Veterinary Surgery最新文献

Objective: To report the use of a hybrid, transarticular external skeletal fixator and platelet-rich plasma injection without primary tenorrhaphy for management of partial calcanean tendon disruption in dogs.

Study design: Multi-institutional retrospective study.

Animals: A total of 11 client-owned dogs.

Methods: Medical records from two referral centers from 2019 to 2022 were reviewed for inclusion in the study. Dogs diagnosed with partial, non-traumatic calcanean tendon disruption treated with hybrid, transarticular external skeletal fixation and platelet-rich plasma injection were included in the study. Cases that did not include complete postoperative follow-up over 8-12 weeks and owner-reported outcomes at >6 months were excluded from the study. Dogs with traumatic laceration or those in which a primary tenorrhaphy was performed were also excluded.

Results: A total of 11 (n = 11) dogs met the inclusion criteria. Median follow-up time was 18.5 months (6 months-34 months). Mean time of fixation was 9 weeks (6 weeks-12 weeks). Five dogs returned to full, pain-free function (5/11 = 45%). Five dogs had an acceptable return to function (5/11 = 45%). One dog had an unacceptable outcome (1/11 = 9%). Pin tract complications occurred in five dogs (5/11 = 45%) and resolved with medical intervention.

Conclusion: The results of this study suggest that temporary tibiotarsal immobilization with a hybrid, transarticular external skeletal fixator and platelet-rich plasma injection without primary tenorrhaphy can lead to a successful outcome in dogs with partial calcanean tendon disruption.

Clinical significance: Temporary hybrid, transarticular external skeletal fixation and platelet-rich plasma injection without primary tenorrhaphy may play a role in the management of partial calcanean tendon disruption in dogs.

Objective: To provide an overview of available research about effects of horseshoes on equine kinetics and kinematics.

Methods: The terms, "horse/equine," "hoof," "shoes/horseshoes," "kinetics," and "kinematics" were searched in PubMed, Web of Science, Center for Agriculture and Bioscience International, and United States Department of Agriculture National Agricultural Library for manuscripts from first availability to 2024. Independent reviewers used preferred reporting items for systematic reviews and meta-analyses guidelines to map and extract evidence-based data from sources. Metrics included participant demographics, research methods, major findings, and study limitations. Knowledge gaps were also identified.

Results: A total of 46 studies were included. Most utilized non-lame horses to compare original shoe designs or modifications to unshod or a standard open-heel shoe. Horse demographics and gait, study design and outcome measures varied widely. Prevalent data collection equipment included force platforms and pressure plates, wearable force measuring technology, and videography. Many studies reported shoeing effects on limb forces and motion, but there was little consensus among unrelated studies. Common limitations included insufficient data resolution, no randomization, small sample size, single breed, and outcome measures specific or unique to the study. Knowledge gaps included data collection from all limbs and the impact of conformation and limb and hoof morphology and health condition on outcomes.

Conclusion: Information from manuscripts that met inclusion criteria confirmed distinct, variable effects of shoe characteristics on equine gait parameters.

Clinical significance: Details from published work can serve as resource for clinical decisions and to guide standardization among investigations on shoe configuration effects on equine motion.

Objective: The aim of the study was to evaluate time to closure, bursting pressures and luminal diameters of a single and double-layer end-to-end anastomoses in normal equine descending colon.

Study design: Experimental study.

Sample population: Eight adult horses.

Methods: Four segments of descending colon from each horse were randomly assigned to a control (n = 8, CON), one-layer (n = 12, group 1; continuous Lembert pattern), or two-layer group (n = 12, group 2; simple continuous oversewn with Cushing pattern). Anastomoses were performed, and time to closure and luminal diameter were measured. Bursting pressures were determined, and location of failure was recorded. Mixed analysis of variance (ANOVA) was employed.

Results: Mean time to completion was decreased (p = .003) in group 1 (18.6 min ± 22.8 s) compared with group 2 (21.35 min ± 22.8 s). Luminal diameter was reduced (p < .0001) in group 2 (47 ± 2.46 mm) compared to group 1 (65 ± 2.77 mm). Location of failure was remote to the anastomosis in all but one segment; therefore, differences in anastomotic bursting pressures could not be determined.

Conclusion: Two-layer closures resulted in significant luminal reduction and took longer to complete than one-layer anastomoses.

Clinical significance: Use of one-layer closures may be advantageous primarily with respect to luminal diameter.

Objective: The aim of the present study was to report the outcomes and complications of minimally invasive tarsal arthrodesis (MITA) in dogs.

Study design: Bi-institutional retrospective study.

Sample population: A total of 15 client-owned dogs.

Methods: Medical records of dogs undergoing MITA were reviewed to determine outcome and complications. Radiographs were recommended every 4 weeks until clinical union and reviewed to evaluate tibiotarsometatarsal alignment, implant position, subsequent osseous union of the debrided articulations. Time to clinical union and complications were recorded. Clinical union was defined as functional weightbearing limb use with at least 50% of osseous union. Final limb function was defined as full, acceptable, or unacceptable.

