3D打印模型辅助手术治疗犬髌骨Ⅳ级内脱伴前交叉韧带断裂

doi:10.11843/j.issn.0366-6964.2023.09.035

Abstract

Abstract: The aim of this study was to report the effect of surgery assisted by 3D printing technique in the treatment of a dog with grade Ⅳ medial patellar luxation and cranial cruciate ligament rupture. A Shiba Inu with grade Ⅳ medial patellar luxation and cranial cruciate ligament rupture is treated in two ways. First, the modified tibial plateau leveling osteotomy (TPLO) and trochlear wedge recession are used. Then, the femoral deformity is evaluated through CT scanning and 3D printing of the femoral model to assist in formulating the surgical plan and carrying out distal femoral lateral closing wedge osteotomy (DFO). The degree of lameness, patella position and imaging examination are used to determine the recovery of the dog. The results showed that patellar luxation recurred 8 weeks after the modified TPLO and trochlear wedge recession, indicating that this method can not completely correct the grade Ⅳ medial patellar luxation. With the help of 3D printing technique, the DFO surgical planning is formulated, lameness is significantly improved after treatment, and postoperative recovery is good. In the case of high-level patellar luxation with cranial cruciate ligament rupture, attention should be paid to whether there is femoral deformity; The use of 3D printing technology can assess bone morphology more accurately, assist in formulating femoral osteotomy plan, and improve the success rate of surgery.

Key words: medial patellar luxation, cranial cruciate ligament disease, modified tibial plateau leveling osteotomy, distal femoral lateral closing wedge osteotomy, 3D printing technology

CLC Number:

ZHANG Bin, ZHANG Han, SHI Lei, YUAN Zhankui. Clinical Application of 3D-Printed Model for Surgical Planning and Treatment of Grade Ⅳ Medial Patellar Luxation and Cranial Cruciate Ligament Rupture in a Dog[J]. Acta Veterinaria et Zootechnica Sinica, 2023, 54(9): 3977-3984.

