Mid- to Long-Term Outcome after Arthroscopy and Proximal Abducting Ulnar Osteotomy Versus Arthroscopy Alone in Dogs with Medial Compartment Disease: Thirty Cases,Veterinary and Comparative Orthopaedics and Traumatology

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Mid- to Long-Term Outcome after Arthroscopy and Proximal Abducting Ulnar Osteotomy Versus Arthroscopy Alone in Dogs with Medial Compartment Disease: Thirty Cases
Veterinary and Comparative Orthopaedics and Traumatology ( IF 1.3 ) Pub Date : 2020-10-01 , DOI: 10.1055/s-0040-1716843
Fiona J Coghill ₁ , Louisa K Ho-Eckart ₁ , Wendy I Baltzer ₂

Affiliation

Abstract

Objective The aim of this study was to determine owner-assessed mid- to long-term outcome for dogs with medial compartment disease treated arthroscopically with fragment removal with or without proximal abducting ulnar osteotomy (PAUL).

Study Design This was a retrospective clinical study.

Materials and Methods Records from 30 dogs with medial compartment disease treated with arthroscopy with or without PAUL were retrospectively reviewed over a 5-year period. Proximal abducting ulnar osteotomy cases were matched to arthroscopy-alone controls based on bodyweight and modified Outerbridge score. Outcome was assessed via owner questionnaire using the Canine Brief Pain Inventory (CBPI), frequency of non-steroidal anti-inflammatory drug (NSAID) administration and owner-assessed overall improvement.

Results Canine Brief Pain Inventory score for dogs in the PAUL group was not significantly different from the control group (p = 0.54). Non-steroidal anti-inflammatory drug administration was similar between groups (p = 0.61) and there was no significant difference between modified Outerbridge score and outcome (p = 0.57) over a median of 43 months post-surgically (range: 7–66 months). Canine Brief Pain Inventory and NSAID use were affected by the age of the dog with dogs greater than 3 years of age at the time of surgery having a higher CBPI score and increased NSAID use regardless of the surgery that was performed. Overall, owner-assessed improvement was not different between groups (p = 0.72).

Clinical Significance Proximal abducting ulnar osteotomy showed no owner-assessed benefit over arthroscopic medial coronoid fragment removal for dogs with medial compartment disease and modified Outerbridge score of 3 or greater. A prospective, blinded, controlled clinical trial is warranted to determine the appropriate clinical application of the PAUL procedure.

Authors' Contributions

Fiona J. Coghill contributed to conception of study, acquisition of data and data analysis and interpretation. Louisa K. Ho-Eckart contributed to study design. Wendy I. Baltzer contributed to data analysis and interpretation. All authors drafted, revised and approved the submitted manuscript.

Publication History

Received: 21 March 2020

Accepted: 27 July 2020

Publication Date:
01 October 2020 (online)

Georg Thieme Verlag KG
Stuttgart · New York

中文翻译：

关节镜和近端外展尺骨截骨术与单独关节镜检查后的中长期结果：30 例

摘要

目的本研究的目的是确定主人评估患有内侧筋膜室疾病的犬的中长期结果，这些犬在关节镜下进行骨折块切除，伴或不伴近端外展尺骨截骨术 (PAUL)。

研究设计这是一项回顾性临床研究。

材料和方法对 30 只用关节镜治疗有或没有 PAUL 的患有内侧隔室疾病的狗的记录进行了 5 年的回顾性审查。近端外展尺骨截骨术病例与基于体重和改良 Outerbridge 评分的单独关节镜对照相匹配。使用犬简要疼痛量表 (CBPI)、非甾体抗炎药 (NSAID) 给药频率和主人评估的整体改善情况，通过主人问卷评估结果。

结果 PAUL 组犬的 Canine Brief Pain Inventory 评分与对照组无显着差异 ( p = 0.54)。组间非甾体抗炎药给药相似 ( p = 0.61)，并且在手术后 43 个月的中位数（范围：7-66 个月）中，改良 Outerbridge 评分和结果（p = 0.57）之间没有显着差异）。Canine Brief Pain Inventory 和 NSAID 的使用受狗年龄的影响，手术时超过 3 岁的狗具有较高的 CBPI 评分和增加 NSAID 的使用，无论进行了何种手术。总体而言，业主评估的改善在各组之间没有差异（p = 0.72）。

临床意义近端外展尺骨截骨术显示，对于患有内侧隔室疾病且改良 Outerbridge 评分为 3 或更高的狗，与关节镜下去除内侧冠突碎片相比，业主评估没有任何益处。有必要进行前瞻性、盲法、对照临床试验来确定 PAUL 程序的适当临床应用。