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

개의 슬개골 내측 탈구 교정술에서 활차성형술의 유무에 따른 퇴행성 변화

  • 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)
  • 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)
  • Accepted : 2015.01.20
  • Published : 2015.02.28

Abstract

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.

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.

Keywords

References

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