Μaria Theofilaktidou, Leonidas Pavlidis, Ioannis Savvas, Vasileia Angellou, Apostolos Argyros, N. Michailidis, L. Papazoglou
Objective The aim of the study was to assess the flexural deformation strength of various brands of skin staples postfiring, and to compare the distance and alignment of the staple tips. Study Design In this experimental in vitro study, nine types of commercially available skin staples were tested. Following firing, six staples of each type were mounted on a material testing machine. Mechanical properties of staples were evaluated under uniaxial loading test, which translated to the bending of the staple for determination of flexural deformation strength. Staples were evaluated for tip alignment and distance between pointed tips. Results Maximum force to flexural deformation was greater for Precise (29.633 ± 7.8421 N), than Proximate (16.200 ± 1.1541 N; p = 0.000), Henry Schein (23.383 ± 5.2282 N; p = 0.011), Weck Visistat (24.329 ± 1.0372 N; p = 0.025), Appose (18.133 ± 1.2675 N; p = 0.000), Manipler (14.067 ± 3.7393 N; p = 0.000), and Leukoclip (22.288 ± 1.6915 N; p = 0.002) but was not different from Gima (27.483 ± 6.5637 N; p = 0.370) and Advan (27.283 ± 2.8708 N; p = 0.327) Precise, Appose, and Advan fired staples had their pointed tips met, whereas Manipler, Leukoclip, Gima, Henry Schein, Proximate, and Weck Visistat showed a gap between pointed tips. Proximate staples also showed malalignment between their pointed tips. Conclusion The flexural deformation strength of skin staples manufactured by Precise, Gima, and Advan was between 29 and 27 N and thus significantly superior to the other six staple types tested.
{"title":"In Vitro Evaluation of Flexural Strength of Different Skin Staples","authors":"Μaria Theofilaktidou, Leonidas Pavlidis, Ioannis Savvas, Vasileia Angellou, Apostolos Argyros, N. Michailidis, L. Papazoglou","doi":"10.1055/s-0044-1788577","DOIUrl":"https://doi.org/10.1055/s-0044-1788577","url":null,"abstract":"\u0000 Objective The aim of the study was to assess the flexural deformation strength of various brands of skin staples postfiring, and to compare the distance and alignment of the staple tips.\u0000 Study Design In this experimental in vitro study, nine types of commercially available skin staples were tested. Following firing, six staples of each type were mounted on a material testing machine. Mechanical properties of staples were evaluated under uniaxial loading test, which translated to the bending of the staple for determination of flexural deformation strength. Staples were evaluated for tip alignment and distance between pointed tips.\u0000 Results Maximum force to flexural deformation was greater for Precise (29.633 ± 7.8421 N), than Proximate (16.200 ± 1.1541 N; p = 0.000), Henry Schein (23.383 ± 5.2282 N; p = 0.011), Weck Visistat (24.329 ± 1.0372 N; p = 0.025), Appose (18.133 ± 1.2675 N; p = 0.000), Manipler (14.067 ± 3.7393 N; p = 0.000), and Leukoclip (22.288 ± 1.6915 N; p = 0.002) but was not different from Gima (27.483 ± 6.5637 N; p = 0.370) and Advan (27.283 ± 2.8708 N; p = 0.327) Precise, Appose, and Advan fired staples had their pointed tips met, whereas Manipler, Leukoclip, Gima, Henry Schein, Proximate, and Weck Visistat showed a gap between pointed tips. Proximate staples also showed malalignment between their pointed tips.\u0000 Conclusion The flexural deformation strength of skin staples manufactured by Precise, Gima, and Advan was between 29 and 27 N and thus significantly superior to the other six staple types tested.","PeriodicalId":443672,"journal":{"name":"VCOT Open","volume":"27 13","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141845720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. D. de Lucena, B. Minto, José Aloizio Gonçalves Neto, Danyelle Rayssa Cintra Ferreira, Luís Gustavo Gosuen Gonçalves Dias
Abstract Objective The aim of this article was to describe, in detail, the safe portals and surgical approaches for minimally invasive interlocking nail osteosynthesis. Methods Fifteen dog cadavers weighing between 30 and 40 kg were used, 10 for an anatomical study and 5 for creation of the minimally invasive interlocking nail osteosynthesis portals. Anatomical dissections were used to establish landmarks and precise anatomical interrelationships of the surgical approaches for the minimally invasive use of interlocking nails in the tibia, femur, and humerus. Subsequent dissection was made to evaluate potential iatrogenic lesions. Results The reference points for, and anatomical interrelationships of, the minimally invasive surgical approaches to the tibial, femur, and humerus diaphyses were detailed. No damage to any important neurovascular structures was observed in any cadaver. Conclusion Safe portals for approaching the humerus, femur, and tibia were described in detail to allow safe application of interlocking nails in a minimally invasive fashion.
