Veterinary and Comparative Orthopaedics and Traumatology最新文献

Chemical restraint influences canine hip dysplasia scores for both the standard ventrodorsal hip-extended radiographs and during stress radiography. There is, however, no consensus on the optimal anaesthesia protocol for these stress radiographs. The objective of this study was to evaluate the impact of sedation/anaesthesia on the highest laxity index while using a validated force-measuring device.Ten Beagle dogs were randomly assigned to undergo stress radiographs under four different sedation/anaesthesia protocols on three separate occasions. Vital parameters, ease of procedure and laxity index were evaluated.Parameters such as temperature, heart rate and respiratory rate remained within normal ranges for all protocols. One dog experienced a seizure after dexmedetomidine and ketamine sedation (protocol C). Protocol B (dexmedetomidine/butorphanol/midazolam) and protocol A (dexmedetomidine/butorphanol) scored significantly better than protocol C (dexmedetomidine/ketamine) and D (dexmedetomidine/propofol) in various aspects of ease of the procedure. While the maximum laxity was similar between protocols A, B and D, only in protocols A and B, a plateau phase was reached. Overall, protocols A and B performed similarly; the best scores were, however, consistently allocated to protocol B.The sedation protocol dexmedetomidine, butorphanol and midazolam emerged as the most favourable sedation protocol for stress radiography of the coxofemoral joint, offering practicality and a high laxity index, without adverse effects.

The aim of this study was to compare different secondary fixation methods in a canine tibial fracture gap model.Twelve paired tibiae from large-breed dogs were examined. The tibiae were classified into four groups using a random block design. Implant fixation methods included a single 3.5 mm locking plate (3.5 LP), a 3.5 LP with a single 2.8 mm intramedullary pin (3.5 LP/2.8 IM pin) and two 2.0 mm or 2.7 mm orthogonal locking plates (3.5/2.0 LP or 3.5/2.7 LP). The tibial constructs were non-destructively tested in four-point bending and torsion and tested to failure in craniocaudal or lateromedial bending.In the non-destructive tests, the 3.5/2.7 LP had higher torsional stiffness than the others (p < 0.001). In the destructive tests with the craniocaudal bending, the 3.5/2.7 LP had higher yield stiffness (vs. 3.5 LP, p = 0.002; vs. 3.5 LP/2.8 IM pin, p = 0.041; vs. 3.5/2.0 LP, p = 0.021) and bending moment (vs. 3.5 LP, p = 0.002; vs. 3.5 LP/2.8 IM pin, p = 0.017; vs. 3.5/2.0 LP, p = 0.038) than the others. In lateromedial bending, the 3.5 LP/2.8 IM pin had a higher yield angle than the other constructs (vs. 3.5/2.0 LP, p = 0.020; vs. 3.5/2.7 LP, p = 0.012).The orthogonal plating technique using the 3.5/2.7 LP was the strongest construct and may have a mechanical advantage over other secondary fixation methods tested.

This aim of this study was to document the management and outcomes of dogs having total hip replacement (THR) following a failed hip toggle.Retrospective case series.Eleven dogs that had a failed hip toggle and subsequent conversion to THR.Medical records were examined for pertinent information regarding the initial luxation event, the hip toggle surgery, coxofemoral joint conformation and any pre-existing pathology, THR materials, complications and outcomes. Pre- and postoperative hip toggle and THR radiographs were examined. The Liverpool Osteoarthritis in Dogs questionnaires were sent to all clients with dogs in this study.Hip toggles failed due to re-luxation (n = 8) and chronic lameness (n = 3). Radiographs identified osteoarthritis in 10/11 dogs. The percentage of femoral head coverage was <50% in 8/11 dogs. The initial luxation aetiology was traumatic (n = 5), atraumatic (n = 4) and unknown (n = 2). A pre-THR culture was performed for 5/11 dogs via Fine Needle Aspirate (FNA), femoral toggle rod or button and suture material. The intrapelvic toggle rod was removed intraoperatively and cultured in six dogs. Complications were intraoperative (n = 2) and postoperative (n = 2), and were minor (n = 1), major (n = 2) and catastrophic (n = 1). The Liverpool Osteoarthritis in Dogs scores were obtained for 8/11 dogs, with a median score of 6.5. A successful outcome was documented for 9/11 dogs.Total hip replacement was successful in 9/11 dogs. The median Liverpool Osteoarthritis in Dogs scores were within the previously published range for dogs having uncomplicated THR. Despite the requirement for additional considerations, THR can be safely and effectively performed in dogs following failed hip toggle surgery.

