Cranial cruciate ligament rupture: surgical treatment by tibial plateau leveling osteotomy
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2016-07-29
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A rotura de ligamento cruzado cranial é uma das mais importantes doenças ortopédicas que afectam o cão e a causa mais frequente de osteoartrite do joelho e claudicação do membro posterior. Muito se tem vindo a descobrir desde a primeira publicação em 1926, no entanto a patogenia exacta da doença permanece desconhecida.
A rotura pode ser traumática ou degenerativa, representando a ultima a maioria dos casos. Pode ocorrer em cães de qualquer tamanho, idade ou raça embora seja mais frequente em cães jovens adultos de raças grandes.
O diagnóstico baseia-se na história de claudicação, anamnese e outras ferramentas específicas de diagnóstico como radiografias ou artroscopia. A rutura do ligamento cruzado cranial pode ser tratada medicamente ou cirurgicamente. O tratamento cirurgico é frequentemente o recomendado pois atinge-se uma estabilização do joelho mais rápida bem como um retorno mais precoce à sua função.
Actualmente, os procedimentos cirúrgicos mais utilizados no tratamento da da rotura de ligamento cruzado cranial são a Tibial Plateau Leveling Osteotomy (TPLO), Tibial Tuberosity Advancement (TTA) e Extracapsular Stabilization (ES). Contudo, o grande número de técnicas existentes sugere que não há uma técnica que seja unanimemente aceite. Esta escolha deverá ser baseada em vários critérios como tamanho, idade, cronicidade da lesão, aceitação do proprietário, preferência do cirurgião e nível de experiência com um ou outro procedimento.
Este estudo retrospectivo tem por objetivo analisar os resultados da Tibial Plateau Levelling Osteotomy (TPLO) avaliando os resultados clínicos e cirúrgicos bem como as complicações associadas à técnica.
Cranial cruciate ligament disease is one of the most important orthopaedic conditions of the dog and the most common cause of stifle osteoarthritis and pelvic limb lameness. Much has been learned since the first report in 1926, however the exact aetiopathogenesis of this condition remains unknown. The rupture can be traumatic or degenerative, the last one represents the majority of the cases. It can occur in dogs of any size, age or breed, though it is more frequent in young adult dogs belonging to large breeds. Diagnosis is based in the history of lameness, anamnesis and specific diagnostic tools (radiographs, arthroscopy). Cranial cruciate disease may be treated either medically or surgically. Surgical treatment is frequently recommended to achieve a more rapid stifle stabilization, meniscal treatment and earlier return to clinical function. Currently, the most commonly performed surgical procedures include the Tibial Plateau Levelling Osteotomy (TPLO), the Tibial Tuberosity Advancement (TTA) and the Extracapsular Stabilization (ES). Nevertheless, the large number of techniques performed suggests that no single technique is unanimously accepted. This selection should be based upon numerous criteria including size, age, chronicity of the injury, acceptance of the owner, surgeon’s preference and experience level with the procedure. The objective of this retrospective study is to analyse the results of the Tibial Plateau Levelling Osteotomy by evaluating the clinical and surgical outcomes and eventual complications associated with the technique.
Cranial cruciate ligament disease is one of the most important orthopaedic conditions of the dog and the most common cause of stifle osteoarthritis and pelvic limb lameness. Much has been learned since the first report in 1926, however the exact aetiopathogenesis of this condition remains unknown. The rupture can be traumatic or degenerative, the last one represents the majority of the cases. It can occur in dogs of any size, age or breed, though it is more frequent in young adult dogs belonging to large breeds. Diagnosis is based in the history of lameness, anamnesis and specific diagnostic tools (radiographs, arthroscopy). Cranial cruciate disease may be treated either medically or surgically. Surgical treatment is frequently recommended to achieve a more rapid stifle stabilization, meniscal treatment and earlier return to clinical function. Currently, the most commonly performed surgical procedures include the Tibial Plateau Levelling Osteotomy (TPLO), the Tibial Tuberosity Advancement (TTA) and the Extracapsular Stabilization (ES). Nevertheless, the large number of techniques performed suggests that no single technique is unanimously accepted. This selection should be based upon numerous criteria including size, age, chronicity of the injury, acceptance of the owner, surgeon’s preference and experience level with the procedure. The objective of this retrospective study is to analyse the results of the Tibial Plateau Levelling Osteotomy by evaluating the clinical and surgical outcomes and eventual complications associated with the technique.
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Dissertação de Mestrado Integrado em Medicina Veterinária
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Cães , Ligamento cruzado cranial , Rotura , Procedimentos cirúrgicos operatórios , Osteotomia de Nivelamento Plantar Tibial (TPLO)