{"title":"Surgical Approaches for Minimally Invasive Interlocking Nail Osteosynthesis in Dogs","authors":"D. D. de Lucena, B. Minto, José Aloizio Gonçalves Neto, Danyelle Rayssa Cintra Ferreira, Luís Gustavo Gosuen Gonçalves Dias","doi":"10.1055/s-0043-1777109","DOIUrl":"https://doi.org/10.1055/s-0043-1777109","url":null,"abstract":"Abstract Objective The aim of this article was to describe, in detail, the safe portals and surgical approaches for minimally invasive interlocking nail osteosynthesis. Methods Fifteen dog cadavers weighing between 30 and 40 kg were used, 10 for an anatomical study and 5 for creation of the minimally invasive interlocking nail osteosynthesis portals. Anatomical dissections were used to establish landmarks and precise anatomical interrelationships of the surgical approaches for the minimally invasive use of interlocking nails in the tibia, femur, and humerus. Subsequent dissection was made to evaluate potential iatrogenic lesions. Results The reference points for, and anatomical interrelationships of, the minimally invasive surgical approaches to the tibial, femur, and humerus diaphyses were detailed. No damage to any important neurovascular structures was observed in any cadaver. Conclusion Safe portals for approaching the humerus, femur, and tibia were described in detail to allow safe application of interlocking nails in a minimally invasive fashion.","PeriodicalId":443672,"journal":{"name":"VCOT Open","volume":"389 1","pages":"e150 - e155"},"PeriodicalIF":0.0,"publicationDate":"2023-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139364524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jackie D. Cornell, S. W. Frederick, B.E. Shessel, A. Cross
Abstract Lateral humeral condylar (LHC) nascent malunion fractures are challenging to treat because of extensive callus formation, scar tissue and contracture of surrounding tissues. The objective of this retrospective case series is to describe the novel procedural use of an intraoperative distraction device to aid in the reduction and anatomical alignment of nascent malunion LHC fractures along with long-term functional outcomes in these cases. Medical records of five consecutive cases of dogs with seven nascent malunion LHC fractures that were treated between 2015 and 2018 with the aid of an intraoperative distraction device were reviewed. Relevant clinical and radiographic data, forelimb circumference, elbow goniometry and clinical outcome were evaluated. Anatomic reduction and fixation with complete healing were achieved in all seven cases. Implants were removed in four cases to resolve persisting lameness. Three dogs (4 cases) were available for long-term follow-up: mean circumference and range of motion were decreased in the operated limbs as compared with the contralateral normal limbs. One dog (with bilateral fractures) was euthanized due to poor outcome. In the other five elbows, outcome was acceptable. Based on the results of this case series, use of an intraoperative distraction device to aid in anatomical reduction and fixation of nascent malunion LHC fractures should be considered.