References

[1] LANGENBACH A,MARCELLIN-LITTLE D J.Management of concurrent patellar luxation and cranial cruciate ligament rupture using modified tibial plateau levelling[J].J Small Anim Pract,2010,51(2):97-103.
[2] JOHNSTON S A,TOBIAS K M.Veterinary surgery:small animal expert consult[M].2nd ed.Amsterdam:Elsevier,2017:1141-1159.
[3] PERRY K L,DÉJARDIN L M.Canine medial patellar luxation[J].J Small Anim Pract,2021,62(5):315-335.
[4] FAURON A H,BRUCE M,JAMES D R,et al.Surgical stabilization of concomitant canine medial patellar luxation and cranial cruciate ligament disease:effect of fixation method on postoperative complication rate and clinical outcome[J].Vet Comp Orthop Traumatol,2017,30(3):209-218.
[5] CAMPBELL C A,HORSTMAN C L,MASON D R,et al.Severity of patellar luxation and frequency of concomitant cranial cruciate ligament rupture in dogs:162 cases (2004-2007)[J].Am Vet Med Assoc,2010,236(8):887-891.
[6] MUIR P.Advances in the canine cranial cruciate ligament[M].2nd ed.Hoboken:American College of Veterinary Surgeons Foundation,2018:261-268.
[7] LEONARD K C,KOWALESKI M P,SAUNDERS W B,et al.Combined tibial plateau levelling osteotomy and tibial tuberosity transposition for treatment of cranial cruciate ligament insufficiency with concomitant medial patellar luxation[J].Vet Comp Orthop Traumatol,2016,29(6):536-540.
[8] 刘佳怡,王媛,马春丽,等.3D打印PLA-nHA复合支架膜在犬牙周组织再生中的应用[J].新疆医科大学学报,2021,44(2):155-161.
LIU J Y,WANG Y,MA C L,et al.Application of 3D printing PLA-nHA composite scaffold membrane in canine GTR[J].Journal of Xinjiang Medical University,2021,44(2):155-161.(in Chinese)
[9] 赵雯,邹彤,吕阳欧,等.犬BMSCs复合3D打印支架制备组织工程半月板及体外成软骨诱导时间对其分化的影响[J].畜牧兽医学报,2019,50(7):1486-1492.
ZHAO W,ZOU T,LÜ Y O,et al.Preparation of tissue engineering meniscus by canine BMSCs composite 3D printed Scaffold and effect of chondrogenic induction time on its differentiation in vitro[J].Acta Veterinaria et Zootechnica Sinica,2019,50(7):1486-1492.(in Chinese)
[10] VEZZONI L,BAZZO S,BOIOCCHI S,et al.Use of a modified tibial plateau levelling osteotomy with double cut and medial crescentic closing wedge osteotomy to treat dogs with cranial cruciate ligament rupture and tibial valgus deformity[J].Vet Comp Orthop Traumatol,2020,33(1):59-65.
[11] YEADON R,FITZPATRICK N,KOWALESKI M P.Tibial tuberosity transposition-advancement for treatment of medial patellar luxation and concomitant cranial cruciate ligament disease in the dog:surgical technique,radiographic and clinical outcomes[J].Vet Comp Orthop Traumatol,2011,24(1):18-26.
[12] LIVET V,TARONI M,FERRAND F X,et al.Modified triple tibial osteotomy for combined cranial cruciate ligament rupture,tibial deformities,or patellar luxation[J].J Am Anim Hosp Assoc,2019,55(6):291-300.
[13] TOMO Y,EDAMURA K,YAMAZAKI A,et al.Evaluation of hindlimb deformity and posture in dogs with grade 2 medial patellar luxation during awake computed tomography imaging while standing[J].Vet Comp Orthop Traumatol,2022,35(3):143-151.
[14] BROWER B E,KOWALESKI M P,PERUSKI A M,et al.Distal femoral lateral closing wedge osteotomy as a component of comprehensive treatment of medial patellar luxation and distal femoral varus in dogs[J].Vet Comp Orthop Traumatol,2017,30(1):20-27.
[15] TOMLINSON J,FOX D,COOK J L,et al.Measurement of femoral angles in four dog breeds[J].Vet Surg,2007,36(6):593-598.
[16] DUDLEY R M,KOWALESKI M P,DROST W T,et al.Radiographic and computed tomographic determination of femoral varus and torsion in the dog[J].Vet Radiol Ultrasound,2006,47(6):546-552.
[17] YASUKAWA S,EDAMURA K,TANEGASHIMA K,et al.Evaluation of bone deformities of the femur,tibia,and patella in Toy Poodles with medial patellar luxation using computed tomography[J].Vet Comp Orthop Traumatol,2016,29(1):29-38.
[18] LEE J,SIM H,JEONG J,et al.Biomechanical analysis of canine medial patellar luxation with femoral varus deformity using a computer model[J].BMC Vet Res,2020,16(1).471.
[19] LONGO F,SAVIO G,CONTIERO B,et al.Accuracy of an automated three-dimensional technique for the computation of femoral angles in dogs[J].Vet Rec,2019,185(14):443.
[20] WORTH A J,CROSSE K R,KERSLEY A.Computer-assisted surgery using 3D printed saw guides for acute correction of antebrachial angular limb deformities in dogs[J].Vet Comp Orthop Traumatol,2019,32(3):241-249.
[21] HALL E L,BAINES S,BILMONT A,et al.Accuracy of patient-specific three-dimensional-printed osteotomy and reduction guides for distal femoral osteotomy in dogs with medial patella luxation[J].Vet Surg,2019,48(4):584-591.
[22] WONG K C.3D-printed patient-specific applications in orthopedics[J].Orthop Res Rev,2016,8:57-66.
[23] 吴楚琳,王佳尧,张晗,等.前十字韧带断裂犬胫骨平台角的X线和CT测量[J].中国畜牧兽医,2021,48(10):3896-3904.
WU C L,WANG J Y,ZHANG H,et al.Radiographic and CT measurements of tibial plateau angle in dogs with cranial cruciate ligament rupture[J].China Animal Husbandry & Veterinary Medicine,2021,48(10):3896-3904.(in Chinese)

Clinical Application of 3D-Printed Model for Surgical Planning and Treatment of Grade Ⅳ Medial Patellar Luxation and Cranial Cruciate Ligament Rupture in a Dog

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[1]	SHI Lei, MA Yihan, YUAN Zhankui, SUN Yihong, WANG Xiao, ZHANG Bin, QIAO Kangjia. Analysis of Surgical Effect and Complications of Tibial Plateau Leveling Osteotomy for the Treatment of Cranial Cruciate Ligament Disease in Dogs [J]. Acta Veterinaria et Zootechnica Sinica, 2023, 54(9): 3964-3976.
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