Veterinary and Comparative Orthopaedics and Traumatology最新文献

To establish a highly standardized elbow computed tomography (CT) examination protocol and evaluate inter- and intraobserver reliability of assessment of canine elbow sclerosis in the absence of elbow pathology.Dogs that presented for CT screening for elbow dysplasia prior to breeding were evaluated. Only dogs diagnosed with CT as being free of elbow dysplasia were included. The CT images were randomized and assessed by five blinded observers. Two observers re-reviewed 30 randomly selected studies on a second occasion. A standardized approach to CT image reconstruction to create consistent image planes was used. Sclerosis was subjectively as graded 0 (no sclerosis), 1 (mild sclerosis), and 2 (marked sclerosis). Objective assessment of sclerosis using Hounsfield units (HU) was measured within a standardized region of interest at the medial aspect of the humeral condyle (MAHC) and medial coronoid process (MCP).Complete agreement between observers in ordinal scoring of sclerosis was moderate for each region (MCP traditional 38.8%, MCP modified 28.6%, MAHC 26.5%). Intraobserver reliability of ordinal sclerosis scoring was poor to moderate. The inter- and intraobserver reliability of HU measurements was good to moderate, and good to excellent, respectively. Correlation between sclerosis scores and HU measurements was low to moderate.Subjective and objective assessment of sclerosis of the MCP and MAHC in the absence of elbow pathology is unreliable despite the use of a highly standardized protocol.

The aim of this study was to investigate the short-term outcomes of tibial plateau levelling osteotomy (TPLO) and tibial tuberosity transposition (TTT) for the combined treatment of cranial cruciate ligament rupture and medial patellar luxation (MPL) in small-breed dogs weighing up to 15 kg.Retrospective case series of dogs treated with a single session TPLO-TTT from five referral centres between 2015 and 2023. Intraoperative and postoperative complications were assessed. Osteotomy healing, lameness and presence of patellar luxation or tibial thrust were assessed at a 6- to 12-week follow-up.A total of 37 stifles in 35 dogs. At the time of follow-up, the tibial compression test was negative in all stifles. The MPL grade improved from a median of 3/4 preoperatively to a median of 0/4 (p = 0.0001) postoperatively. Lameness grade improved from a median of 3/5 to 1/5. There were seven minor complications and seven major complications. No catastrophic complications occurred. Osteotomy healing was appropriate in all dogs. Three intraoperative complications related to a TPLO screw near the joint required replacement. Postoperative MPL was noted in three stifle joints (grade 1/4, 3/4 and 4/4). One distal tibial tuberosity fracture and one patella fracture were managed conservatively. Patella ligament desmitis was managed conservatively in five stifles.Combined TPLO-TTT is an effective treatment of cranial cruciate ligament rupture and MPL in small-breed dogs, but surgical accuracy is needed to minimize complications. High-grade patellar luxation may require alternative methods of stabilization.

This study aimed to evaluate percutaneous reduction of feline tibial fractures (gap model) using a three-dimensional-printed external skeletal fixator (jig) and assess the contralateral tibia as a template for virtual planning.Postmortem computed tomography (CT) was performed on 11 skeletally mature feline specimens. A mid-shaft tibial fracture gap model was created, followed by the placement of two lead-marked K-wires per fragment. The DICOMS images of repeated CT scans were imported into the virtual planning software to design a specimen-specific jig using the contralateral side as a template. The jig housed the leads and acted as a connecting bar to facilitate fracture reduction. Post-procedure radiography and CT were performed to evaluate fracture reduction.A total of 22 tibiae of 11 cats were reduced using a jig. There was an average difference of <1 mm in terms of tibial length and <5 degrees in joint angulations and in terms of rotation when comparing the post-procedure tibia with the initial CT/radiograph (p < 0.05). The alignment was considered anatomical in 16 of 21 limbs and acceptable in 5 of 21 limbs. Pin loosening occurred in one case during the jig process.Temporary fracture reduction using the three-dimensional-printed jig was feasible and accurate in 21 of the 22 procedures. When using the contralateral tibia as a template, an asymmetry of up to 6% in terms of joint angulations should be considered.