{"title":"Intraoperative Distraction Device for Open Reduction of Nascent Lateral Humeral Condylar Fractures in Five Dogs","authors":"Jackie D. Cornell, S. W. Frederick, B.E. Shessel, A. Cross","doi":"10.1055/s-0043-1771399","DOIUrl":"https://doi.org/10.1055/s-0043-1771399","url":null,"abstract":"Abstract Lateral humeral condylar (LHC) nascent malunion fractures are challenging to treat because of extensive callus formation, scar tissue and contracture of surrounding tissues. The objective of this retrospective case series is to describe the novel procedural use of an intraoperative distraction device to aid in the reduction and anatomical alignment of nascent malunion LHC fractures along with long-term functional outcomes in these cases. Medical records of five consecutive cases of dogs with seven nascent malunion LHC fractures that were treated between 2015 and 2018 with the aid of an intraoperative distraction device were reviewed. Relevant clinical and radiographic data, forelimb circumference, elbow goniometry and clinical outcome were evaluated. Anatomic reduction and fixation with complete healing were achieved in all seven cases. Implants were removed in four cases to resolve persisting lameness. Three dogs (4 cases) were available for long-term follow-up: mean circumference and range of motion were decreased in the operated limbs as compared with the contralateral normal limbs. One dog (with bilateral fractures) was euthanized due to poor outcome. In the other five elbows, outcome was acceptable. Based on the results of this case series, use of an intraoperative distraction device to aid in anatomical reduction and fixation of nascent malunion LHC fractures should be considered.","PeriodicalId":443672,"journal":{"name":"VCOT Open","volume":"16 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126471894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract The aim of this study is to describe a novel conformation-based approach to surgical planning and execution, as well as novel orthopaedic planning and rehearsal software. This report presents two cases of angular limb deformity correction, utilizing a novel conformation-based technique. A combination of computed tomography and radiographs was used to characterize the deformities for each case. Case 1 presented with a biapical deformity of the left antebrachium. Case 2 presented with deformities affecting the left femur and tibia. Rendering of a three-dimensional (3D) bone model, surgical planning, and production of multistep surgical jigs were executed using a traditional mesh-modeling workflow for case 1, whereas case 2 utilized the described novel software. No intraoperative complications were encountered while using the surgical kits. The multistep surgical jigs facilitated major procedural steps with precision, including application of definitive fixation. The novel software reduced the surgical planning time and the operator's requirement for 3D modeling skill. All osteotomies were stabilized in compression with acceptable alignment and good patient outcomes. This novel conformation-based approach and planning software, developed by the corresponding author, may provide an alternative method of correcting canine angular limb deformities. Further research on this technique and software is indicated before commercial availability.
{"title":"Correction of Angular Limb Deformities in Two Dogs Using a Conformation-Based Surgical Approach and Planning Software","authors":"Tyler J. Wyatt, Albert Lynch","doi":"10.1055/s-0043-1771233","DOIUrl":"https://doi.org/10.1055/s-0043-1771233","url":null,"abstract":"Abstract The aim of this study is to describe a novel conformation-based approach to surgical planning and execution, as well as novel orthopaedic planning and rehearsal software. This report presents two cases of angular limb deformity correction, utilizing a novel conformation-based technique. A combination of computed tomography and radiographs was used to characterize the deformities for each case. Case 1 presented with a biapical deformity of the left antebrachium. Case 2 presented with deformities affecting the left femur and tibia. Rendering of a three-dimensional (3D) bone model, surgical planning, and production of multistep surgical jigs were executed using a traditional mesh-modeling workflow for case 1, whereas case 2 utilized the described novel software. No intraoperative complications were encountered while using the surgical kits. The multistep surgical jigs facilitated major procedural steps with precision, including application of definitive fixation. The novel software reduced the surgical planning time and the operator's requirement for 3D modeling skill. All osteotomies were stabilized in compression with acceptable alignment and good patient outcomes. This novel conformation-based approach and planning software, developed by the corresponding author, may provide an alternative method of correcting canine angular limb deformities. Further research on this technique and software is indicated before commercial availability.","PeriodicalId":443672,"journal":{"name":"VCOT Open","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129728858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Increased distal femoral procurvatum has been reported sporadically in dogs following malunion of Salter-Harris type I, II, and III fractures of distal femur. The resultant increased procurvatum can be poorly tolerated because of subsequent loss of stifle extension. This case report represents a dog with the increased procurvatum of the distal femur ascribed to a previous Salter-Harris type V injury. Surgical planning and successful outcome following the corrective procedures have been documented. A 6.5-month-old fox-terrier presented with a persistent weight bearing left pelvic limb lameness, 2 months after being hit by a car. The predominant orthopaedic finding was a 20-degree decrease in left stifle extension. Radiographic and computerized tomography evaluation revealed premature eccentric closure of the left distal femoral physis ascribed to a previous Salter-Harris type V injury. The left femoral procurvatum was 30 degrees. The left tibial plateau angle was increased by 11.5 degrees compared with the right. The femoral deformity was characterized, and a corrective procedure was planned using Paley's centre of rotation of angulation methodology. A cranial closing wedge ostectomy of the left distal femur was performed and stabilized using a locking plate. Proximal tibial epiphysiodesis was also performed to reduce the tibial plateau slope. Union of the osteotomy site and reduction in tibial plateau angle by 5.4 degrees were documented 50 days after surgery with a good functional outcome.
