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Estudo retrospetivo para caracterização de artroscopias eletivas para tratamento de osteocondrose dissecante num hospital de referência em Portugal
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A osteocondrose dissecante faz parte do complexo das doenças ortopédicas do desenvolvimento. Este conjunto de patologias caracteriza-se por uma anomalia durante o processo de formação do esqueleto, durante as primeiras etapas do desenvolvimento, e manifesta-se em várias espécies, entre estas, os equinos. Esta patologia em particular define-se como uma afeção multifocal em que há uma falha no processo de ossificação endocondral com formação de fragmentos ósseos, livres ou não, no espaço articular. A presença do fragmento na articulação é causa de inflamação e consequentemente desenvolvimento de processos secundários como osteoartrite. Na indústria equestre, a osteocondrose dissecante está associada a grandes perdas econômicas, relacionadas não só com o tratamento da patologia em si, mas também, com a desvalorização dos animais jovens e comprometimento da futura carreira desportiva. Atualmente, e de acordo com os estudos publicados, o tratamento mais adequado é a artroscopia. Sob anestesia geral, é feita lavagem da articulação afetada, removido o fragmento e a lesão é curetada até ao osso subcondral saudável. O presente estudo retrospetivo teve como objetivo caracterizar as artroscopias eletivas para remoção de fragmentos de osteocondrose dissecante, realizadas no Serviço de Cirurgia e Urgência de Equinos da Faculdade de Medicina Veterinária da Universidade de Lisboa, no período entre 2016 e 2021. A amostra era constituída por noventa indivíduos, dos quais setenta e dois eram Puro Sangue Lusitano com menos de quatro anos de idade. 96% destes animais foram referenciados para o serviço para tratamento da lesão, previamente diagnosticada. Além da caracterização da amostra foram ainda descritos vários parâmetros relacionados com a cirurgia, como cento e quarenta e três articulações intervencionadas, lesões presentes na artroscopia, além do fragmento, em 63% dos casos, taxa de complicações pós cirúrgicas de 6,7% e duração média do período de recuperação de oito semanas. Os resultados da análise estatística mostram-se maioritariamente concordantes com bibliografia existente, incluindo a taxa de complicações reduzida, característico deste tipo de intervenções
ABSTRACT - RESTROSPECTIVE STUDY FOR DESCRIPTION OF ELECTIVE ARTHROSCOPIES FOR TREATMENT OF OSTEOCHONDROSIS DISSECANS AT A REFERRAL HOSPITAL IN PORTUGAL - Osteochondrosis dissecans is part of the complex denominated developmental orthopaedic diseases. This group of pathologies arises abnormalities during endochondral ossification which occurs in the preliminary stages of development, and it is described in several species, including equids. This particular disease can be defined as a multifocal affection in which there is an abnormal endochondral ossification, with formation of bonny fragments in the articular space, either loose or attached to the articular surface. The presence of a fragment leads to joint inflammation and subsequent development of secondary pathologies such as osteoarthritis. Osteochondrosis dissecans it is one of the major causes of economic losses amongst the equine industry, not just because of the costs added for treating the disease, but also due to the loss of economic value of young horses and compromised athletic careers. Nowadays, according to the studies published, arthroscopy is the most suitable treatment course. Generally preformed under general anaesthesia, the affected joint is thoroughly flushed, the fragment is removed, and the lesion is curetted down to healthy subchondral bone. The aim of the present retrospective study was to describe the elective arthroscopies performed for removal of bone fragments, due to osteochondrosis dissecans, performed at Serviço de Cirurgia e Urgência de Equinos from Faculdade de Medicina Veterinária of Universidade de Lisboa, between 2016 and 2021. The sample was composed of ninety individuals, in which seventy-two were Puro Sangue Lusitano under the age of four years old. Ninety-six percent of these animals were referred to the hospital for treatment of said lesions, previously diagnosed by the referral veterinarian. Additionally, some parameters related to the surgery were described, such as one hundred and forty-three operated joints, other lesions visualised during the arthroscopy in 63% of the cases, 6,7% post-surgical complications rate, and average recovery period length of eight weeks. The results of the statistical analysis are mostly in agreement with the existing literature, including the reduced complications rate, quite characteristic of this type of intervention
ABSTRACT - RESTROSPECTIVE STUDY FOR DESCRIPTION OF ELECTIVE ARTHROSCOPIES FOR TREATMENT OF OSTEOCHONDROSIS DISSECANS AT A REFERRAL HOSPITAL IN PORTUGAL - Osteochondrosis dissecans is part of the complex denominated developmental orthopaedic diseases. This group of pathologies arises abnormalities during endochondral ossification which occurs in the preliminary stages of development, and it is described in several species, including equids. This particular disease can be defined as a multifocal affection in which there is an abnormal endochondral ossification, with formation of bonny fragments in the articular space, either loose or attached to the articular surface. The presence of a fragment leads to joint inflammation and subsequent development of secondary pathologies such as osteoarthritis. Osteochondrosis dissecans it is one of the major causes of economic losses amongst the equine industry, not just because of the costs added for treating the disease, but also due to the loss of economic value of young horses and compromised athletic careers. Nowadays, according to the studies published, arthroscopy is the most suitable treatment course. Generally preformed under general anaesthesia, the affected joint is thoroughly flushed, the fragment is removed, and the lesion is curetted down to healthy subchondral bone. The aim of the present retrospective study was to describe the elective arthroscopies performed for removal of bone fragments, due to osteochondrosis dissecans, performed at Serviço de Cirurgia e Urgência de Equinos from Faculdade de Medicina Veterinária of Universidade de Lisboa, between 2016 and 2021. The sample was composed of ninety individuals, in which seventy-two were Puro Sangue Lusitano under the age of four years old. Ninety-six percent of these animals were referred to the hospital for treatment of said lesions, previously diagnosed by the referral veterinarian. Additionally, some parameters related to the surgery were described, such as one hundred and forty-three operated joints, other lesions visualised during the arthroscopy in 63% of the cases, 6,7% post-surgical complications rate, and average recovery period length of eight weeks. The results of the statistical analysis are mostly in agreement with the existing literature, including the reduced complications rate, quite characteristic of this type of intervention
Descrição
Dissertação de Mestrado Integrado em Medicina Veterinária, na científica de Clínica
Palavras-chave
Cavalo Osteocondrose dissecante Artroscopia Fragmento Horse Osteochondrosis dissecans Arthroscopy Fragment
Contexto Educativo
Citação
Ribeiro LFS. 2023. Estudo retrospetivo para caracterização de artroscopias eletivas para tratamento de osteocondrose dissecante num hospital de referência em Portugal [dissertação de mestrado]. Lisboa: FMV-Universidade de Lisboa
Editora
Universidade de Lisboa, Faculdade de Medicina Veterinária