Inter-rater reliability in performing stifle goniometry in normal and cranial cruciate ligament disease affected dogs: a prospective randomized controlled study.

BACKGROUND: Goniometry can be performed clinically in dogs with cranial cruciate ligament disease (CCLD). The purpose of this study was (1) to compare reliability of stifle goniometry in dogs with CCLD and healthy dogs and (2) to investigate the effect of compliance on measurements. Dogs presented for surgical intervention for CCLD (CCL-Dogs; n = 15) and orthopedically healthy dogs (C-Dogs; n = 11) were enrolled in this prospective randomized controlled trial. In each dog, three observers randomly measured maximum stifle flexion (mSF) and maximum stifle extension (mSE) three times with a standard goniometer with the scale covered, while dog compliance was scored (Scores: C0: excellent - C4: poor). Intraclass correlation coefficient (ICC) was calculated for intra-/interobserver reliability. Effects on measurements were evaluated with mixed-effect models (MEM). RESULTS: Maximum stifle extension and mSE-compliance were significantly decreased in CCL-Dogs compared to C-Dogs (p ≤ 0.004), but mSF and mSF-compliance did not differ between groups. Intraobserver reliability was excellent for all dogs during mSE (ICC:0.75-0.99) and mSF (ICC:0.89-0.99). Interobserver reliability was excellent for mSF in both groups (ICC: C-Dogs:0.84, CCL-Dogs:0.9) and for mSE in CCL-Dogs (ICC:0.94) but only fair for mSE in C-Dogs (ICC:0.58). Robust MEM showed that the combined average of all mSE measurements of all three observers was affected by compliance in both groups (p < 0.001). This effect was not observed for single mSE-measurements by themselves. CONCLUSION: The results of this study indicate that compliance may affect goniometric stifle extension measurements in healthy and CCLD dogs. In a clinical setting, intra-/interobserver reliability was excellent for all measurements except for maximum stifle extension in healthy dogs.

Assessment of a continuous passive motion assistive device in dogs following stifle surgery.

Canine rehabilitation optimizes recovery and the quality of life in dogs with musculoskeletal conditions or after surgery. Achieving proper range of motion (ROM) is vital post-stifle surgery, often accomplished through manual therapy and active exercises. We investigated the mechanical performance of a continuous passive motion (CPM) device for dogs and its potential use in canine rehabilitation therapy. In the ethical review process, our research was accepted to be evaluated in a sample of four dogs that had undergone left stifle surgery. Each dog underwent four sessions with the device at three different speeds. Results showed the device replicated extension angles close to goniometer measurements used in manual therapy. Flexion was also achieved, but not to the same extent. A force threshold stopped the device, avoiding discomfort in dogs with restricted ROM. Dog-specific factors like body position, opposition to movement, limb size, stage of recovery, haircoat, and discomfort, appeared to influence device operation. Mechanical improvements to allow for enhanced flexion are recommended in future CPM device designs, including a resistance threshold that could be adjusted for individual dogs and stages of healing. This study serves as a foundation for future advancements in canine rehabilitation systems. A canine CPM device may provide an affordable option to improve ROM. This could be beneficial for dog owners, who may not be comfortable with manual therapy, to assist with home rehabilitation exercises.

An Optimization Approach for Creating Application-specific Ultrasound Speckle Tracking Algorithms.

OBJECTIVE: Ultrasound speckle tracking enables in vivo measurement of soft tissue deformation or strain, providing a non-invasive diagnostic tool to quantify tissue health. However, adoption into new fields is challenging since algorithms need to be tuned with gold-standard reference data that are expensive or impractical to acquire. Here, we present a novel optimization approach that only requires repeated measurements, which can be acquired for new applications where reference data might not be readily available or difficult to get hold of. METHODS: Soft tissue motion was captured using ultrasound for the medial collateral ligament (MCL) of three quasi-statically loaded porcine stifle joints, and medial ligamentous structures of a dynamically loaded human cadaveric knee joint. Using a training subset, custom speckle tracking algorithms were created for the porcine and human ligaments using surrogate optimization, which aimed to maximize repeatability by minimizing the normalized standard deviation of calculated strain maps for repeat measurements. An unseen test subset was then used to validate the tuned algorithms by comparing the ultrasound strains to digital image correlation (DIC) surface strains (porcine specimens) and length change values of the optically tracked ligament attachments (human specimens). RESULTS: After 1500 iterations, the optimization routine based on the porcine and human training data converged to similar values of normalized standard deviations of repeat strain maps (porcine: 0.19, human: 0.26). Ultrasound strains calculated for the independent test sets using the tuned algorithms closely matched the DIC measurements for the porcine quasi-static measurements (R > 0.99, RMSE < 0.59%) and the length change between the tracked ligament attachments for the dynamic human dataset (RMSE < 6.28%). Furthermore, strains in the medial ligamentous structures of the human specimen during flexion showed a strong correlation with anterior/posterior position on the ligaments (R > 0.91). CONCLUSION: Adjusting ultrasound speckle tracking algorithms using an optimization routine based on repeatability led to robust and reliable results with low RMSE for the medial ligamentous structures of the knee. This tool may be equally beneficial in other soft-tissue displacement or strain measurement applications and can assist in the development of novel ultrasonic diagnostic tools to assess soft tissue biomechanics.