{"title":"Corrective Osteotomy in a Dog to Address Increased Distal Femoral Procurvatum Ascribed to a Distal Femoral Salter-Harris Type V Injury","authors":"P. Memarian, D. Lewis, Massimo Bucci, M. Isola","doi":"10.1055/s-0043-57243","DOIUrl":"https://doi.org/10.1055/s-0043-57243","url":null,"abstract":"Abstract Increased distal femoral procurvatum has been reported sporadically in dogs following malunion of Salter-Harris type I, II, and III fractures of distal femur. The resultant increased procurvatum can be poorly tolerated because of subsequent loss of stifle extension. This case report represents a dog with the increased procurvatum of the distal femur ascribed to a previous Salter-Harris type V injury. Surgical planning and successful outcome following the corrective procedures have been documented. A 6.5-month-old fox-terrier presented with a persistent weight bearing left pelvic limb lameness, 2 months after being hit by a car. The predominant orthopaedic finding was a 20-degree decrease in left stifle extension. Radiographic and computerized tomography evaluation revealed premature eccentric closure of the left distal femoral physis ascribed to a previous Salter-Harris type V injury. The left femoral procurvatum was 30 degrees. The left tibial plateau angle was increased by 11.5 degrees compared with the right. The femoral deformity was characterized, and a corrective procedure was planned using Paley's centre of rotation of angulation methodology. A cranial closing wedge ostectomy of the left distal femur was performed and stabilized using a locking plate. Proximal tibial epiphysiodesis was also performed to reduce the tibial plateau slope. Union of the osteotomy site and reduction in tibial plateau angle by 5.4 degrees were documented 50 days after surgery with a good functional outcome.","PeriodicalId":443672,"journal":{"name":"VCOT Open","volume":"232 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116172350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Caudal cruciate ligament (CaCL) femoral avulsion fractures are rarely documented, and a true incidence is unclear. A literature search revealed very few cases of a CaCL avulsion fracture or rupture combined with a cranial cruciate ligament (CrCL) rupture. Only a single case report described surgical treatment of this combination by fragment removal and stifle stabilization with an extracapsular suture. A 1-year-old female spayed Labrador Retriever presented with a hindlimb lameness. Examination revealed cranial drawer of the stifle, consistent with CrCL rupture. Stifle effusion, as well as a bone opacity seen in the trochlear groove, was evident on radiographs. At surgery, arthrotomy revealed a torn CrCL as well as an avulsion fracture of the CaCL origin from the medial femoral condyle. The avulsion fracture was reduced, and three 0.035-inch Kirschner's wires (K-wires) were placed in a divergent fashion through the fragment into the medial femoral condyle. A tibial plateau leveling osteotomy (TPLO) was then performed. Six-week recheck radiographs showed good healing of the TPLO as well as the repaired avulsion fracture, despite breakage of one of the K-wires. The dog was mildly lame at the 6-week follow-up and subsequently improved to clinically normal on the limb at 8-month follow-up with optimal bone healing on radiographs. To the authors' knowledge, this is the first case report to describe a CaCL avulsion fracture repair with K-wires combined with a TPLO for a torn CrCL, with an excellent clinical outcome.
