수의학회지 (Journal of Veterinary Clinics)

  • 제32권1호
  • /
  • Pages.22-27
  • /
  • 2015
  • /
  • 1598-298X(pISSN)
  • /
  • 2384-0749(eISSN)
한국임상수의학회 (The Korean Society of Veterinary Clinics)
권호 표지
DOI QR코드

DOI QR Code

개의 슬개골 내측 탈구 교정술에서 활차성형술의 유무에 따른 퇴행성 변화

Degenerative Joint Disease After Medial Patellar Luxation Repair in Dogs with or Without Trochleoplasty

  • 윤대영 (서울대학교 수의과대학 수의외과학교실) ;
  • 강병재 (서울대학교 수의과대학 수의외과학교실) ;
  • 김용선 (서울대학교 수의과대학 수의외과학교실) ;
  • 이승훈 (서울대학교 수의과대학 수의외과학교실) ;
  • 류다은 (서울대학교 수의과대학 수의외과학교실) ;
  • 김완희 (서울대학교 수의과대학 수의외과학교실) ;
  • 권오경 (서울대학교 수의과대학 수의외과학교실)
  • Yoon, Dae-Young (Department of Veterinary Surgery, BK21 PLUS Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University) ;
  • Kang, Byung-Jae (Department of Veterinary Surgery, BK21 PLUS Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University) ;
  • Kim, Yongsun (Department of Veterinary Surgery, BK21 PLUS Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University) ;
  • Lee, Seung Hoon (Department of Veterinary Surgery, BK21 PLUS Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University) ;
  • Rhew, Daeun (Department of Veterinary Surgery, BK21 PLUS Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University) ;
  • Kim, Wan Hee (Department of Veterinary Surgery, BK21 PLUS Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University) ;
  • Kweon, Oh-Kyeong (Department of Veterinary Surgery, BK21 PLUS Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University)
  • 심사 : 2015.01.20
  • 발행 : 2015.02.28
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

이 연구는 개에서 내측 슬개골 탈구 2도와 3도를 수술적으로 교정한 증례를 활차성형술 적용 여부에 따라 후향적으로 평가한 것이다. 본 후향 연구는 63마리의 개에서 68건의 수술한 케이스를 대상으로 하였으며, 합병증, 회복기간 및 방사선 검사로 퇴행성 관절 변화를 평가하였다. 수술 후 최소 3개월 이상 정기적으로 예후를 평가하였다. 합병증은 총 10.3% (7/68)의 재탈구와 1 케이스에서 경골조면 이식 실패를 확인하였다. 재탈구와 합병증 때문에 재수술을 요하는 경우는 활차성형술을 적용한 군에서는 3케이스(3/47, 6.4%), 활차성형술을 적용하지 않은 군에서는 1케이스(1/21, 4.8%)였다. 활차성형술을 적용하지 않은 군은 적용한 군에 비교하여 회복시간이 유의적으로 짧았고, 방사선 검사상 확인된 퇴행성 관절 변화에서 유의적인 차이를 보였다. 따라서, 2도와 3도의 내측 슬개골 탈구의 경우, 활차성형술을 적용하지 않는 수술방법이 수술적 예후를 향상 시킬 것으로 생각한다.

We evaluated outcomes of dogs surgically treated for grade 2 or 3 medial patellar luxation (MPL) with and without trochleoplasty. A retrospective study of 63 dogs with grade 2 or 3 MPL surgically treated with or without trochleoplasty was performed. Results of radiographic evaluation were expressed numerically as degenerative joint disease score and were compared between the groups with and without trochleoplasty. The study included 7 (7/68, 10.3%) cases of reluxation and 1 case of tibial tuberosity transposition implant failure. Reluxation and complications requiring additional surgery were confirmed in 3 cases (3/47, 6.4%) in trochleoplasty group and in 1 case (1/21, 4.8%) in nontrochleoplasty group. The nontrochleoplasty group showed a shorter recovery time than the trochleoplasty group (P < 0.05). There was a significant difference in degenerative joint disease scores over time between the groups, with nontrochleoplasty group having lower scores (P < 0.05). This study suggests that surgical treatment without trochleoplasty results in favorable outcomes compared to treatment with trochleoplasty. It is not mandatory to exclude trochleoplasty when performing surgery for grade 2 or 3 MPL, but we propose that surgical treatment without trochleoplasty is one option when choosing a combination of surgical techniques.