To report complications and long-term outcomes of partial tarsal arthrodesis (ParTA) in dogs and cats.Retrospective observational study.Medical records (2016-2023) were reviewed for cases with tarsal instability treated with ParTA using laterally applied plates. Data collected included signalment, concurrent orthopedic disease, surgical technique, postoperative complications, and outcomes. Long-term outcome was assessed using the canine brief pain inventory (CBPI) and feline musculoskeletal pain index (FMPI).A total of 34 dogs and 9 cats met the inclusion criteria. The overall complication rate in dogs was 22/34 with a major complication rate of 15/34. Plantar necrosis had an incidence of 1/34. Major I complications (6/34) required partial or complete explantation, revision partial tarsal or pantarsal arthrodesis. Incidence of surgical site infection was 11/34. Minor complications occurred in cats 5/9, including mild rotational deformity, while only 1/9 cats had a major complication (rotational deformity) requiring revision surgery. Long-term follow-up was available in 21/34 dogs and 6/9 cats. Canine outcomes were excellent or very good in 14/21 dogs. The mean FMPI was 3/36 indicating very good long-term outcome.Although canine ParTA has high major complication rate, 14/21 dogs had an excellent or very good long-term outcome. Cats had a low major complication rate and very good long-term outcomes.

The aim of this study was to determine the biomechanics of a supercutaneously placed String of Pearls plate (SOP) and supercutaneously placed locking compression plate (LCP) to be used in lieu of a type Ia external fixator.Nine surrogate constructs of 3.5 mm SOP, 3.5 mm LCP and type Ia external fixator offset 20 mm from the cortex over a 10-mm fracture gap were tested in non-destructive loading to 200 N and then tested in load to 100% displacement.Maximum displacement was used to calculate median maximum displacement in non-destructive axial compression testing for the SOP, LCP and external fixator, measuring 8.5 mm (interquartile range [IQR] 8.23-8.95), 10.3 mm (IQR 9.99-10.40) and 1.2 mm (IQR 1.17-1.31), respectively. There was a difference between the external fixator to LCP (p = 0.0050), external fixator to SOP (p = 0.0050) and LCP to SOP (p = 0.0050). Maximum load was used in compression to 100% displacement to calculate the median maximum load. The SOP, LCP and external fixator, withstood median loads to 100% displacement of 244 N (IQR 231.83-257.19), 168 N (IQR 165.07-170.86) and 766 N (IQR 688.14-784.29), respectively. There was a difference between external fixator to SOP (p = 0.0047), external fixator to LCP (p ≤ 0.001) and LCP to SOP (p = 0.0024).The type Ia external fixator is significantly stiffer compared with the supercutaneous 3.5 mm SOP and 3.5 mm LCP. Given the low stiffness and high displacement, supercutaneously placed locking plates may be unsuitable for clinical fracture repair in a 20-kg dog with an expected axial load of 200 N.

To determine the effect of plate-bone distance and screw number on 2.0-mm locking compression plate (LCP) torsional stiffness and plate strain for a fixed working length in a diaphyseal fracture gap model. In vitro biomechanical study.The LCP was tested with nine different combinations of plate-bone distance (PBD) (1, 1.5, and 3 mm) and screw number (SN) (two, three, or four screws per fragment) across the same working length. Six replicates per group were tested. Constructs were subjected to quasi-static, non-destructive torsion producing overall construct stiffness data (Nm/degree). Plate surface strain data were recorded from three-dimensional digital image correlation during testing for all constructs.A greater PBD and a low SN resulted in lower construct stiffness (p = 0.015, and P > 0.0001, respectively) in torsion. Across all PBD, there was significantly less stiffness for constructs with two screws per fragment, compared with three screws or four screws. No significant difference was detected in plate strain for any combination of PBD and SN.In this model, incrementally increasing the PBD and decreasing the SN resulted in less construct stiffness in torsion, with marked reduction in torsional stiffness in constructs with two screws per fragment compared with three or four screws per fragment.