{"title":"Unilateral Repair of an Avulsion Fracture of the Caudal Cruciate Ligament Origin Combined with a Ruptured Cranial Cruciate Ligament in a Dog","authors":"A. A. Pike, R. Balfour","doi":"10.1055/s-0043-1771232","DOIUrl":"https://doi.org/10.1055/s-0043-1771232","url":null,"abstract":"Abstract Caudal cruciate ligament (CaCL) femoral avulsion fractures are rarely documented, and a true incidence is unclear. A literature search revealed very few cases of a CaCL avulsion fracture or rupture combined with a cranial cruciate ligament (CrCL) rupture. Only a single case report described surgical treatment of this combination by fragment removal and stifle stabilization with an extracapsular suture. A 1-year-old female spayed Labrador Retriever presented with a hindlimb lameness. Examination revealed cranial drawer of the stifle, consistent with CrCL rupture. Stifle effusion, as well as a bone opacity seen in the trochlear groove, was evident on radiographs. At surgery, arthrotomy revealed a torn CrCL as well as an avulsion fracture of the CaCL origin from the medial femoral condyle. The avulsion fracture was reduced, and three 0.035-inch Kirschner's wires (K-wires) were placed in a divergent fashion through the fragment into the medial femoral condyle. A tibial plateau leveling osteotomy (TPLO) was then performed. Six-week recheck radiographs showed good healing of the TPLO as well as the repaired avulsion fracture, despite breakage of one of the K-wires. The dog was mildly lame at the 6-week follow-up and subsequently improved to clinically normal on the limb at 8-month follow-up with optimal bone healing on radiographs. To the authors' knowledge, this is the first case report to describe a CaCL avulsion fracture repair with K-wires combined with a TPLO for a torn CrCL, with an excellent clinical outcome.","PeriodicalId":443672,"journal":{"name":"VCOT Open","volume":"101 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116410086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Objective The aim of the study was to measure canine stifle intra-articular pressures (IAP) during arthroscopy using three different fluid pump pressure (FPP) settings. Study Design Frozen thawed canine cadavers were used. The stifle was distended using a 2.7 mm arthroscope connected to a commercial fluid pump. Intra-articular pressure was measured using a portable pressure gauge connected to an intra-articular 18 G needle. Intra-articular pressure was recorded during stifle extension, 90 degrees flexion and full flexion at three different FPP (30, 50, 80 mm Hg). Results Testing was performed on 27 stifles. Intra-articular pressure significantly increased at higher FPP ( p < 0.01). At FPP 30, 50, and 80 mm Hg, the mean IAP was 51.8 (95% confidence interval [CI]: 41.3–62.2), 103.3 (95% CI: 92.8–113.7), and 175.2 mm Hg (95% CI: 164.8–185.6), respectively. At FPP 30 and 50 mm Hg, IAP always remained under 170 mm Hg. At 80 mm Hg, IAP raised to or above 170 mm Hg in 11/14 stifles. Stifle position significantly affected IAP ( p < 0.01). Changing stifle position from 90 degrees flexion to extension significantly decreased IAP by 22.4 mm Hg (95% CI: 16.2–28.5), and changing to full flexion significantly increased IAP by 20.9 mm Hg (95% CI: 14.8–27.1; p < 0.01). Conclusion Our results suggest that caution should be used during stifle arthroscopy to limit risk for iatrogenic capsular damage. Fluid pump pressure 30 mm Hg is considered safe when using a 2.7 mm arthroscope and high flow cannula. If higher FPP is necessary for visualization, duration of stifle flexion should be limited. Fluid pump pressure 80 mm Hg should be avoided.
摘要目的通过三种不同的流体泵压力(FPP)设置来测量关节镜下犬膝关节内压力(IAP)。研究设计使用冷冻解冻的犬尸体。使用连接商用流体泵的2.7 mm关节镜对膝关节进行扩张。使用连接关节内18g针的便携式压力表测量关节内压力。在三种不同的FPP(30、50、80 mm Hg)下，记录膝关节伸展、90度屈曲和完全屈曲时的关节内压力。结果对27头猪进行了检测。高FPP时关节内压力显著升高(p < 0.01)。在FPP 30,50和80 mm Hg时，平均IAP分别为51.8(95%可信区间[CI]: 41.3-62.2)， 103.3 (95% CI: 92.8-113.7)和175.2 mm Hg (95% CI: 164.8-185.6)。当FPP为30和50 mm Hg时，IAP始终保持在170 mm Hg以下。当FPP为80 mm Hg时，IAP在11/14组中上升至或高于170 mm Hg。窒息体位对IAP有显著影响(p < 0.01)。将膝关节位置从90度屈折变为伸直可显著降低IAP 22.4 mm Hg (95% CI: 16.2-28.5)，而完全屈折可显著增加IAP 20.9 mm Hg (95% CI: 14.8-27.1;P < 0.01)。结论我们的研究结果表明，在膝关节镜检查时应谨慎，以限制医源性关节囊损伤的风险。当使用2.7 mm关节镜和高流量套管时，流体泵压力30 mm Hg被认为是安全的。如果需要更高的FPP，则应限制膝关节屈曲的持续时间。流体泵压力应避免80mmhg。
{"title":"Intra-articular Pressure Changes during Stifle Arthroscopy Using a Cadaver Model","authors":"B. Salmelin, P. Gilbert","doi":"10.1055/s-0043-1771400","DOIUrl":"https://doi.org/10.1055/s-0043-1771400","url":null,"abstract":"Abstract Objective The aim of the study was to measure canine stifle intra-articular pressures (IAP) during arthroscopy using three different fluid pump pressure (FPP) settings. Study Design Frozen thawed canine cadavers were used. The stifle was distended using a 2.7 mm arthroscope connected to a commercial fluid pump. Intra-articular pressure was measured using a portable pressure gauge connected to an intra-articular 18 G needle. Intra-articular pressure was recorded during stifle extension, 90 degrees flexion and full flexion at three different FPP (30, 50, 80 mm Hg). Results Testing was performed on 27 stifles. Intra-articular pressure significantly increased at higher FPP ( p < 0.01). At FPP 30, 50, and 80 mm Hg, the mean IAP was 51.8 (95% confidence interval [CI]: 41.3–62.2), 103.3 (95% CI: 92.8–113.7), and 175.2 mm Hg (95% CI: 164.8–185.6), respectively. At FPP 30 and 50 mm Hg, IAP always remained under 170 mm Hg. At 80 mm Hg, IAP raised to or above 170 mm Hg in 11/14 stifles. Stifle position significantly