Veterinary and Comparative Orthopaedics and Traumatology最新文献

Objectives:  The aim of this retrospective study was to report the magnitude of the craniocaudal angulation of the proximal tibia (CCAPT) quantified by the angle between the anatomical axis (AA) and the mechanical axis (MA), called the AMA angle, and the tibial plateau angle (TPA) in dogs >50 kg that were treated by cranial closing wedge osteotomy based on the AMA angle (AMA-based CCWO). Furthermore, the percentage of dogs in which the AA and MA could be aligned postoperatively and the rate of surgical site infection (SSI) were reported.

Study design:  Medical records (between January 2016 and September 2023) were reviewed for 204 dogs that had AMA-based CCWO stabilized with a double locking plate (DLP) fixation with or without joint exploration plus a Robert Jones bandage (RJB) and were given postoperative antibiotics.

Results:  The median (range) preoperative AMA angle and TPA were 3.1° (0-5.1°) and 30° (22-49.6°), respectively, and the postoperative AMA angle and TPA were 0° (-2.4 to 1.6°) and 9.2° (4-15°), respectively. The AA and MA were aligned in 82% of dogs. Grade 4 healing occurred in all osteotomies by 8 weeks postoperatively. Except for one dog, no SSIs were recorded.

Conclusion:  Concerning the magnitude of CCAPT in dogs >50 kg and the low SSI rate, AMA-based CCWO stabilized with a DLP fixation plus an RJB and postoperative antibiotics should be considered for treating cranial cruciate ligament-deficient stifles in this subset of dogs.

Objective:  To introduce a novel universal guide design for distal femoral osteotomy (DFO) to treat femoral deformities and other hindlimb orthopaedic diseases, and to compare its accuracy to the patient-specific guide in vitro and ex vivo on X-ray and computed tomography (CT).

Methods:  Thirteen anatomic specimens of canine femurs and 13 3D-printed femoral bone models were subjected to DFO using a patient-specific and a universal guide. The anatomical lateral distal femoral angle and anteversion angle were measured on radiographic and CT images before and after surgical procedure and used to compare the accuracy of the surgical guides in treating uniplanar or biplanar deformities. Bone models were used to compare the accuracy with ex vivo models.

Results:  The mean correction errors were -1.18° to 0.72° on X-ray and -1.91° to 0.53° on CT scan. The analysis showed no statistically significant difference in the mean error between the groups based on type of guide used, nor in the mean error between groups based on whether anteversion correction was performed based on both the CT and X-ray imaging data.

Conclusion:  Both the patient-specific and universal guides can produce accurate results in DFO surgery, and the universal guide shows potential as a useful surgical tool.

Objective:  Patellar luxation (PL) is commonly diagnosed in dogs and cats; however, a traumatic cause is poorly reported in the literature. The aim of this study was to report the clinical presentation, surgical treatment, and outcome in dogs and cats surgically treated for traumatic PL.

Study design:  This is a retrospective study. Medical records of dogs and cats operated for traumatic PL were reviewed. Short- and long-term follow-ups were assessed with medical records and telephone interviews with owners and referring veterinarians. Data on signalment, lameness, PL characteristics, surgery, complications, and outcome were recorded.

Results:  Eleven dogs and 5 cats were included. Both species had a median lameness grade of 4/5 and a median PL grade of 3/4. PL was medial in most cases (13/16). Joint capsule lesions were identified in 15 cases, 4 cases had trochlear ridge cartilage damage. All cases had a capsular imbrication, 12 cases had a fabello-patellar suture (FPS). Mean long-term follow-up time was 70.8 ± 42.5 months in 9 dogs and 4 cats. Ten cases out of 13 had no lameness at the 2-month follow-up, and 11/13 cases had no long-term lameness. Eleven cases out of 13 had no PL at the 2-month follow-up. No long-term PL was reported by owners. Complications were mild in 5 cases, moderate in 1, severe in 3. Functional outcome was full in 10 cases and acceptable in 3.

Conclusion:  Soft tissue techniques and FPS were effective in the surgical treatment of traumatic PL in dogs and cats, resulting in acceptable to full long-term function in all cases, with limited severe complications.

Objectives:  The aim of the study was to investigate the contact mechanics and kinematic changes in the stifle in different standing angles.

Study design:  We performed a biomechanical ex vivo study using pairs of canine cadaver hindlimbs. Motion sensors were fixed to the tibia and the femur for kinematic data acquisition. Pressure mapping sensors were placed between the femur and both menisci. Thirty percent bodyweight was applied to the limbs with the stifle in 125, 135, or 145 degrees of extension.

Results:  Stifle flexion angle influences femoromeniscal contact mechanics significantly. The load on both menisci was significantly higher for 125 and 135 degrees in comparison to 145 degrees. Additionally, the center of force was located significantly more caudal when comparing 125 to 145 degrees in the medial meniscus as well as in both menisci combined.

Conclusion:  The angle of knee flexion significantly impacts the contact mechanics between the femur and the meniscus. As the knee flexes, the load on both menisci increases.

Objective:  The aim of this study was to report (1) the prevalence of contralateral humeral intracondylar GAP/HIF (HIF) in French Bulldogs with humeral condylar fractures (HCF) and (2) treatment and short- and long-term outcome in French Bulldogs with HCF.

Materials and methods:  Medical records of French Bulldogs treated surgically for HCF between January 2011 and November 2022 were reviewed. Perioperative imaging, surgical technique, complications, and long-term outcome were assessed.