This aim of this study was to determine feline stifle joint stability and muscle force ratios after cranial cruciate ligament transection and intra-articular reconstruction, and assess the feasibility of this reconstruction in cats.Ten feline hindlimbs were tested in an axial limb press with 30% body weight load. Femoral angles were set to 60 degrees, and stifle and hock angles to 120 degrees. The cranial cruciate ligament was transected, and testing was repeated. Intra-articular reconstruction was performed using a 16-strand ultra-high molecular weight polyethylene graft and four 3 mm interference screws. Friedman's repeated-measures analysis of variance compared angles, forces, and tibial translation.Tibial translation increased significantly after cranial cruciate ligament transection (p = 0.02) but did not differ from intact joints post-reconstruction (p = 0.5). Forces (p = 0.72, p = 0.74) and bone/joint angles (p = 0.12) did not differ across test situations. Mean quadriceps force was twice the gastrocnemius force. Measurement repeatability was good, with a within-subject standard deviation for distance at 0.4 mm and for angles at 0.4 to 1.1 degrees.Limb press positioning was consistent and repeatable, and muscle forces approached in vivo values. Intra-articular reconstruction restored joint stability under static load and appeared feasible for use in cats.

The aim of this study was to assess fracture distribution and involvement of functional systems in cats presenting with craniomaxillofacial (CMF) trauma using computed tomography imaging. Involvement of functional systems, including the oral cavity, nasal airways and nasopharynx, orbita and eye and neurocranium, including the tympanic bulla, was assessed.The study consisted of 48 cats with complete computed tomography imaging of the skull using a '1.0-mm' slice thickness. Fractures were classified according to their anatomical location, and the involvement of functional systems was assessed.Fractures of the mandible were most common and present in 40/48 cats. Fractures of the temporomandibular joint were found in 25/48 cats. Fractures involving the maxillofacial structures were present in 36/48 cats. Fractures of the orbita, nasopharynx, zygomatic arch and neurocranium were diagnosed in 30/48, 29/48, 12/48 and 6/48 cats, respectively. Combined involvement of two or more functional systems was present in 36/48 cats. Functional system involvement of the oral cavity combined with nasal airways was found in 36/46 cats. Involvement of the nasal airways combined with the orbita and eye was found in 30/36 cats.Craniomaxillofacial trauma in cats causes multifocal, concomitant involvement of functional systems. A multimodal therapeutic approach to all potential functional deficits seems to be essential in managing craniomaxillofacial trauma in the cat.

This study aimed to compare the stress distribution in proximal interphalangeal joint arthrodesis with locking compression plate in horses based on the type and method of screw implantation in the proximal hole and partial or total removal of implants after fusion.Finite element analysis.Proximal interphalangeal joint arthrodesis was simulated using a 3-hole, 4.5-mm narrow locking compression plate combined with two 5.5-mm transarticular screws. Models were created according to the type (cortex or locking) and method of implantation (uni- or bicortical) of the screw in the proximal hole of the locking compression plate. Four conditions were simulated: Immediate postoperative, ankylosis, ankylosis with partial removal (transarticular screws remaining) and ankylosis with no implants. An axial load of 8,700 N was applied, and the major principal stresses in the bones and von Mises stress in the implants were evaluated.Cortical screws in the proximal hole better distributed the stresses, reducing their concentration along the diaphysis of the proximal phalanx in the postoperative condition. Stress distribution did not differ between partial and total implant removal. High stresses were observed in the implants, especially when locking screws were used, with a reduction observed after ankylosis simulation.A cortex screw in the proximal hole reduces stress concentration in the proximal phalanx. Retaining the transarticular screws after ankylosis did not alter the stress pattern in the bone.

