Veterinary and Comparative Orthopaedics and Traumatology最新文献

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 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 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 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.

The aim of our study was to assess the conformation of the radioulnar joint using transverse plane computed tomography in dogs with medial coronoid disease (MCD).The study included 101 elbow joints with arthroscopically confirmed MCD and 20 sound control elbow joints. To assess the conformation of the radioulnar joint, we determined the ratio for the radial head centre of supination and pronation toward the ulnar joint surface in the transverse computed tomography plane. In addition, we assessed the opening angle of the radioulnar joint.The MCD group showed decreased lateral, laterocentral and central radioulnar ratios, with 1.78 (± 0.09) and 1.81 (± 0.07) centrally (p = 0.044), 1.75 (± 0.10) and 1.78 (± 0.09) laterocentrally (p = 0.044) and 1.74 (± 0.09) and 1.77 (± 0.08) laterally (p = 0.044), in the MCD and control groups, respectively, indicating radioulnar joint malformation. The mediocentral and medial sections showed no differences in radioulnar ratios consistent with joint congruity. The opening angle of the radioulnar joint showed no significant differences between the groups.Dogs with MCD showed lateral, centrolateral and central malformation and incongruity of the radioulnar joint in the transverse computed tomography plane. Medial coronoid disease appears to coincide with radioulnar joint malformation ipsilateral to the medial coronoid process and medial joint compartment. Radioulnar malformation in the lateral and central compartments could be a factor in the development of MCD and limit the success rate in arthroscopic MCD treatment.