Veterinary and Comparative Orthopaedics and Traumatology最新文献

(1) To describe and compare the morphometric changes of the tibia following four virtual proximal tibial osteotomies for treatment of canine cranial cruciate ligament deficiency and (2) to determine how these changes are affected by the initial tibial plateau angle (TPA).A total of 30 mediolateral radiographic views of canine stifle were selected. A dedicated radiographic digital planning software was used to virtually perform four osteotomy techniques for each case: tibia plateau levelling osteotomy (TPLO), cranial closing wedge osteotomy (CCWO), modified cranial closing wedge osteotomy (mCCWO), and centre of rotation of angulation-based levelling osteotomy (CBLO). Changes in tibial length, anatomical-mechanical axis angle (AMA angle), proximal tibial angulation, and patellar ligament insertion point were measured and compared.All the parameters evaluated were significantly affected by the osteotomy technique and the initial TPA. Mean ± SD of tibial length pre-simulation was 174.2 ± 23.6 mm, and the largest significant reduction was observed after mCCWO (169.6 ± 23.3 mm) (P < 0.001). Mean ± SD of AMA angle pre-simulation was 3.1 ± 1.4 degrees and a significant reduction was observed after CCWO (1.1 ± 0.16 degrees) (P = 0.0782), but there was no significant difference among treatments. Mean ± SD of the distal tibia axis/proximal tibial axis (DTA/PTA) angle pre-simulation was 4.5 ± 2.8 degrees, and the biggest significant reduction was seen with CBLO (-10.94 ± 0.65) (P < 0.0001). The cranial and distal shift of the patellar ligament insertion point was significant after CCWO (P = 0.0004, P < 0.0001 respectively), mCCWO (P = 0.0001, P < 0.0001 respectively), and CBLO (P = 0.03, P = 0.0006 respectively) osteotomy techniques.Proximal tibial osteotomy techniques cause morphometric changes of the tibia, and a steeper TPA exacerbates these changes. TPLO caused the fewest morphometric changes. Further investigations are warranted to understand the clinical implications on the biomechanics of the stifle.

Rabbits with end-stage kidney failure often develop hypercalcaemia and osteosclerosis. Secondary renal hyperparathyroidism and fibrous osteodystrophy can be experimentally induced in rabbits through nephrectomy and a low-calcium:high-phosphorus diet, but clinical case reports are rare. A thin, mixed-breed, neutered male rescue rabbit was brought to a veterinary clinic due to lameness of the right hind limb and gait difficulties. Radiographs showed severe osteodystrophy. Additionally, there was a displaced, ununited simple fracture in the right mid-femur and a healed simple fracture in the right mid-tibia. Dentition was normal. The rabbit was euthanized. Blood tests revealed mildly elevated urea (12.3 mmol/mL), glucose (10.6 mmol/L), and alkaline phosphatase (179 mmol/L). High levels of serum parathyroid hormone (281.1 pg/mL) and a 25-hydroxyvitamin D concentration of 11.2 ng/mL were also noted. Creatinine was 105 µmol/L and inorganic phosphate was 1.53 mmol/L. Bone density in the mid-tibia was very low (934.6 mg/cm³). Tests for Encephalitozoon cuniculi antibodies were negative. Post-mortem examination showed severe chronic renal interstitial fibrosis and severe bilateral parathyroid hyperplasia. This case report highlights the novel finding that secondary renal hyperparathyroidism and fibrous osteodystrophy, accompanied by pathological fractures, can manifest as sequelae of end-stage renal disease in rabbits. This revelation is clinically significant and should be carefully considered by veterinarians when managing older rabbits presenting with fractures.

