Veterinary and Comparative Orthopaedics and Traumatology最新文献

This study aimed to quantify the effect of double pelvic osteotomy (DPO) on dorsal acetabular rim angle (DARA) in a clinical cohort of dogs.Retrospective study.The DARA was measured on computed tomographic (CT) studies of 27 client-owned dogs that underwent DPO due to hip dysplasia. The change in DARA was determined for 30-, 25- and 20-degree preangled-locking DPO plates. The preoperative DARA was compared to the immediate postoperative DARA, and where available, the postoperative DARA was compared to short- and long-term DARA measurements.27 dogs underwent DPO, resulting in 49 hips available for analysis. The median preoperative DARA was 16.3 degrees (Q1-Q3, 12.3-22.2) and 17.6 degrees (Q1-Q3, 12.42-1.0) for right and left hip, respectively. The median postoperative DARA was -4.5 degrees (Q1-Q3, [-8.8]-[-1.3]) for the right hip and -4.1 degrees (Q1-Q3, [-7.6] to 5.8) for the left hip. The median change in DARA was 23.4 degrees (Q1-Q3, 17.5-26.15), 16.7 degrees (Q1-Q3, 12.2-20) and 15 degrees (Q1-Q3, 14.1-15.2) for a 30-, 25- and 20-degree plate, respectively. Short-term follow-up CT was available for 16 dogs (30 hips) at a median of 48 days (Q1-Q3, 45-57 days) and long-term follow-up CT was available for 12 dogs (22 hips) at a median of 386 days (Q1-Q3, 325-557). The postoperative DARA and short- and long-term DARA measurements did not change significantly (p > 0.05).The acetabular ventroversion achieved with DPO is less than the predetermined plate angle. The median differences for the 30-, 25-, and 20-degree plates are 6.6, 8.3, and 5 degrees, respectively.The results can aid in implant selection for DPO.

Musculoskeletal ultrasound is a versatile imaging technique, surpassing conventional radiographic examinations in detecting certain alterations in the musculoskeletal system and showing effectiveness comparable to magnetic resonance imaging in assessing articular and periarticular soft tissues. The objective of this review is to discuss the physical principles of ultrasound elastography and its applications in the musculoskeletal system of veterinary medicine. This bibliographic review compiles relevant studies exploring elastography's physical basis, its technological development, and its clinical applications in veterinary contexts. Elastography complements B-mode ultrasound by assessing tissue stiffness, offering unique diagnostic insights beyond acoustic impedance and flow properties. Studies have demonstrated the potential of elastography in evaluating tendon injuries, muscle disorders, and bone healing, with promising results in dogs, horses and experimental models like sheep. Techniques such as compression elastography and shear wave elastography provide qualitative and quantitative data, enhancing the assessment of pathological changes. Shear wave elastography enables precise measurements of tissue elasticity, aiding the diagnosis, monitoring of healing and evaluation of therapeutic interventions. Despite technical challenges, elastography is a valuable tool that can optimize musculoskeletal diagnostics and treatment planning. Its expanding use in veterinary medicine underscores its clinical relevance and potential for widespread adoption as a complementary imaging modality.

The aim of this study was to compare the strength (load at failure) and the number of cycles to failure of 3.5- and 4.0-mm cortical screw-bone constructs for repair of navicular bone fractures in horses.This was an in vitro biomechanical study that used a four-point bending apparatus to determine the load at failure of 3.5- and 4.0-mm cortical screw-bone constructs subjected to static and cyclic loading.In static testing, pairwise comparison of 4.0-mm cortical screw-bone constructs demonstrated significantly greater strength (mean increase: +16%, p = 0.0135) compared with those in the 3.5-mm group. In cyclic testing, the mean number of cycles to failure for the 4.0-mm cortical screw-bone construct was not significantly different from that of the 3.5-mm cortical screw-bone construct, due to a high variability in the values.A 4.0-mm cortical screw offers biomechanical advantages over a 3.5-mm cortical screw and may be an alternative implant for the treatment of navicular bone fractures in horses. Further clinical studies are needed to determine whether this screw can also be inserted without complications in vivo.

