Comparison of Tibial Tuberosity Transposition and Anti-rotation Suture for Medial Patellar Luxation in 133 Small-breed Dogs

Abstract

This retrospective study is designed to compare the clinical results of tibial tuberosity transposition (TTT) and anti-rotation suture (ARS) treatments for medial patellar luxation (MPL). Medical records of 133 dogs were reviewed that had undergone surgical correction of MPL between January 2013 and May 2017. MPL correction was performed on 182 stifles, with TTT and ARS being performed on 101 stifles and 81 stifles. The common dog breeds receiving surgical treatment for MPL were Maltese, Pomeranian, Chihuahua and Poodle. Mean age of dogs with MPL was 32.6 months, and their mean body weight was 4.26 kg. Seventy dogs (52.6%) were male and 63 (47.4%) were female. Of the 182 stifles with MPL, grade II, III and IV were 18.7%, 72.0% and 9.3%. Total complications after TTT and ARS were recorded in 16.8% and 29.6%. Major complications after TTT and ARS were recorded in 5.9% and 12.3%, minor complications after TTT and ARS were recorded in 10.9% and 17.3%. The risk of complication and reluxation rate after TTT were significantly lower than that for ARS (p<0.05). However, the rate of reluxation among dogs treated by ARS (1.2%) for grade II MPL was significantly lower than that for dogs treated by ARS (8.6%) for grade III MPL (p<0.05). The TTT group had a shorter recovery period after surgical intervention than that in the ARS group (p<0.001). In conclusion, TTT had a significantly lower incidence of complication and a shorter recovery period than ARS. However, ARS for grade II MPL appears to be a good surgical option for reducing the rate of reluxation after surgery. These results of this study could be used to provide therapeutic guidelines for surgical MPL correction in small-breed dogs.

본 연구에서는 내측 슬개골탈구 교정수술을 받은 개에서, 경골조면이식술과 경골회전방지술의 효과를 비교하였다. 2013년 1월부터 2017년 5월까지 내측 슬개골탈구 교정수술을 실시한 개 133두를 대상으로 하였다. 내측 슬개골탈구 교정술은 182례의 슬관절에 실시하였고, 그 중 경골조면이식술은 101례, 경골회전 방지술은 81례였다. 수술을 받은 개의 품종 분포에서는 말티즈가 가장 많았고 그 다음으로 포메라이언, 치와와 및 푸들이었다. 수술 당시의 평균 연령은 32.6개월이었고, 평균 체중은 4.26kg이었으며, 성비는 수컷52.6%, 암컷47.4%이었다. 수술 당시의 개의 슬개골탈구 등급은 2기, 3기 및 4기는 각각 18.7, 72.0 및 9.3%였다. 경골조면이식술 후 합병증은 16.8%가 발생하였고, 그 중 중증은 5.9%, 경증은 10.9%였다. 경골회전방지술 후 합병증은 29.6%가 발생하였고, 그 중 중증은 12.3%, 경증은 17.3%였다. 경골회전방지술 보다 경골조면이식술에서 합병증 발생률 및 재탈구율이 유의적으로 낮았다(p<0.05). 그러나 슬개골 탈구 등급 2기에 적용한 경골회전방지술의 재탈구율은 1.2%로써 3기의 8.6%보다 유의적으로 낮았다(p<0.05). 수술 후 파행이 없어지는 기간은 경골회전방지술이 경골조면이식술 보다 유의적으로 길었다(p<0.001). 결론적으로, 경골조면 이식술이 경골회전방지술 보다 수술 후 합병증이 적고 회복이 빨랐다. 그러나 소형견 슬개골탈구 등급 2기에서는 경골회전방지술을 적용하는 경우에는 재탈구율이 낮았다.