This study analysed alterations in the stifle and quadriceps femoris muscle of healthy dogs and dogs with cranial cruciate ligament rupture using ultrasound and strain elastography.B-mode ultrasound was performed bilaterally in the stifle and quadriceps femoris muscle of the animals from both groups, healthy animals (HA, n = 16) and diseased animals (DA, n = 10), using strain elastography with strain ratio measurement.The strain ratio means between infrapatellar fat pad/patellar ligament were 0.92 ± 0.29 in the right pelvic limbs and 1.1 ± 0.51 in the left pelvic limbs for group HA and 1.7 ± 0.9 in the right pelvic limbs and 1.8 ± 1.0 in the left pelvic limbs for group DA. As for the strain ratio between infrapatellar fat pad/cranial cruciate ligament, the means were 1.1 ± 0.36 in the right pelvic limbs and 1.1 ± 0.52 in the left pelvic limbs for group HA and 2.7 ± 1.2 in the right pelvic limbs and 2.6 ± 0.96 in the left pelvic limbs for group DA. The ratio in group DA increased, showing statistical significance in the mean comparison, thus indicating higher stiffness in the patellar ligament and CCL of diseased animals. The main B-mode ultrasound findings in the DA group include suprapatellar recess effusion, osteophyte proliferation, and meniscal alterations. Seven dogs had increased echogenicity in the vastus medialis muscle, which was associated with higher elasticity but potentially related to alterations, such as necrosis and inflammation.The increased cruciate ligament stiffness suggests its application as an early indicator of degenerative alterations.

This study aimed to describe an orthogonal angle-stable (ASO) intramedullary nail, evaluate its mechanical properties, and compare its performance with a conventional and an angle-stable nails.Synthetic diaphyseal models with a 25-mm gap fracture were 3D printed using polylactic acid. The ASO nail, fabricated from 316 L stainless steel, featured two orthogonal distal holes spaced 5.5-mm apart. Mechanical properties were evaluated through axial compression and torsion tests until failure. The stiffness and yield load under axial compression and peak torque under torsion were used to compare the ASO nail (ASO group) with a conventional interlocking (IC group) and a uniplanar angle-stable (ASU group) nails. Seven tests per group were performed and analysed using Kruskal-Wallis and Dunn's post hoc tests.The ASO and ASU nails exhibited similar stiffness under axial loading and demonstrated greater stiffness than the IC nails. No differences were observed among the groups regarding yield load or peak torque under torsion.The ASO nail exhibited biomechanical properties similar to the ASU nail and both demonstrated superiority over the IC. Further studies focusing on implant development and refinement of the implantation technique are necessary before clinical application can be considered.

The aim of this study was to describe the physeal pathology of the proximal radius in four skeletally immature male Pugs. Physical examination, radiography, and computed tomography (CT) of the thoracic limbs were performed in all four dogs. Two Pugs were available for long-term follow-up and two Pugs were euthanatized after the diagnostic imaging results. Four male Pugs, aged between 6 and 7 months, were presented with a history of thoracic limb lameness lasting 2 to 3 months. Radiography and CT of the thoracic limbs showed irregularity of the proximal radial physes with varying degrees of radiolucency within the adjacent metaphyses. The pathology was associated with elbow joint incongruity and angular deformity of the antebrachium. Two dogs were euthanatized, one of which was autopsied, and histopathology of the proximal radius revealed bilateral physeal dysplasia. At long-term follow-up of the two surviving dogs, lameness had resolved. Radiography and CT scans of the thoracic limbs revealed normal bone opacity within the proximal radius and resolution of the radiolucent areas of the proximal radial physes. However, incongruity of the radioulnar joint remained. In this report, the resolution of identified physeal pathology at the proximal radius in juvenile Pugs demonstrates the potential for spontaneous remission despite the presence of notable radiographic changes.