To compare immediate, static interfragmentary compression patterns of three tibial plateau leveling osteotomy (TPLO) plate designs.TPLO was performed on 15 synthetic canine tibiae (SYNBONE AG, Switzerland) using 3D-printed guides. Compression was evaluated using pressure-sensitive films (Prescale, Fujifilm, UK). Three 3.5-mm TPLO plates were tested according to the manufacturer guidelines for dynamic compression screws placement: Synthes, Arthrex, and Biocurve. Each plate was tested five times using a new bone model. The interfragmentary surface was divided into quadrants: Q1 (craniomedial), Q2 (craniolateral), Q3 (caudomedial), and Q4 (caudolateral). Compression was classified as low (<0.12 MPa), moderate (0.12-0.25 MPa), or high (>0.25 MPa).Significant differences in overall interfragmentary compression were found among the plates (p < 0.001). The Biocurve plate generated the highest and most uniform compression (Q1: 0.285 ± 0.023 MPa; Q2: 0.304 ± 0.010 MPa; Q3: 0.220 ± 0.014 MPa; Q4: 0.237 ± 0.010 MPa). The Arthrex plate produced high compression in Q2 (0.292 ± 0.012 MPa) and moderate in other quadrants (Q1: 0.177 ± 0.016 MPa; Q3: 0.141 ± 0.011 MPa; Q4: 0.189 ± 0.013 MPa). The Synthes plate showed the lowest compression throughout (Q1: 0.050 ± 0.008 MPa; Q2: 0.075 ± 0.009 MPa; Q3: 0.111 ± 0.008 MPa; Q4: 0.109 ± 0.008 MPa).The Biocurve plate, with two angled dynamic compression screw holes, provided the highest, most uniform compression. Further studies are needed to assess clinical relevance.

The objective of this study was to evaluate the relationship between displaceable meniscal tears of the medial meniscus, such as bucket handle tears and flap tears, and articular cartilage wear of the medial femoral condyle.Articular cartilage was scored at the time of arthroscopy and tibial plateau leveling osteotomy as normal, mild, moderately, or severely damaged based on the modified Outerbridge classification system. Dogs with complete cranial cruciate ligament rupture were included; there were 245 stifles in total and 116 had a concurrent displaceable meniscal tear consisting of 115 bucket handle tears and 1 flap tear. Stifles were classified as either having no/mild or moderate/severe cartilage wear. The frequency of moderate/severe wear was compared between stifles with normal menisci and stifles with displaceable meniscal tears using a Fisher's exact test.Stifles with displaceable meniscal tears had a significantly higher frequency of moderate/severe cartilage wear of the medial femoral condyle in comparison to stifles with normal menisci (p = 0.009).These findings suggest that dogs with cranial cruciate ligament rupture and concurrent bucket handle tears may increase the risk of moderate to severe cartilage injury to the medial femoral condyle.

To develop a patient-specific implant designed for dorsal access instrumentation, which also serves as a guide for screw insertion, for use in dogs with atlantoaxial instability. The implant must demonstrate no failure in finite element analysis.The development of an implant utilizing computational resources based on a computed tomography scan of a patient with atlantoaxial instability. The final implant model was analysed using finite element methods in flexion, extension, lateral flexion, and torsion to evaluate stress distribution and displacement.A patient-specific implant for dorsal instrumentation was developed, featuring six holes for the insertion of 1.7-mm bicortical locking screws, including two transarticular screws and two additional screws per vertebra. The implant demonstrated a maximum stress point of 425 MPa, well below the material yield strength of 880 MPa, with a maximum displacement of only 0.13 mm.The proposed implant shows promise as it can function as a drilling guide, potentially enhancing safety during instrumentation. Using safe corridors may improve the rigidity of the construct. The implant model did not exhibit any failure when subjected to finite element analysis according to the established criteria.