Results:  Eighty-nine dogs with HCF were included and 36/89 were diagnosed with HIF. Surgical repair was performed in all HCF and a prophylactic transcondylar screw was placed in 20/36 HIF. For prophylactic transcondylar screw placement, two dogs required immediate revision surgery. Complications occurred in 12/89 HCF, and there were major complications in 6/89 HCF. Long-term outcome evaluated by owner questionnaire (n = 27) was rated as being excellent in 18/27 dogs, good in 8/27 dogs, and fair in 1/27 dogs.

Clinical significance:  Forty percent of French Bulldogs with HCF had a contralateral HIF. HIF as a cause of HCF should be considered in the French Bulldog, and a computed tomography (CT) scan of both elbows may be advisable prior to HCF repair. The complication rate of HCF surgery in the French Bulldog is significant.

Objective:  To report the use of a Lateral Epicondylar Anatomical Plate for the management of humeral condylar fractures (HCF) in dogs.

Study design:  Medical records of dogs with HCF stabilized using the Lateral Epicondylar Anatomical Plate at six UK veterinary referral centres between April 2018 and February 2021 were reviewed. Long-term follow-up (>6 months) was obtained via owner questionnaire, which incorporated the Liverpool Osteoarthritis in Dogs clinical metrology instrument.

Results:  Sixty-two HCF were treated in 61 dogs (44 lateral condylar fractures [LCF] and 18 intracondylar (T/Y) fractures [ICF]). Fifty-one dogs were Spaniels or Spaniel crossbreeds. Intraoperative contouring of the plate was required for one dog-a French Bulldog. Postoperative complications occurred in 14/42 LCF and 6/18 ICF; overall there were 14 minor, 8 major, and 2 catastrophic complications. On final follow-up imaging, there was evidence of partial or complete osseous continuity of the condylar part of the fracture 32/53 HCF (24/39 LCF and 8/14 ICF) and lateral epicondylar part of the fracture in 53/53 HCF (39/39 LCF and 14/14 ICF). At final reexamination, 20/28 dogs with LCF and 5/13 dogs with ICF were not lame and the remaining dogs demonstrated mild lameness. According to the owner questionnaire, 17/17 dogs with LCF and 8/10 dogs with ICF returned to full limb use and median Liverpool Osteoarthritis in Dogs scores were 2/52 for LCF and 6.5/52 for ICF.

Conclusion:  The Lateral Epicondylar Anatomical Plate can be used successfully for the surgical stabilization of HCF in dogs.

Objective:  The aim of this study was to determine if variations in Hounsfield units (HU) are present within the elbow between asymptomatic dogs of two breeds of dogs susceptible to elbow dysplasia.

Study design:  Guide Dogs and Border Collies that presented for routine computed tomography (CT) screening for elbow dysplasia prior to breeding were evaluated. All dogs had no documented history of lameness. Dogs diagnosed with CT as being free of elbow dysplasia were included. The CT images were randomized and assessed by three blinded observers. A standardised approach to CT image reconstruction to create consistent image planes was used. Hounsfield units were measured within a standardised region of interest (ROI) at the humeral trochlea and medial coronoid process. The minimum, mean and maximum HU within each ROI was recorded.

Results:  Eighty-six elbows were included in the study with 32 Guide Dogs, and 11 Border Collies. Guide Dogs had significantly higher minimum (99.75 HU, 95% confidence interval [CI]: 15.02-184.48, p = 0.022), mean (115.09 HU, 95% CI: 80.53-149.64, p < 0.01) and maximum (74.00 HU, 95% CI: 44.58-103.42, p < 0.01) difference in HU within the medial coronoid process ROI, and significantly higher mean (146.49 HU, 95% CI: 100.12-192.87, p < 0.01) and maximum (147.77 HU, 95% CI: 102.57-192.97, p < 0.01) difference in HU within the humeral trochlea ROI.

Conclusion:  In this dataset breed variations in elbow HU were present between asymptomatic Guide Dogs and Border Collies. This needs to be considered in breeding screening programmes to avoid over-interpretation of elbow sclerosis, in the absence of elbow pathology.

The aim of this study was to describe three dogs with permanent fibular nerve injury following tibial plateau levelling osteotomy (TPLO). Fibular nerve injury following TPLO led to atrophy of the cranial tibial muscle, absent hock flexion and a mild lameness. Fibular nerve injury was confirmed in one case with electrodiagnostics. All three cases had a drill tract in the same location, on the caudal aspect of the tibia, immediately distal to the tibial osteotomy. Permanent fibular nerve injury following TPLO occurred with a more caudally positioned plate and care should be taken when drilling the tibia from medial to lateral in the region described. Careful gait assessment at routine follow-up was required to identify this complication.

Objective:  The aim of this study was to evaluate the stress changes in the radii beneath the locking plates (LP) of dogs implanted with LP using finite element analysis (FEA).

Study design:  The study included radii harvested from eight dogs. After computed tomography (CT) scans of the forelimb, the articular surface of the radius was fixed using resin. Material tests were conducted to identify the yield and fracture points and for verification with FEA. The CT data of the radius were imported into FEA software. The radii were classified into three groups based on the placement of the LP (nonplate placement, intact group; 1 mm above the radial surface, LP + 1 mm group; 3 mm above the radial surface, LP + 3 mm group). Equivalent, maximum, and minimum principal stresses and minimum principal strain were measured after FEA at the radial diaphysis beneath the plate.

Results:  In shell elements, the LP + 1 mm and LP + 3 mm groups showed a significantly lower maximum principal stress compared with the intact group. In solid elements, the LP + 1 mm and LP + 3 mm groups showed a significantly higher equivalent stress and a significantly lower maximum principal stress compared with the intact group.

Conclusion:  When an axial load is applied to the radius, LP placement reduces the tension stress on the cortical bone of the radius beneath the plate, possibly related to implant-induced osteoporosis and bone formation in the cortical bone beneath the plate.