Veterinary and Comparative Orthopaedics and Traumatology最新文献

It is well-established that hip joint laxity is the primary cause of degenerative changes in canine hip dysplasia, although some fundamental characteristics of stress radiography are still scarce, especially regarding the appropriate applied force. The objective of this study was to validate the recently published force-laxity relationship from a cadaver study and to determine the force necessary to measure a sufficient proportion of laxity present in coxofemoral joints in sedated dogs.Twenty-one dogs (10 Beagles and 11 Labrador Retrievers) underwent a radiographic protocol, including stress radiographs with increasing force, using the Vezzoni Modified Badertscher Distension-measuring Device. The Laxity Index (LI) and osteoarthritis (OA) were scored.The force-laxity curves and the maximal Laxity Index (LI_max) were not significantly influenced by OA, gender or side. Weight was significantly associated with LI_max and the force-laxity curves. Ninety per cent of hip joints achieved sufficient laxity at a force of 80.45 N, which is practically achievable and less than that in cadavers. Bias due to low LI_max in the Labrador Retriever group and the only presence of radiographic signs of mild OA in the Beagle group should be considered.This study confirmed the relation between applied force and LI, the robustness of this stress radiography technique and the use of a minimum 80.45 N of measured force to reach sufficient LI. Future studies with inclusion criteria regarding a broad LI_max range and OA scores should be conducted.

This retrospective study assessed the complications and mid-term outcomes of osteosynthesis using the String of Pearls Low Profile (SOP-LP) plate system in cats and small dogs with appendicular fractures.Clinical data from April 2018 to June 2021, involving 30 fractures in 29 cases, were reviewed. Fractures were stabilized using either the 1.5-mm or 2.0-mm SOP-LP plate. Data included patient signalment, fracture description, repair method, intraoperative complications and short-term follow-up outcomes. Midterm follow-up was performed by telephone-based veterinary questionnaires.Of the 30 fractures, 3 had complications linked to the SOP-LP system. Overall, 7/30 had complications. Major complications (n = 6) included two implant failures, one implant-associated irritation and three Kirschner wire migrations. Implant failures (n = 2) were with the 1.5-mm plates stabilizing radius/ulna fractures in dogs weighing over 2.9 kg. Short-term radiographic follow-up demonstrated clinical or radiographic union in all cases. In all cases available (n = 18) for midterm follow-up, the function was found to be full or acceptable.The SOP-LP plate can be used successfully for a wide variety of fractures in cats and small dogs; however, careful case selection is required, particularly when using the 1.5-mm plate as a single implant in patients weighing over 3 kg.

This study aimed to report the clinical, radiographic, and computed tomography results of supracutaneous locking plate (SLP) application in radial-ulnar and tibial fractures.In this clinical prospective study, cats and dogs with nonarticular radial, ulnar, and tibial fractures were managed with SLP. Surgical records, fracture healing, complications, and lameness were reviewed during scheduled rechecks. Fracture healing was assessed by clinical, radiographic, and tomographic reexaminations.All cases were reevaluated during clinical and radiological follow-up examinations for 13 weeks. Supracutaneous locking plates were used in 8 radial-ulnar and 25 tibial fractures. Closed reduction was used in 10 cases, and the minimally invasive osteosynthesis approach technique was used in 20 cases. The median fracture healing time was 50.5 days (range: 27-88). Callus area, the Hounsfield units value of callus tissue, and three-dimensional bone volume gradually increased during fracture healing (p < 0.05).Using SLPs to manage nonarticular diaphyseal radial-ulnar and tibial fractures in cats and dogs resulted in acceptable clinical outcomes. Cats and dogs tolerated SLPs well, and no complications related to structural integrity were encountered in most cases.