키워드

참고문헌

  1. Arthurs GI, Langley-Hobbs SJ. Complications associated with corrective surgery for patellar luxation in 109 dogs. Vet Surg 2006; 35: 559-566. https://doi.org/10.1111/j.1532-950X.2006.00189.x
  2. Bollet A. Connective tissue polysaccharide metabolism and the pathogenesis of osteoarthritis. Adv Intern Med 1967; 13: 33-60.
  3. Campbell J, Pond M. The canine stifle joint II. Medial luxation of the patella. J Small Anim Pract 1972; 13: 11-18. https://doi.org/10.1111/j.1748-5827.1972.tb06792.x
  4. De Bruin T, De Rooster H, Bosmans T, Duchateau L, Van Bree H, Gielen I. Radiographic assessment of the progression of osteoarthrosis in the contralateral stifle joint of dogs with a ruptured cranial cruciate ligament. Vet Rec 2007; 161: 745-750. https://doi.org/10.1136/vr.161.22.745
  5. Deangelis M. Patellar luxation in dogs. Vet Clin North Am Small Anim Pract 1971; 1: 403-415.
  6. Denny H, Butterworth S. The stifle. In: A guide to canine and feline orthopaedic surgery, 4th ed. Oxford: Blackwell Science. 2000: 517-525.
  7. Denny H, Minter HM. The long term results of surgery of canine stifle disorders. J Small Anim Pract 1973; 14: 695-714. https://doi.org/10.1111/j.1748-5827.1973.tb06408.x
  8. Flo G, Brinker W. Fascia lata overlap procedure for surgical correction of recurrent medial luxation of the patella in the dog. J Am Vet Med Assoc 1970; 156: 595-599.
  9. Fossum TW. Diseases of the joints. In: Small animal surgery, 3rd ed. St. Louis: Mosby. 2007: 1289-1297.
  10. Gibbons S, Macias C, Tonzing M, Pinchbeck G, Mckee W. Patellar luxation in 70 large breed dogs. J Small Anim Pract 2006; 47: 3-9. https://doi.org/10.1111/j.1748-5827.2006.00004.x
  11. Hayes A, Boudrieau R, Hungerford L. Frequency and distribution of medial and lateral patellar luxation in dogs: 124 cases (1982-1992). J Am Vet Med Assoc 1994; 205: 716-720.
  12. Hulse D. Pathophysiology and management of medial patellar luxation in the dog. Vet Med Small Anim Clin 1981; 76: 43-51.
  13. Hulse DA, Miller D, Roberts D, Shires P, Shoji H. Resurfacing canine femoral trochleoplasties with free autogenous periosteal grafts. Vet Surg 1986; 15: 284-288. https://doi.org/10.1111/j.1532-950X.1986.tb00228.x
  14. Johnson AL, Probst CW, Decamp CE, Rosenstein DS, Hauptman JG, Weaver BT, Kern TL. Comparison of trochlear block recession and trochlear wedge recession for canine patellar luxation using a cadaver model. Vet Surg 2001; 30: 140-150. https://doi.org/10.1053/jvet.2001.21391
  15. Linney WR, Hammer DL, Shott S. Surgical treatment of medial patellar luxation without femoral trochlear groove deepening procedures in dogs: 91 cases (1998-2009). J Am Vet Med Assoc 2011; 238: 1168-1172. https://doi.org/10.2460/javma.238.9.1168
  16. Meachim G. The effect of scarification on articular cartilage in the rabbit. J Bone Joint Surg Br 1963; 45: 150-161.
  17. Piermattei DL, Flo GL, Decamp CE. The stifle joint. In: Brinker, Piermattei, and Flo's handbook of small animal orthopedics and fracture repair, 4th ed. St. Louis: Saunders/Elsevier. 2006: 562-582.
  18. Rooster HD, Bree HV. Use of compression stress radiography for the detection of partial tears of the canine cranial cruciate ligament. J Small Anim Pract 1999; 40: 573-576. https://doi.org/10.1111/j.1748-5827.1999.tb03024.x
  19. Roush JK. Canine patellar luxation. Vet Clin North Am Small Anim Pract 1993; 23: 855-868. https://doi.org/10.1016/S0195-5616(93)50087-6
  20. Roy RG, Wallace LJ, Johnston GR, Wickstrom SL. A retrospective evaluation of stifle osteoarthritis in dogs with bilateral medial patellar luxation and unilateral surgical repair. Vet Surg 1992; 21: 475-479. https://doi.org/10.1111/j.1532-950X.1992.tb00084.x
  21. Singleton W. The surgical correction of stifle deformities in the dog. J Small Anim Pract 1969; 10: 59-69. https://doi.org/10.1111/j.1748-5827.1969.tb04021.x
  22. Slocum B, Devine T. Trochlear recession for correction of luxating patella in the dog. J Am Vet Med Assoc 1985; 186: 365-369.
  23. Slocum B, Slocum T. Trochlear wedge recession for medial patellar luxation. An update. Vet Clin North Am Small Anim Pract 1993; 23: 869-875. https://doi.org/10.1016/S0195-5616(93)50088-8
  24. Talcott K, Goring R, De Haan J. Rectangular Recession Trochleoplasty tor Treatment of Patellar Luxation in Dogs and Cats. Vet Comp Orthop Traumatol 1993; 6: 33-39.
  25. Thompson Jr RC. An experimental study of surface injury to articular cartilage and enzyme responses within the joint. Clin Orthop Relat Res 1975; 107: 239-248. https://doi.org/10.1097/00003086-197503000-00028
  26. Thompson RC, Clark I. Acid hydrolases in slices of articular cartilage and synovium from normal and abnormal joints. Exp Biol Med 1970; 133: 1102-1108. https://doi.org/10.3181/00379727-133-34633
  27. Tobias KM, Johnston SA. Stifle joint. In: Veterinary surgery: Small animal, St. Louis: Elsevier. 2012: 973-982.
  28. Vaughan L, Robins G. Surgical remodelling of the femoral trochlea: an experimental study. Vet Rec 1975; 96: 447-450. https://doi.org/10.1136/vr.96.20.447
  29. Wander KW, Powers BE, Schwarz P. Cartilage changes in dogs with surgically treated medial patellar luxations. Vet Comp Orthop Traumatol 1999; 12: 183-187. https://doi.org/10.1055/s-0038-1632488
  30. Whittick WG. The canine stifle joint. In: Canine Orthopedics, 2nd ed. Philadelphia: Lea & Febiger. 1990: 693-760.
  31. Willauer C, Vasseur P. Clinical results of surgical correction of medial luxation of the patella in dogs. Vet Surg 1987; 16: 31-36. https://doi.org/10.1111/j.1532-950X.1987.tb00910.x