To investigate extravasation of contrast media injected intraarticularly, either immediately following elbow arthroscopy or after arthrocentesis using computed tomographic (CT) imaging at different time points.Cadaveric dog model.A total of 16 elbows of eight canine cadavers (median age 10.2 years, 5.6 to 16.8 years; median weight 35.0 kg, 26.0 to 42.0 kg) were randomly assigned to the arthroscopy group with the contralateral elbow as control. Right after elbow arthroscopy, both elbows were injected with 2.5 mL contrast fluid. Elbow CT scans were obtained at seven time points. To detect a possible loss of contrast medium from the joint, both the total volume and intensity of the contrast fluid were measured intra- and extraarticularly using rendering software. To compare volume and intensity of contrast fluid, a simple linear model and a linear mixed effect model were used.The total volume of contrast-enhanced fluid was increased (avg. difference: 5115 mm³; linear model std. estimate: 1.69, std. error 0.10) and the total intensity decreased (avg. difference: 1330 Hounsfield Units; linear model std. estimate: -1.66, std. error 0.11) in the arthroscopy group compared with the control. Neither total volume nor total intensity of contrast-enhanced fluid changed significantly within 15 minutes.Extravasation of intraarticular injected contrast fluid after elbow arthroscopy without a significant effect of time could be shown. Injection of liquid therapeutics, e.g., orthobiologics, at a later point after arthroscopy should be considered.

Medial and dorsomedial tarsometatarsal subluxation can be surgically managed by screws and orthopaedic wires. The goal of this retrospective study was to provide long-term clinical and radiographic outcome data for this method in dogs.The medical records of dogs diagnosed with medial or dorsomedial luxation to a referral hospital in France from 2012 to 2023 were recorded. Patients treated with prosthetic ligamentoplasty without cartilage debridement or bone grafting were included. Long-term follow-up data were obtained via questionnaire (owners), and clinical and radiographic evaluations were performed by a single surgeon.At the last follow-up, all owners reported that their pets (n = 20) had regained full or acceptable function of the affected limb; 2/15 had grade I lameness. All tarsometatarsal joints were stable. Follow-up radiographs were performed (mean = 4 years) and revealed partial (11/14) to complete (2/14) radiographic bony ankylosis of the tarsometatarsal joint. Complications, mainly consisting of implant migration, were reported in 7/20 of the dogs.Palpable stability and signs of radiographic bony ankylosis can be achieved by prosthetic ligamentoplasty in cases of medial or dorsomedial tarsometatarsal subluxation, leading to full or acceptable function. Tarsometatarsal cartilage debridement and cancellous bone grafting appear non mandatory for achieving joint stability, with lower patient morbidity and surgical time.

To describe cases of septic synovitis and osteomyelitis in foals younger than 6 months presented to a single hospital and their management and to report the value of computed tomography in diagnosis and management of these cases.This is a retrospective descriptive study.Sixty-five foals were included in this study. Forty-six foals (71%) survived to discharge. The presence of osteomyelitis (p = 0.16), umbilical infection (p = 0.41), or infection with Rhodococcus equi (p = 1) did not significantly influence survival. However, risk of nonsurvival was significantly increased if multiple sites were infected (p = 0.007; odds ratio [OR] = 5.80) or when bony lesions were present on admission radiographs (p = 0.03; OR = 3.47). A large proportion of the foals in this study had osteomyelitis (66%; 43/65). Computed tomography use was not significantly associated with survival (p = 0.27) but allowed identification of osteomyelitis lesions in 16 out of 43 cases (37.2%) where radiological findings were unremarkable.This study reports a high frequency of osteomyelitis in foals in multiple different regions of the skeleton, with or without associated synovial sepsis. The prognosis, defined as survival to discharge, for these orthopaedic infections is positive, especially if only one location is affected. Computed tomography scan allows an early diagnosis as well as detection of radiographically silent lesions and is an interesting tool in targeted treatments of these foals. Gram-positive bacterial infections were overrepresented in this study, suggesting some similarities with human paediatric orthopaedic infections.