To determine (1) whether the tibial plateau angle (TPA) in dogs with Salter-Harris type 1 (SH-1) or type 2 (SH-2) fractures of the proximal tibial physis significantly decreases in the time between diagnosis and reevaluation following surgical repair and (2) whether the method of surgical repair influences the change in TPA over time.This study was a retrospective study. Medical records from 2017 to 2022 were reviewed to identify dogs with SH-1 or SH-2 fractures of the proximal tibial physis that had undergone surgical repair with Kirschner wires (K-wires), with or without a tibial tuberosity tension band. The TPA of the affected limb was measured by four investigators on radiographs taken prior to surgery, immediately postoperatively and at 4-8 weeks follow-up, with the average values recorded.A total of 32 dogs, 22 fractures repaired with K-wires and a tension band, and 10 with K-wires only. There was a mean decrease in TPA from injury to first reevaluation of 5.89 degrees (p < 0.001) and from immediately postoperatively to first reevaluation of 2.2 degrees (p = 0.018); however, no significant decrease in TPA was observed when comparing fractures repaired with or without a tension band.The TPA of dogs with SH-1 and SH-2 fractures of the proximal tibial physis decreased in the reevaluation interim following repair with K-wires with or without a tension band. Despite initial imperfect reduction, the risk of cranial cruciate ligament rupture may not be increased, potentially reducing the need for additional surgery if high TPA is observed postoperatively. This study was overrepresented by small breeds, and future studies on large and giant breeds with extended follow-up would be indicated.

The aim of this study was to assess the clinical outcome of treatment of degenerative lumbosacral stenosis in dogs with a stand-alone intervertebral spacer (S group) and combined with a pedicle screw and rod fixation (S + PSRF group) in the lumbosacral junction.Retrospective study. Medical records (2014-2023) were reviewed for dogs treated with a stand-alone intervertebral spacer (S group) or a spacer combined with PSRF (S + PSRF group). Data collected included clinical signs at the time of presentation, surgical technique, implant type, perioperative bacterial culture, complications, outcomes and subsidence.Minor complications occurred in 10/11 dogs in the S group and 6/17 dogs in the S + PSRF group. Major complications occurred in 3/11 dogs in the S group and 5/17 dogs in the S + PSRF group. Long-term outcome was excellent in 63.6% dogs in the S group and 64.7% dogs in the S + PSRF group. Subsidence was noted in 75% of the cases in the S group compared with 33% of cases in the S + PSRF group. Bacterial cultures were positive in 6/28 cases.Both treatment options were associated with full return of function in 64 to 65% of cases. Complications were more frequent in the S group. The S + PSRF group showed less subsidence of the cage. There was more frequent evidence of bone ingrowth in the intervertebral spacer in the S + PSRF group. Based on the observations in this study, both treatment options are viable for the treatment of degenerative lumbosacral stenosis with similar long-term outcomes; however, S + PSRF may result in less subsidence and better fusion and may therefore be preferable.

The objectives of this study were (1) to evaluate the need for flexed radiographs of the proximal medial trochlear ridge (PMTR) after trauma involving medial tarsus; (2) to evaluate outcome following arthroscopic removal of traumatic osteochondral fragments (TOCF) resulting from direct injury to PMTR.Records of patients with wounds to the medial tarsus were searched and those with TOCF of the PMTR included. Patient history, fracture etiology, preoperative diagnostics, and intraoperative findings were documented. Postoperative performance data were collected using Thoroughbred Racing database or a telephone questionnaire.All cases had wounds with concurrent synovial sepsis of the tarsocrural joint. Standard weight-bearing radiographs were performed preoperatively (n = 15), but most (n = 13) failed to identify PMTR pathology. When acquired (n = 8), flexed radiographs (including a uniquely described flexed plantaroproximolateral dorsodistomedial Pl30Pr45Lat-DoDiM oblique) identified PMTR lesions. PMTR TOCF were removed during the initial surgery (n = 15) or subsequent (n = 3) arthroscopy, performed due to unresolved synovial sepsis. Fifteen out of 16 horses with >6-month follow-up resumed full exercise.Flexed tarsal radiographs should be performed as part of a standard protocol for traumatic wounds involving the medial tarsus. Horses had excellent prognosis following arthroscopic removal of TOCF of the PMTR. Failure to recognize and remove TOCF resulted in refractory synovial sepsis for horses in this study.

