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Arthroscopy for the Diagnosis and Treatment of Failed Trochleoplasty in a Dog

활차구 성형술이 실패한 개에서 관절경을 이용한 진단과 치료

  • Hwang, Junho (College of Veterinary Medicine, Chonbuk National University) ;
  • Heo, Suyoung (College of Veterinary Medicine, Chonbuk National University) ;
  • Kim, Bumseok (College of Veterinary Medicine, Chonbuk National University) ;
  • Lee, Sanghoon (College of Veterinary Medicine, Chonbuk National University) ;
  • Jeong, Seongmok (College of Veterinary Medicine, Chungnam National University) ;
  • Lee, Haebeom (College of Veterinary Medicine, Chungnam National University)
  • Accepted : 2015.04.09
  • Published : 2015.06.30

Abstract

A 3-year-old castrated male Spitz dog (8.4 kg) was referred for hindlimb lameness. The dog had undergone corrective surgery for bilateral medial patellar luxation 6 weeks prior to presentation. Intermittent lameness of both hind limbs was evident on general inspection. Physical examination revealed moderate pain and crepitus upon flexion and extension of the stifle joints. Radiography revealed features consistent with distal deviation of the cartilage flaps and effusion in both stifle joints. Detachment and deviation of both osteochondral blocks were suspected based on the physical and radiographic findings. Arthroscopy confirmed failed osteochondral blocks (right $1.5cm{\times}0.9cm{\times}0.2cm$, left $1.3cm{\times}0.9cm{\times}0.1cm$), which were removed. After removal of the osteochondral blocks, the stepped trochlear grooves were located and debrided using an arthroscopic burr, to prevent patellar tracking disorder. The dog resumed normal ambulation without medial patellar luxation 2 weeks postoperatively, and there were no complications. Arthroscopy is an effective surgical modality for the diagnosis and treatment of canine joint disorders. It offers a magnified view of the joint, which allows accurate evaluation of intra-articular structures. In addition, arthroscopic surgery can reduce the postoperative complications associated with surgical wound.

3살 중성화된 수컷 스피츠 (8.4 kg)가 후지 파행으로 본원에 의뢰되었다. 환자는 6주전 양측 내측 슬개골 탈구 교정술을 받았다. 육안상 양측 뒷다리의 간헐적인 파행을 보였으며 신체검사에서 슬관절의 굴신전시 염발음을 동반한 중등도의 통증을 보였다. 방사선 검사상 양측 슬관절에서 연골편의 원위부 이탈과 함께 관절부종이 관찰되었다. 신체검사와 방사선검사를 토대로 양측 슬관절 골연골편의 분리와 이탈이 의심되었다. 관절경을 통해 이탈한 골연골편(우측 $1.5cm{\times}0.9cm{\times}0.2cm$, 좌측 $1.3cm{\times}0.9cm{\times}0.1cm$)을 확인하고 제거하였다. 골연골편을 제거한 후, 슬개골의 비정상적 움직임을 예방하기 위해 관절경을 통해 burr를 이용하여 층진 활차구를 성형해주었다. 환자는 수술 2주후 정상적인 보행을 하였으며 합병증을 보이지 않았다. 관절경은 개의 관절질환 진단 및 치료를 위한 효과적인 수단이다. 이를 통해 관절내 구조물을 확대해서 관찰 할 수 있고 정확한 진단을 할 수 있다. 게다가 관절경을 통한 수술은 일반적인 술부에서 나타날 수 있는 술 후 합병증을 줄여 줄 수 있다.

Keywords

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