This prospective study aimed to report femoro-patellar joint congruency assessed by computed tomography (CT) following block recession trochleoplasty (BRT) and tibial tuberosity transposition (TTT) in cats with medial patellar luxation (MPL).Six cats (median age 56 months; range 15-86 months) with 10 stifles with grades 2 (n = 5) and 3 (n = 5) MPL were enrolled. Standard BRT and TTT were performed. Standardized CT measurements of the trochlear groove (width, depth, and area) and patella (recessed area) were performed preoperatively (T0), immediately postoperatively (T1), and at a 6-week re-examination (T6) with stifles in extended and flexed positions.Mean femoral trochlear area and depth increased significantly between T0-T1, T1-T6, and T0-T6 (p < 0.05). Mean recessed patellar area significantly increased between all time points when the stifle was flexed and between T0-T1 and T0-T6 when the stifle was extended (p < 0.05). Mean trochlear width increased significantly between T0 and T6 (p < 0.05). No cats had MPL recurrence at the 6-week follow-up.Block recession trochleoplasty combined with TTT improved patellar congruency immediately after surgery, with further improvement documented at the 6-week postoperative re-examination.

Platelet-rich plasma (PRP) is a biological product commonly used in veterinary orthopaedics. There is a lack of descriptive information of the final product used in clinical studies.The objectives were to describe and analyze the intra-individual variability of the quantity and cellular composition of the autologous conditioned plasma (ACP) obtained at various time points in each patient in a group of dogs suffering from elbow dysplasia, and to describe the outcome from an owner's perception.Dogs diagnosed with elbow dysplasia treated with three ACP injections 1 week apart were included. A complete blood count on whole blood and ACP was documented in at least two infiltrations. Volume of ACP and degree of platelet increased concentration factor, leukocyte and red blood cell decreased reduction factor were evaluated at each time point. Intra-individual variability of ACP characteristics, mean ACP volume collected and injected, and number of injected platelets were analyzed. Canine brief pain inventory (CBPI) scores were recorded.In this study 23 dogs were included. No difference was observed in intra-individual ACP volume collected, leukocyte reduction factor and red blood cell reduction factor, or number of platelets injected at various time points, while a significant difference was observed in intra-individual platelets concentration factor. The CBPI scores decreased between pre- and post-injection scores in the majority of the patients.Regarding ACP, platelets concentration factor is variable in the same patient at various time points while the volume collected and the purity are stable.

To report the incidence, and clinical and pathological findings of developmental lateral patellar luxation in Standardbred yearlings diagnosed with femoropatellar dysplasia (FPD) and demonstrate that osteochondral lesions in the lateral trochlear ridge (LTR) of the femur observed in the affected horses are osteochondral lesions related to patellar maltracking.Retrospective case series. Medical records were retrospectively reviewed for Standardbreds <12 months of age diagnosed with FPD between 2017 and 2023.A total of 10 Standardbred yearlings developed FPD (incidence 6.4 cases per 1,000 foals). Patellar instability and femoropatellar joint effusion were observed between 3 and 9 months of age. Six horses developed severe lameness at walk within 6 months from diagnosis. Radiography revealed abnormal patellar tilt in all cases, flattening and osteochondral lesions in the LTR in nine cases, flattening of the intertrochlear groove and patellar ridge in three horses, and patellar displacement in two cases. The condition deteriorated in six cases, leading to euthanasia, while four horses were retired to pasture.FPD is not uncommon in Standardbred yearlings and clinical signs are visible under 12 months of age. The condition is career-limiting and affected horses have poor prognosis despite treatment as racehorses.

The aim of this study was to describe the clinical application and outcomes of a transarticular dynamic external skeletal fixator in the treatment of medial patellar luxation (MPL) associated with internal tibial rotation in dogs.Retrospective clinical case series.Seventeen stifles in fifteen dogs of various breeds and sizes were treated for MPL and rotational tibial deformity using a dynamic external fixator over a 12-year period (2013-2025).Clinical records were reviewed for signalment, MPL grade, surgical technique, treatment duration, and complications. The fixator consisted of a femoral and tibial threaded pins connected by elastic bands. Follow-up included clinical and radiographic evaluation of patellar stability and tibial rotation.Sixteen of seventeen stifles underwent trochlear intervention. Bilateral central threaded pins were used in 6 cases and unilateral pins in 11. The average fixation duration was 8.2 days. Twelve of the 13 dogs treated during the primary procedure showed no recurrence. Four dogs required revision surgery, which included reapplication of the dynamic fixator. No implant failures were observed.The dynamic external skeletal fixator was effective in managing MPL with rotational tibial deformity. It provided controlled correction with low complication rates and proved useful both as a primary and a revision technique. These findings support further investigation into dynamic fixation as a standardized approach in selected MPL cases with tibial rotational deformity.