Results: Partial tarsal arthrodesis was performed in 10 cases and pantarsal arthrodesis in five cases. Postoperative swelling was minimal. Most complications, 26% major and 40% minor, were implant-related, and explant was required in three dogs. No catastrophic complications occurred. Mean (±sd) radiographic follow-up was 11.4 (±13.1) months Mean (±sd) time to radiographic osseous union was 1.8 (±0.5) months. Mean (±sd) time to clinical union was 3.7 (±0.8) months. Physiological alignment was restored in 12/15 dogs. Complete radiographic union occurred in 46% while in the remaining 54% obtained partial radiographic union, but clinical instability was not observed. Limb function was considered full in six and acceptable in eight dogs. Function was unacceptable in one dog, but the cause was not related to MITA.

Conclusion: MITA resulted in restoration of alignment, which was accomplished using MITA techniques. Furthermore, MITA appeared to result in faster healing times and reduced soft tissue complications compared to conventional open approach arthrodesis.

Clinical significance: MITA may be considered as an option to obtain functional arthrodesis in dogs.

Objective: To report a capital physeal fracture as the result of a bone infarction with subsequent neoplastic transformation 4 years following total hip replacement.

Study design: Case report.

Animals: Five-year-old female spayed golden retriever.

Methods: The dog was initially presented for evaluation of a 2 week history of spontaneous right hind-limb lameness. Pelvic radiographs demonstrated a displaced capital epiphysis and proximal femur changes consistent with a bone infarction. A cementless total hip replacement was performed, and limb function returned to normal until 51 months after surgery. A radiolucency adjacent to the femoral stem at the greater trochanter, partial calcar resorption, and stable implants were present on pelvic radiographs acquired 52 months after surgery. Surgical exploration of the surgical site for tissue collection for histopathology and bacteria culture was performed 58 months following surgery. No bacterial growth occurred and histologic findings were nonspecific. A right hind-limb amputation was performed 61 months after total hip replacement due to the dog's progression to a non-weight-bearing lameness, Additional tissue samples were taken from the femur for histopathologic examination.

Results: Histopathologic examination was consistent with a pleomorphic sarcoma. No metallic or polyethylene particulate debris was present. Nine months after surgery there was evidence of regional and distant spread of the neoplasia.

Conclusion: In similar cases, submitting the femoral head for histopathologic examination should be considered at the time of the hip replacement surgery. If bone infarction is diagnosed as a causative agent, given the possibility of malignant transformation, long-term serial radiographic monitoring should be given serious consideration.

Objective: To describe unicondylar humeral fracture (UHF) repair using cannulated transcondylar screws, report postoperative fracture reduction, healing, and complication rates.

Study design: Retrospective.

Animals: A total of 49 client owned dogs with UHF.

Methods: Surgical technique and approach (i.e., open, limited open, or minimally invasive) were recorded. Articular step defect (ASD) and gap (Gap) at the humeral condylar articular surface were measured on pre- and postoperative images and reported as percentages. Fracture healing was graded on follow-up radiographs. Functional outcome was based on client questionnaire over the phone. General linear models were used to assess the impact of surgical approach on %ASD, %Gap, whereas Cox regression was used to assess prognostic factors of full fracture healing.

Results: A total of 49 fractures repaired with a transcondylar screw with or without an antirotational pin(s) were included. Surgical approach did not have an impact on postoperative %ASD, %Gap or development of complications. The overall complication rate was 26% (11/42), with no revision surgery necessary. Of the dogs that encountered complications, 50% required pin and/or screw removal after fracture healing. For 29 dogs with a minimum of four-month owner telephone questionnaire follow-up, 90% reported no lameness and only three reported intermittent lameness. Achieving complete fracture healing was affected by increased postoperative %ASD (p = .033).

Conclusion: The UHFs repaired by transcondylar cannulated screws had acceptable outcomes and fracture reduction with complication rates being similar regardless of the surgical approach.

Clinical significance: Cannulated screws can be implanted with varying surgical approaches to successfully repair UHFs with comparable clinical outcome to previous reports.

Objective: The aim of the present study was to quantify the amount of biologic debris present within disposable bipolar vessel sealing devices after each use for canine splenectomies and determine the aerobic bacterial load of the debris following instrument resterilization with ethylene oxide.

Study design: Prospective observational clinical study.

Study population: Client-owned dogs (n = 40) presenting to a single specialty hospital for open, routine, or emergency splenectomies.

Methods: A total of 16 bipolar vessel sealing devices were randomly assigned to undergo one, two, three, or four splenectomies, manual hand cleanings, and ethylene oxide sterilizations before being dismantled. After final use and sterilization, each handset was agitated in phosphate-buffered saline before disassembly, which was submitted for aerobic culture. Following aseptic disassembly, all biological residue was photo-documented, collected, quantified using a subjective scoring system, and submitted for culture.

Results: Biologic debris was present within the inner mechanics of all devices, specifically under the blade used for vessel transection. A linear increase in debris was not appreciated amongst devices used once versus devices used multiple times. None of the devices nor any of the biologic debris cultured positive following sterilization with ethylene oxide.

Conclusion: The presence of biologic debris was documented after the initial use of disposable bipolar vessel sealing devices, but no devices or debris yielded positive culture results following ethylene oxide sterilization after splenectomies.

Clinical significance: Increased risk of iatrogenic surgical site contamination from reused vessel sealing devices is unlikely when they have been cleaned and sterilized with ethylene oxide after up to four splenectomy surgeries.