affected IAP ( p < 0.01). Changing stifle position from 90 degrees flexion to extension significantly decreased IAP by 22.4 mm Hg (95% CI: 16.2–28.5), and changing to full flexion significantly increased IAP by 20.9 mm Hg (95% CI: 14.8–27.1; p < 0.01). Conclusion Our results suggest that caution should be used during stifle arthroscopy to limit risk for iatrogenic capsular damage. Fluid pump pressure 30 mm Hg is considered safe when using a 2.7 mm arthroscope and high flow cannula. If higher FPP is necessary for visualization, duration of stifle flexion should be limited. Fluid pump pressure 80 mm Hg should be avoided.","PeriodicalId":443672,"journal":{"name":"VCOT Open","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127380208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abstract Recent developments in the medical field of additive manufacturing (AM) have allowed the creation of patient-specific porous titanium implants for use in the medical field. With correct pore size such scaffolds are able to be integrated into surrounding bone. Two dogs were presented with atrophic non-union of the proximal ulna involving the elbow joint due to previous orthopaedic procedures with severe complications that led to segmental bone defects that were not expected to heal without a secondary intervention. Computed tomography (CT) was performed and porous scaffolds and saw guides were designed in silico and printed by AM. Osteotomies in adjacent healthy bone were guided by patient-specific three-dimensional (3D)-printed nylon saw guides allowing a perfect fit for the 3D-printed implant. In one case the scaffold was filled with bone morphogenic protein and held in place by two plates. In the other case the scaffold was filled with cancellous bone graft and held in place by a titanium plate that was part of the scaffold design. Both cases regained function and weight-bearing without lameness. Osseointegration of the implant was shown in both cases on follow-up CT and radiographs and macroscopically evident in the pores of the 3D implant after plate removal. One dog was euthanatized for unrelated disease and micro-CT revealed solid bone bridging through the inner scaffold tunnel. This study showed the successful application of the design, fabrication and clinical use of a patient-specific 3D-printed titanium implant to repair segmental bone defects of the antebrachium in two dogs.
{"title":"Additive Titanium Manufacturing to Repair Critically Sized Antebrachial Bone Defects in Two Dogs","authors":"S. Janssens, K. Willemsen, J. Magré, B. Meij","doi":"10.1055/s-0043-1769011","DOIUrl":"https://doi.org/10.1055/s-0043-1769011","url":null,"abstract":"Abstract Recent developments in the medical field of additive manufacturing (AM) have allowed the creation of patient-specific porous titanium implants for use in the medical field. With correct pore size such scaffolds are able to be integrated into surrounding bone. Two dogs were presented with atrophic non-union of the proximal ulna involving the elbow joint due to previous orthopaedic procedures with severe complications that led to segmental bone defects that were not expected to heal without a secondary intervention. Computed tomography (CT) was performed and porous scaffolds and saw guides were designed in silico and printed by AM. Osteotomies in adjacent healthy bone were guided by patient-specific three-dimensional (3D)-printed nylon saw guides allowing a perfect fit for the 3D-printed implant. In one case the scaffold was filled with bone morphogenic protein and held in place by two plates. In the other case the scaffold was filled with cancellous bone graft and held in place by a titanium plate that was part of the scaffold design. Both cases regained function and weight-bearing without lameness. Osseointegration of the implant was shown in both cases on follow-up CT and radiographs and macroscopically evident in the pores of the 3D implant after plate removal. One dog was euthanatized for unrelated disease and micro-CT revealed solid bone bridging through the inner scaffold tunnel. This study showed the successful application of the design, fabrication and clinical use of a patient-specific 3D-printed titanium implant to repair segmental bone defects of the antebrachium in two dogs.","PeriodicalId":443672,"journal":{"name":"VCOT Open","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133385065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
D. Onis, Henrik Wagter, Boris M Serck, E. G. Wouters
Abstract The aim of this article was to report surgical and medical management, and to evaluate complications and outcome of dogs treated for refractory infection after tibial tuberosity advancement (TTA) with a one-stage revision surgery consisting of implant removal and replacement of a TTA cage. It was a retrospective case series. Seven cases were included in this study. Loss of advancement of the tibial tuberosity or tibial crest fractures did not occur in any case. One-stage revision surgery was successful in 5/7 cases (71%) with good long-term outcomes. Persistent infection resulted in removal of the replaced new cage in 2/7 cases (29%), of which one was associated with septic arthritis caused by multi-resistant bacteria. One-stage revision with immediate replacement of a new TTA cage successfully prevented loss of advancement of the tibial tuberosity and tibial crest fractures in this short case series. Further studies investigating possible improvements in the treatment protocol for refractory infection after TTA are warranted.