The objective of this study is to report radiographic description and outcome of construct failure following cranial closing wedge osteotomy (CCWO) using locking plates in dogs.Medical records and radiographs of dogs with construct failure after CCWO presented at a single institution were reviewed retrospectively. Signalment, history, implants used in initial surgery, time between CCWO surgery and failure, time between initial and revision surgery, cause of failure, and revision details were recorded. Radiographs were reviewed to measure pre- and postoperative tibial plateau angle (TPA) and cortical alignment. Clinical outcomes and complications following revision were noted in short-term follow-up (<6 months).Ten dogs met the inclusion criteria. In all cases, CCWO was initially performed with locking implants. There were no intraoperative complications; two cases had superficial surgical site infection (SSI) after CCWO. Time from surgery to failure was a median of 10 days (4-87). Nine fractures were described, all in the proximal tibia; one case had screw loosening with loss of osteotomy reduction. Multiple failure patterns were identified. Nine of 10 cases underwent surgical revision: one developed SSI. One case was treated conservatively. At follow-up, 9/10 had no or very mild lameness.Construct failure is a potential complication after CCWO using locking plates. Revision surgery is often required, and a good outcome can be expected. Further studies are necessary to investigate specific risk factors and incidence.

Diagnosis of cranial cruciate ligament rupture (CCLR) is primarily through physical examination, imaging, and intra-articular assessment. Assessment of sit position where affected dogs abduct and extend the stifle to reduce discomfort has been proposed to aid diagnosis but not evaluated as a diagnostic test. This study aimed to evaluate the relationship between sit position and CCLR and assess the sit test as a diagnostic tool.Dogs with CCLR or hip dysplasia (HD) diagnosis were prospectively recruited and allocated to affected (CCLR) and unaffected (HD and normal stifles) groups. Dogs were recorded sitting and videos reviewed by three European College of Veterinary Surgeons (ECVS) diplomates and three ECVS residents. Sit position was graded normal, abnormal, equivocal, or inconclusive. Interobserver agreement, sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy were evaluated.Eighty-three dogs (56 affected, 70 unaffected limbs) met inclusion criteria. The sit test demonstrated 61.5% sensitivity, 81.0% specificity, 71.6% PPV, 73.0% NPV, and 72.5% accuracy for CCLR diagnosis. Moderate interobserver agreement was found (κ = 0.536, p < 0.001). Of dogs with the CCLR, 72.5% were correctly identified; however, 27.0% of dogs with a negative sit test were affected by CCLR.The sit test offers a screening test for CCLR in conscious dogs with greater sensitivity and similar specificity to cranial draw and tibial compression tests. It may be a valuable addition in CCLR diagnosis, particularly for conscious remote evaluation.

This case series aims to explore the application of 3D-printed patient-specific guides (PSG) in feline shoulder arthrodesis, addressing the scarcity of literature on this procedure in cats. The primary objectives include assessing the feasibility, accuracy, and outcomes of the procedure in four feline cases.The study employed a retrospective analysis of cases involving feline shoulder arthrodesis performed using PSG. Surgical planning utilized CAD-based techniques, and 3D-printed guides were created for precise osteotomies and implant placement. Follow-ups included radiographic assessments, re-examinations, and owner-reported outcomes.Four feline cases with distinct shoulder issues were successfully treated using PSG. Postoperative management, radiographic evaluations, and long-term follow-ups revealed positive outcomes in terms of limb function and patient activity. The study demonstrates the potential of PSG in achieving accurate humeroscapular alignment in feline shoulder arthrodesis.This case series highlights the clinical significance of PSG in enhancing the precision of humeroscapular alignment during feline shoulder arthrodesis. The positive outcomes observed in various shoulder pathologies suggest that this technique could contribute to improved surgical outcomes.