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Vergleich der Langzeitergebnisse nach Therapie des fragmentierten Processus coronoideus medialis der Ulna beim Hund. Arthroskopie versus Arthrotomie
Vergleich der Langzeitergebnisse nach Therapie des fragmentierten Processus coronoideus medialis der Ulna beim Hund. Arthroskopie versus Arthrotomie
This study was designed to provide an objective comparison between athrotomic and arthroscopic treatment of the FPC, considering long-term follow-up. 20 dogs after athrotomy and 24 dogs after arthroscopic removal of the FCP were examined clinically, radiologically and with the help of a computerized gait analysis. All patients included in this study had a follow-up examination. The control interval after surgery was set at a minimum of six months. On clinical examination at the time of follow-up, 13 (65%) of the patients after arthrotomy showed no lameness, 4 (20%) showed low-grade lameness and 3 (15%) showed marked low-grade lameness. 18 (75%) of the patients after arthroscopic treatment showed no lameness at the time of follow-up, 4 (16.7%) showed low-grade lameness, 1 (4.2%) showed marked low-grade lameness and 1 (4.2%) showed moderate-grade lameness. Looking at the change in the lameness level of the animals between the preoperative and postoperative examination, the following picture emerges: Overall, the lameness of the patients treated with arthrotomy improved by an average of 1.1 (± 1.1) degrees as compared to the patients treated with arthroscopy which improved by an average of 1.3 (± 1.2) degrees. Improvement occurred in 16 dogs (66.7%) after arthrotomy and in 21 dogs (87.5%) after arthroscopy. On gait analysis, at the time of long-term follow-up, 13 patients (65%) showed no lameness after arthrotomy and 7 (35%) patients showed lameness. In patients treated arthroscopically, 21 (87.5%) patients showed no signs of lameness, 3 (12.5%) patients continued to show lameness. When considering the kinetic parameters, the patients after arthroscopy showed a greater similarity to the gait pattern of the healthy comparison group (n=21) than the patients after arthrotomy. The kinematic data analysis also showed that the patients after arthroscopy had a more physiological gait pattern for most of the parameters recorded. In particular, a significantly greater ROM of the elbow joint could be demonstrated for the patient group after arthroscopy compared to the patient group after arthrotomy. Radiologically, a progression of the arthritic change could be determined with two different assessment methods. Due to the different time interval at the control examination between the two patient groups, a matching pair analysis was performed. This supports the results of the overall groups in the gait analysis. No difference in the development of arthrosis between the patient groups could be detected. In summary, taking into account the examination procedures used, it was determined that the patients who underwent arthroscopic treatment achieved a better clinical and gait analysis result on most points, without reaching statistical significance.
dog, elbow dysplasia, fragmented coronoid process (FCP), arthroscopy versus arthrotomy, gait analysis
Großmann, Christian
2023
Deutsch
Universitätsbibliothek der Ludwig-Maximilians-Universität München
Großmann, Christian (2023): Vergleich der Langzeitergebnisse nach Therapie des fragmentierten Processus coronoideus medialis der Ulna beim Hund: Arthroskopie versus Arthrotomie. Dissertation, LMU München: Tierärztliche Fakultät
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Abstract

This study was designed to provide an objective comparison between athrotomic and arthroscopic treatment of the FPC, considering long-term follow-up. 20 dogs after athrotomy and 24 dogs after arthroscopic removal of the FCP were examined clinically, radiologically and with the help of a computerized gait analysis. All patients included in this study had a follow-up examination. The control interval after surgery was set at a minimum of six months. On clinical examination at the time of follow-up, 13 (65%) of the patients after arthrotomy showed no lameness, 4 (20%) showed low-grade lameness and 3 (15%) showed marked low-grade lameness. 18 (75%) of the patients after arthroscopic treatment showed no lameness at the time of follow-up, 4 (16.7%) showed low-grade lameness, 1 (4.2%) showed marked low-grade lameness and 1 (4.2%) showed moderate-grade lameness. Looking at the change in the lameness level of the animals between the preoperative and postoperative examination, the following picture emerges: Overall, the lameness of the patients treated with arthrotomy improved by an average of 1.1 (± 1.1) degrees as compared to the patients treated with arthroscopy which improved by an average of 1.3 (± 1.2) degrees. Improvement occurred in 16 dogs (66.7%) after arthrotomy and in 21 dogs (87.5%) after arthroscopy. On gait analysis, at the time of long-term follow-up, 13 patients (65%) showed no lameness after arthrotomy and 7 (35%) patients showed lameness. In patients treated arthroscopically, 21 (87.5%) patients showed no signs of lameness, 3 (12.5%) patients continued to show lameness. When considering the kinetic parameters, the patients after arthroscopy showed a greater similarity to the gait pattern of the healthy comparison group (n=21) than the patients after arthrotomy. The kinematic data analysis also showed that the patients after arthroscopy had a more physiological gait pattern for most of the parameters recorded. In particular, a significantly greater ROM of the elbow joint could be demonstrated for the patient group after arthroscopy compared to the patient group after arthrotomy. Radiologically, a progression of the arthritic change could be determined with two different assessment methods. Due to the different time interval at the control examination between the two patient groups, a matching pair analysis was performed. This supports the results of the overall groups in the gait analysis. No difference in the development of arthrosis between the patient groups could be detected. In summary, taking into account the examination procedures used, it was determined that the patients who underwent arthroscopic treatment achieved a better clinical and gait analysis result on most points, without reaching statistical significance.