This study aimed to investigate the influence of cup positioning accuracy of two different cup impactors handled by two surgeons with different levels of total hip replacement surgery experience.This was a cadaveric study (n = 20). A standard and a new prototype Kyon impactor were used by two surgeons (beginner and senior) to impact 80 prosthetic cups in 40 canine normal acetabula. The angle of lateral opening, angle of cup retroversion, and their corresponding deviations from the ideal postoperative values were measured using radiographic imaging to evaluate the accuracy of cup positioning.The accuracy of cup positioning was not affected by the type of impactor used by the senior surgeon. For the beginner surgeon, the standard impactor was associated with a significantly higher mean error (3.9 ± 6.5 degrees) and mean value (48.90 ± 6.5 degrees) for the angle of lateral opening compared with the prototype impactor that showed a lower mean error (-1.8 ± 6.3 degrees) and mean values (43.20 ± 6.34 degrees) closer to the ideal value of 45 degrees. No significant differences were found between the standard impactor and the prototype regarding the accuracy of the angle of cup retroversion.The new features of the prototype impactor and its improved handling can assist inexperienced surgeons in achieving a more accurate angle of lateral opening compared with the standard impactor. In contrast, the accuracy of the cup retroversion angle appears to be more closely related to the surgeon's experience rather than the type of impactor used.

To evaluate the feasibility and accuracy of vertebral pedicle screws in cats using a custom 3D-printed drill guide and 3D-printed vertebral columns.To simulate the surgical procedure, six vertebral columns from adult cats were 3D-printed. The columns were printed with a radiolucent material (PLA enriched with calcium carbonate-PLA+). One 3D-printed guide was created for each vertebra (from T10 to L7). Each preplanned hole was drilled and filled with a graphite cylinder for better visualization of the tunnel. All the phantoms were CT-scanned after the drilling operation. Each hole was graded using a modified classification scheme (grades 0 to 3) and compared to the planned tunnel angle. We enrolled one 5-year-old female patient with spinal trauma requiring vertebral stabilization presented at our hospital.A total of 126 holes were drilled. The overall mean screw deviation angle was 0.61 degrees (SD = 0.72). In safety evaluation, 117 (93%) screws were contained in the pedicle (grade 0), 7 screws (5.5%) were outside the pedicle by less than 0.5 mm (grade 1), and 2 (1.5%) screws were between 0.5 and 1 mm outside the pedicle. In the thoracic segment, all the holes (48/48) were classified as a grade 0, while in the lumbar segment, with a total of 78 holes drilled, there were 69 holes classified as grade 0 (88%), 7 holes classified as grade 1 (8.9%), and 2 holes classified as grade 2 (2.5%). The feline patient had suffered a T12 complete oblique vertebral body fracture. A total of six 1.7 mm screws, 20 mm long, (Fix-In, INTRAUMA) were placed: three in T12 and three in T13.Overall, there was a mean deviation of the hole angle from the planned angle of 0.61 degrees. The overall safety was 91.2% (screws graded as 0). A statistically significant association between screw grades and vertebral segment was found (p-value 0.02) as all the thoracic vertebrae are grade 0, while grade 1 and grade 2 were found only in the lumbar segment. Using pedicle screws in cats' vertebrae may reduce surgical trauma, as it requires exposure of only the most dorsal portion of the vertebral lamina, avoiding the need to expose the costal attachments. Also, placing cement dorsally is easier and can incorporate screw heads bilaterally. We effectively and safely performed the surgical procedure in one clinical case. Based on our results, the use of pedicle screws, previously applied in canine patients, could also be extended to feline patients, provided that 3D-printed guides are used to ensure accurate placement.