香港的医生说胖妞的骨刺太严重了

[虎妞]

我把胖妞的X光片发给香港的医生，他说胖妞的骨刺太严重了。不适合做置换的手术。因为操作空间太小，仪器太大。他们还在努力看能不能从国外进口更小的仪器，但是还没有结果。我真的好失望呀。

不知道置换手术为什么和骨刺还有关系？有什么办法能让骨刺减少吗？还是说已经长出了骨刺，就不可能消减了？我该怎么做呢？

还有，听他们说置换手术有很多种，他们采用的是比较新的技术，因此对狗的股骨头和关节的状况要求比较高。不知道还有哪些类型的置换手术，是能够适合胖妞的？

[amy]

我想沒有這個問題吧,李醫師和王醫師看了妞妞的X光片也沒說他不合適啊,或許是香港的醫生自己沒把握吧
再說所謂新技術其時是非骨水泥系統,愛屋的醫生早就在執行了
每一隻狗的狀況不同,但總有方法可以去解決的
當初Yellow的案例美國其他醫生也說非常困難(Yellow的難度李醫師在美國那麼多年也只看過2例)可是Yellow的手術還是很成功啊

你可以樂觀些,先把保守療做好,未來既使要選擇手術的方式,也可以擁有比較好的手術條件

[doggydc]

Ya, Amy is right. We don't think too much osteophytes is the major problem for THR. Indeed, niu-niu 's hip doesn't have too much osteophytes. Only thing you have to know is niuniu possible need to do THR on both sides because complete luxation of both sides.
Dr. Lee

【譯文如下】
Amy說得沒錯，我們不認為骨刺太多會造成人工髖關節置換手術的問題，事實上，妞妞的骨刺也不多，你唯一得知道的是，妞妞雙側的髖關節都必須置換，因為兩側都已完全鬆脫。
李醫師回覆

(翻譯by 小莫麻)

[Jeff Wang]

Well, Actually bone spurs are the friend the the tatal hip replacement because it makes the operating space bigger. The condition we hate most is like Yellow's condition. Bilateral luxation and has less DJD. At this situation the acetebulum will be very shellow and the difficulty will raise. But, as I remember, NiuNiu's condition is very similar to Yellow's, right? I don't remember the severe bone spurs.

Jeffrey Wang DVM, Mph

【譯文如下】
事實上呢，骨刺是髖關節置換手術的好朋友，因為手術讓骨頭的活動空間加大了。我們最怕的是像Yellow那種狀況，兩側髖關節都已鬆脫，又有輕微的退化性關節疾病，在這種狀況下髖臼（acetebulum）會很淺，困難度也會提高。但就我印象所及，妞妞的狀況和Yellow很類似是吧？我倒不記得有嚴重的骨刺。
王醫師答覆

(翻譯by小莫麻)

[虎妞]

Thanks for your explanation. I will talk with HK doctors to make further clarafication. Besides this, would you please let me know in what kind of condition that THR cannot be performed to the dog? I was told from HK doctors the only reason is the bone spurs. If Niu-niu dosen't have severe bone spurs,why HK docters told me so?? How can I ready this from the X-rays?

And I know Niu-niu has to do THR for both sides. Her left leg is still a little bit lame now. I have bought Synoquin for her. Hope it helps. I will keep conservative treatment on her. May I ask how often should I take X-rays? I almost take it once a month. But Niu-niu feels very uncomfortable when taking the X-ray.

Do you need to see her original copies of X-ray before you preparing for the operation?

Sorry for so many questions.

【譯文如下】
謝謝您的解釋。我會和香港的醫師再做確認。除此之外，不知能否向您請教，在何種狀況下會無法進行髖關節置換手術？香港的醫師告訴我，骨刺是唯一的原因，如果妞妞沒有嚴重的骨刺問題，香港的醫生為什麼要這樣說呢？我要如何從X光片來判斷呢？
我知道妞妞兩隻腳都必須做髖關節置換手術。她的左腳還是有點跛，我幫她買了Synoquin，希望有幫助，我也會繼續進行保守療法，可以請教應該多久幫她拍一次X光片呢？我大概一個月拍一次，不過妞妞很不喜歡拍X光。
手術前您會不會需要看他原本的X光片呢？
很抱歉問題這麼多。

（翻譯by小莫麻）

[doggydc]

The only possibility that can't perform THR is that there is bony structure damage on acetabulum and femoral neck/shaft which are two places the implants will be put in. The way we have to wait till one year old to perform surgery is that we have to make sure the bony structure is good and mature enough to accept the implants.
It is very difficult to teach you how to read the x-ray film from the website. I really need to show you the film and point out the changes. I will try to post a normal hip x-ray for you to compare to niu-niu's x-ray.
We need you to have niu-niu checked by your regular doctor and have x-ray taken every 2 months untill ready for surgery. We will redo x-ray just before surgery to get the most update condition and size of the pelvic bone, so we can measure and find out the best size of implants for niu-niu.
Plase continuous to keep niu-niu on chondroprotective medicine to prevent further damage and use pain killer as needed.
Dr. Lee

【譯文如下】
唯一無法進行髖關節置換手術的狀況，是髖臼和大腿骨/頸的骨頭結構有傷害，因為這兩處是動手術的位置。我們必須等到一歲才動手術的原因，就是為了確定骨骼發育良好，而且足以接受置換手術。
我很難從網站上教你怎麼判讀X光片，我得親自把片子秀給你看，指出變化之處。我會試著找出髖關節正常的X光片，讓你和妞妞的X光片做比較。在適合動手術之前，要請你每兩個月帶妞妞去給醫生檢查，並拍X光，手術前我們也會再照一次X光，以掌握最新狀況，以及骨盆骨骼的位置，以計算出最適合妞妞的髖關節大小。
請繼續讓妞妞吃關節保健藥品，避免進一步傷害，有需要時也要吃止痛藥。
李學文醫師答覆

（翻譯by小莫麻）