Prótese total de anca como tratamento da displasia de anca no cão: importância do seu desenvolvimento em Portugal
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2014
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A Displasia da anca canina é um dos problemas ortopédicos mais comuns na clínica de animais de companhia. Esta doença apresenta uma etiologia multifatorial. É caracterizada
por hereditariedade do tipo poligénica, com uma forte participação da componente ambiental
para que ocorra a sua expressão.
Para que a variedade de tratamentos disponíveis para a sua resolução seja o mais
abrangente possível é importante que seja realizado um despiste precoce (4 a 9 meses de
idade). Quando o diagnóstico é efectuado numa fase tardia, com sinais de osteoartrite, as
cirurgias preventivas já não sejam passíveis de serem realizadas. Nesta fase, a Prótese total de
anca é a melhor solução a medio-longo prazo, pois elimina completamente as dores sentidas a
nível da articulação, melhora significativamente a locomoção e bem estar do cão.
Existem várias formas de fixação de PTA, não sendo possível concluir que um método
seja melhor do que outro. Os diferentes cirurgiões possuem preferências distintas,
dependendo da sua experiência e resultados. Independentemente da técnica de fixação a taxa
de sucesso varia entre os 90-97%.
Na tentativa de encontrar uma percentagem de animais com indicação cirúrgica para
prótese total de anca, foi realizado um estudo retrospetivo no VetOeiras – Hospital
Veterinário Central da Linha de Cascais, onde foram analisados 109 cães. Estes animais
foram submetidos a exames ortopédico e radiográfico com o objetivo de alcançar a sua
classificação da Fédération Cynologique Internationale. A classificação radiográfica e o
resultado do exame ortopédico permitiu-nos classificar o grau de displasia de anca e assim
indicar a melhor terapêutica para estes cães.
Neste estudo os animais foram divididos em dois grupos etários (menos de 8 meses e
mais de 8 meses de idade), devido às diferenças existentes, quer no diagnóstico, quer nas
opções terapêuticas. No total dos animais, foi diagnosticado displasia de anca em 62 animais,
nos quais 40 apresentavam indicação para prótese total de anca, em pelo menos uma das
ancas, sendo que foram realizadas apenas 3 intervenções.
O inquérito realizado nos 62 centros de atendimento médico veterinário ao longo de
Portugal continental, obteve 50% de respostas. No total das respostas obtidas, 96.8% dos
médicos veterinários indicou que mencionava este tipo de técnica aos proprietários, quando se
deparava com cães com essa indicação, mostrando abertura por parte da classe para este tipo cirurgia. Os valores obtidos no nosso estudo demonstram a importância do desenvolvimento
deste técnica em Portugal, pois existe um elevado número de animais com indicação para prótese total de anca, justificando a existência da mesma neste país.
Hip dyplasia is one of the most common orthopedic problems in small animal practice. Multiple factors contribute to the development of this condition. It is characterized by a poligenic heredity and a strong environmental component that leads to the its expression. In order for the possibilities of treatment to be as wide as possible, it is important to perform an early diagnostic test (at 4 to 9 months of age). When the diagnosis is achieved in a late stage and there are signs of osteoarthritis, preventive surgeries cannot be performed anymore. In this stage, total hip replacement is the best medium-long term solution since it fully eliminates joint pain and significantly improves the dog’s locomotion and wellbeing. There are a lot of different techniques to perform a total hip replacement and none has been proven the best. Different surgeons have different preferences depending on their experience and outcomes with different methods. Regardless of the used technique, the reported success rate is 90-97%. A retrospective study was performed in VetOeiras – Central Veterinary Hospital of Linha de Cascais, where 109 dogs were analyzed in order to achieve a percentage of surgical candidates for total hip replacement. These patients underwent orthopedic and radiographic examinations for further classification in the Fédération Cynologique Internationale scale. Radiographic classification and the results of the orthopedic examinations allowed a classification of the degree of hip dyaplasia and therefore the establishment of the best treatment for these dogs. For the study, two groups were created (patients with less than 8 months in one group and with more than 8 months on the other) considering different diagnosis and therapeutical options. A total of 62 dogs were diagnosed with hip dysplasia of which 40 had surgical indication for total hip replacement on either one or both hips, but surgery was performed in only 3 patients. An inquiry was conducted to 62 veterinary clinics, across Portugal and had a 50% feedback. 96.8% of the veterinarians stated that had made reference to this technique while enlightening owners about the condition, which shows openness to this kind of procedure. The results of this study show that there are numerous surgical candidates for total hip replacement which justifies the development of this technique in Portugal.
Hip dyplasia is one of the most common orthopedic problems in small animal practice. Multiple factors contribute to the development of this condition. It is characterized by a poligenic heredity and a strong environmental component that leads to the its expression. In order for the possibilities of treatment to be as wide as possible, it is important to perform an early diagnostic test (at 4 to 9 months of age). When the diagnosis is achieved in a late stage and there are signs of osteoarthritis, preventive surgeries cannot be performed anymore. In this stage, total hip replacement is the best medium-long term solution since it fully eliminates joint pain and significantly improves the dog’s locomotion and wellbeing. There are a lot of different techniques to perform a total hip replacement and none has been proven the best. Different surgeons have different preferences depending on their experience and outcomes with different methods. Regardless of the used technique, the reported success rate is 90-97%. A retrospective study was performed in VetOeiras – Central Veterinary Hospital of Linha de Cascais, where 109 dogs were analyzed in order to achieve a percentage of surgical candidates for total hip replacement. These patients underwent orthopedic and radiographic examinations for further classification in the Fédération Cynologique Internationale scale. Radiographic classification and the results of the orthopedic examinations allowed a classification of the degree of hip dyaplasia and therefore the establishment of the best treatment for these dogs. For the study, two groups were created (patients with less than 8 months in one group and with more than 8 months on the other) considering different diagnosis and therapeutical options. A total of 62 dogs were diagnosed with hip dysplasia of which 40 had surgical indication for total hip replacement on either one or both hips, but surgery was performed in only 3 patients. An inquiry was conducted to 62 veterinary clinics, across Portugal and had a 50% feedback. 96.8% of the veterinarians stated that had made reference to this technique while enlightening owners about the condition, which shows openness to this kind of procedure. The results of this study show that there are numerous surgical candidates for total hip replacement which justifies the development of this technique in Portugal.
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária
Palavras-chave
Cão , Displasia da anca , Prótese total de anca , Despiste precoce