{"title":"One-Stage Revision with Cage Replacement as Treatment for Refractory Infections after Tibial Tuberosity Advancement in 7 Dogs","authors":"D. Onis, Henrik Wagter, Boris M Serck, E. G. Wouters","doi":"10.1055/s-0043-1761601","DOIUrl":"https://doi.org/10.1055/s-0043-1761601","url":null,"abstract":"Abstract The aim of this article was to report surgical and medical management, and to evaluate complications and outcome of dogs treated for refractory infection after tibial tuberosity advancement (TTA) with a one-stage revision surgery consisting of implant removal and replacement of a TTA cage. It was a retrospective case series. Seven cases were included in this study. Loss of advancement of the tibial tuberosity or tibial crest fractures did not occur in any case. One-stage revision surgery was successful in 5/7 cases (71%) with good long-term outcomes. Persistent infection resulted in removal of the replaced new cage in 2/7 cases (29%), of which one was associated with septic arthritis caused by multi-resistant bacteria. One-stage revision with immediate replacement of a new TTA cage successfully prevented loss of advancement of the tibial tuberosity and tibial crest fractures in this short case series. Further studies investigating possible improvements in the treatment protocol for refractory infection after TTA are warranted.","PeriodicalId":443672,"journal":{"name":"VCOT Open","volume":"2 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116829095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
B. Garland, Emilian Adrian Dumitru, Alejandro Ororbia, B. Oxley
Abstract A 4-month-old male entire French bulldog was presented for the investigation of acute left thoracic limb lameness. Computed tomography (CT) revealed a right-sided humeral intracondylar fissure (HIF) and a left-sided medial humeral condylar fracture which was managed by open reduction and internal fixation. Follow-up CT at 36 days after surgery revealed healing of the condylar fracture and partial resolution of the HIF, which was radiographically unapparent on further CT images 105 days thereafter (at 220 days of life). To the best of the authors' knowledge, this is the first reported case of spontaneous resolution of a HIF beyond the normal age of reported humeral condyle ossification center closure.
{"title":"Spontaneous Resolution of a Humeral Intracondylar Fissure in a Skeletally Immature French Bulldog","authors":"B. Garland, Emilian Adrian Dumitru, Alejandro Ororbia, B. Oxley","doi":"10.1055/s-0043-1762901","DOIUrl":"https://doi.org/10.1055/s-0043-1762901","url":null,"abstract":"Abstract A 4-month-old male entire French bulldog was presented for the investigation of acute left thoracic limb lameness. Computed tomography (CT) revealed a right-sided humeral intracondylar fissure (HIF) and a left-sided medial humeral condylar fracture which was managed by open reduction and internal fixation. Follow-up CT at 36 days after surgery revealed healing of the condylar fracture and partial resolution of the HIF, which was radiographically unapparent on further CT images 105 days thereafter (at 220 days of life). To the best of the authors' knowledge, this is the first reported case of spontaneous resolution of a HIF beyond the normal age of reported humeral condyle ossification center closure.","PeriodicalId":443672,"journal":{"name":"VCOT Open","volume":"11 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"121032232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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