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Tratamento cirúrgico da rutura do ligamento cruzado cranial do joelho – complicações da técnica de avanço da tuberosidade tibial
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Abstract(s)
A rutura do ligamento cruzado cranial é a lesão mais comum a afectar o membro posterior dos cães. Pode ter origem num episódio traumático, no entanto a associação com alterações ou processos degenerativos que originam a fragilidade do ligamento cruzado cranial, é a sua etiologia mais frequente.
Atualmente encontram-se descritas várias técnicas cirúrgicas para o tratamento da rutura do ligamento cruzado cranial em cães. A técnica de avanço da tuberosidade tibial é uma das mais recentes, tendo vindo a ganhar popularidade entre os cirurgiões. Todos os anos são publicados novos estudos que visam melhorar a sua performance.
Neste trabalho faremos uma breve descrição da articulação do joelho, seguida de uma revisão sobre a rutura do ligamento cruzado cranial para, posteriormente, referir os métodos de diagnóstico desta lesão e enunciar as principais técnicas para o seu tratamento, com recurso à osteotomia da tíbia proximal.
O objetivo principal deste trabalho é fazer uma revisão bibliográfica acerca dos vários aspetos referentes ao avanço da tuberosidade tibial, colocando especial ênfase nas suas complicações e respetivas resoluções, não descurando no entanto, outras vertentes, tais como, a descrição da técnica propriamente dita, as suas indicações, assim como, a comparação com uma das técnicas mais realizadas na atualidade, a osteotomia niveladora da meseta tibial.
Uma vez que existe uma panóplia de intervenções cirúrgicas para a resolução desta lesão, torna-se fundamental tentar determinar a que oferece maior garantia de sucesso com o menor grau de complicações possível.
Atualmente não existe um consenso acerca de qual das técnicas modificadoras da meseta tibial é a melhor, sendo que todas elas estão constantemente a sofrer aperfeiçoamentos. Como tal, considerámos pertinente dar um contributo nesta conjuntura, revendo os artigos mais recentes sobre o avanço da tuberosidade tibial, suas complicações e respetivas soluções.
The cranial cruciate ligament rupture is the most common lesion affecting the dogs hind limb. It may be originated from a traumatic episode, however the association with alteration of the degenerative processes which lead to fragility of cranial cruciate ligament is the most frequent ethiology. Currently, there are described several surgical techniques for the treatment of the cranial cruciate ligament rupture in dogs. The tibial tuberosity advancement is one of the most recent techniques, having gained popularity among surgeons. Every year are published new studies to improve its performance. This paper has a brief description of the stifle joint, followed by a review of the cranial cruciate ligament rupture, then, to refer the diagnostic methods of this lesion and statement the main techniques for its treatment, using the proximal tibial osteotomy. The main goal of this paper is to review the existing literature on the various aspects of the tibial tuberosity advancement, placing special emphasis on its complications and respective resolutions, not forgetting however other aspects, such as technique description, its indications, as well as comparison with one of the most performed techniques nowadays, the tibial plateau leveling osteotomy. Since there is a range of surgical procedures for the resolution of this lesion, it is essential to try to determine which offers greater guarantee of success with the least amount of possible complications. Currently, there is no consensus about which of the modifying techniques of tibial plateau is the best, all of each are constantly undergoing improvements. As such, it was pertinent to make a contribution in this context, reviewing the lastest articles about the tibial tuberosity advancement, its complications and respective resolutions.
The cranial cruciate ligament rupture is the most common lesion affecting the dogs hind limb. It may be originated from a traumatic episode, however the association with alteration of the degenerative processes which lead to fragility of cranial cruciate ligament is the most frequent ethiology. Currently, there are described several surgical techniques for the treatment of the cranial cruciate ligament rupture in dogs. The tibial tuberosity advancement is one of the most recent techniques, having gained popularity among surgeons. Every year are published new studies to improve its performance. This paper has a brief description of the stifle joint, followed by a review of the cranial cruciate ligament rupture, then, to refer the diagnostic methods of this lesion and statement the main techniques for its treatment, using the proximal tibial osteotomy. The main goal of this paper is to review the existing literature on the various aspects of the tibial tuberosity advancement, placing special emphasis on its complications and respective resolutions, not forgetting however other aspects, such as technique description, its indications, as well as comparison with one of the most performed techniques nowadays, the tibial plateau leveling osteotomy. Since there is a range of surgical procedures for the resolution of this lesion, it is essential to try to determine which offers greater guarantee of success with the least amount of possible complications. Currently, there is no consensus about which of the modifying techniques of tibial plateau is the best, all of each are constantly undergoing improvements. As such, it was pertinent to make a contribution in this context, reviewing the lastest articles about the tibial tuberosity advancement, its complications and respective resolutions.
Description
Keywords
Avanço da tuberosidade tibial Rutura do ligamento cruzado cranial Cão Complicações do avanço da tuberosidade tibial Fratura da tíbia Tibial tuberosity advancement Cranial cruciate ligament rupture Dog Complications of tibial tuberosity advancement Tibial fracture