The goal of this study was to compare the accuracy and safety of a transcondylar screw (TCS) placed using a 3D-printed patient-specific guide (PSG) or a generic aiming device (AD). We hypothesized that PSG is more accurate (i.e., positioning and orientation closer to the optimal trajectory) and safer (reduced incidence of joint violation) than the AD.A total of seven pairs of forelimbs were allocated to PSG and AD groups. After CT scanning, the optimal TCS orientation was planned in silico by a surgical specialist, and guides were printed. Using the PSG or AD, a 2.5-mm drill hole was drilled from medial to lateral across the humeral condyle. The positioning of the "planned" and "achieved" drill holes was defined on postoperative CT. The accuracy of TCS positioning and the risk of joint penetration were then calculated for the two groups.Positioning of the entry and exit holes was significantly more accurate in the PSG group. Differences in screw angulation were not significantly different between groups. Despite the presence of an outlier (caused by incomplete seating of the PSG against the bone), 7 out of 7 screws positioned with PSG were "safe," while 3 out of 7 from the AD group would have violated the joint.Our data confirm the technical superiority of PSG over the AD for placement of a TCS in the humeral condyle.

The Canine Orthopedic Index (COI) questionnaire was developed to assess chronic pain and functional impairment in dogs with orthopaedic conditions. This study aimed to perform a linguistic validation and cross-cultural adaptation of the COI from the original English version into Universal German and Universal Spanish.We employed the Functional Assessment of Chronic Illness Therapy translation methodology, which involves two forward translations, one reconciliation of the two forward translations, a back translation into English, multiple reviews, and cognitive debriefing interviews with a representative sample of dog carers. We followed a universal approach to translation, with translators and study participants from different German- and Spanish-speaking countries.The two independent forward translations differed by four parts for the German COI and eight parts for the Spanish COI. Comparing the backward translations with the original document identified 10 items or instructions in both translations that required retranslation. Cognitive debriefing interviews with dog carers confirmed that the translated instruments effectively conveyed the same concepts as the original version, leading to no further changes in the Universal German COI and four minor revisions to the Universal Spanish COI.We provide linguistically validated and culturally adapted versions of the COI suitable for use in all German- and Spanish-speaking countries.

To investigate the frequency and factors of medial meniscal injury (MMI) associated with cranial cruciate ligament rupture (CrCLR) in toy breed dogs by arthroscopic evaluation.Toy breed dogs (≤5 kg) diagnosed with CrCLR using stifle arthroscopy were included. Age, sex, body weight, breed, medial patellar luxation grade, degree of lameness at diagnosis, and duration of lameness until diagnosis were obtained from medical records. The tibial plateau angle was evaluated using preoperative radiography. On arthroscopic evaluation, degree of CrCLR was classified as partial or complete; MMI was classified as no, mild, or severe injury. MMI grade was used as objective variable; ordered logistic regression was used, and the final model was created using forward-backward stepwise selection.Overall, 202 stifles of 178 dogs were evaluated. Arthroscopic evaluation revealed partial and complete CrCLR, and MMI in 58, 144, and 74 stifles, respectively. MMI with mild and severe damage was noted in 50 and 24 stifles, respectively. Final model included body weight, lameness score, and degree of cranial cruciate ligament damage. A grade 3 lameness score had a higher MMI factor than grade 1. Higher body weight was associated with MMI, and complete rupture had a higher MMI factor than partial tears.Arthroscopic evaluation of CrCLR cases showed MMI in toy breed dogs. Cases with complete CrCLR or severe lameness are at high risk of MMI and should be evaluated cautiously.