Effect of tibial plateau angle < 5° on ground reaction forces in dogs treated with tibial plateau leveling osteotomy for cranial cruciate ligament rupture up to 6 months postoperatively.

Tibial plateau leveling osteotomy (TPLO) has been commonly performed in dogs with cranial cruciate ligament disease (CCLD) since the introduction by Slocum and Slocum (1993). To reduce cranial tibial thrust the TPLO technique aims for a postoperative tibial plateau angle (TPA) of 5-6.5°. In recent years studies have shown that a postoperative TPA below 5° could be beneficial regarding stifle stability or meniscal load. Dogs with CCLD that were treated with TPLO, were examined preoperatively, six weeks, three and six months postoperatively with gait analysis and grouped according to their postoperative TPA. The aims of study was (1) to evaluate if dogs with a postoperative TPA below 5° would have a faster limb function recovery up to six months postoperatively as measured objectively with ground reaction forces (GRFs) and (2) to determine whether the postoperative TPA correlates with the outcome measurements. Dogs with TPA <5° showed no faster limb function recovery postoperatively up to six months as measured with peak vertical force (PVF) or vertical impulse (VI) (p > 0.05). No correlation for the postoperative TPA <5° on GRFs was demonstrated. But the postoperative TPA showed a significant correlation with the symmetry indices of PVF (SIPVF) and VI (SIVI) for all dogs (>5° and <5° TPA together), indicating that with lower postoperative TPA dogs had a more symmetrical gait in hindlimbs SIPVF (r = 0.144, p < 0.05) and SIVI (r = 0.189, p < 0.01). The study indicates that a lower postoperative TPA could be beneficial regarding hindlimb symmetry indices of GRFs.

Prevalence of osteoarthritis in the shoulder, elbow, hip and stifle joints of dogs older than 8 years.

Osteoarthritis is one of the most common diseases in veterinary medicine. There are various causes for joints developing OA, with some of them being well investigated, while others are still a matter of speculation. In this retrospective study we examined the prevalence of OA in the shoulder, elbow, hip and stifle joints in a clinic population of dogs older than 8 years, which were presented mostly due to orthopaedic complaints. Dogs were included in the study if one or more of the aforementioned joints was included in the radiographs. Radiographs were reviewed by three different observers and graded by severity. Prevalence of OA was 39.2%, 57.4%, 35.9% and 36.4% for the shoulder, elbow, hip and stifle, respectively. There was no correlation between higher grades of OA and weight as well as age, but significantly higher prevalence of OA in heavier groups when grouped for weight. Sex and castration status did not affect presence of OA. As most of the examined joints were free of OA, radiographic findings suggestive of OA should not be considered normal in senescent dogs.

Effects of various load magnitudes on ACL: an in vitro study using adolescent porcine stifle joints.

INTRODUCTION: The escalating incidence of anterior cruciate ligament (ACL) injuries, particularly among adolescents, is a pressing concern. The study of ACL biomechanics in this demographic presents challenges due to the scarcity of cadaveric specimens. This research endeavors to validate the adolescent porcine stifle joint as a fitting model for ACL studies. METHODS: We conducted experiments on 30 fresh porcine stifle knee joints. (Breed: Yorkshire, Weight: avg 90 lbs, Age Range: 2-4 months). They were stored at - 22 °C and a subsequent 24-h thaw at room temperature before being prepared for the experiment. These joints were randomly assigned to three groups. The first group served as a control and underwent only the load-to-failure test. The remaining two groups were subjected to 100 cycles, with forces of 300N and 520N, respectively. The load values of 300N and 520N correspond to three and five times the body weight (BW) of our juvenile porcine, respectively. RESULT: The 520N force demonstrated a higher strain than the 300N, indicating a direct correlation between ACL strain and augmented loads. A significant difference in load-to-failure (p = 0.014) was observed between non-cyclically loaded ACLs and those subjected to 100 cycles at 520N. Three of the ten samples in the 520N group failed before completing 100 cycles. The ruptured ACLs from these tests closely resembled adolescent ACL injuries in detachment patterns. ACL stiffness was also measured post-cyclical loading by applying force and pulling the ACL at a rate of 1 mm per sec. Moreover, ACL stiffness measurements decreased from 152.46 N/mm in the control group to 129.42 N/mm after 100 cycles at 300N and a more significant drop to 86.90 N/mm after 100 cycles at 520N. A one-way analysis of variance (ANOVA) and t-test were chosen for statistical analysis. CONCLUSIONS: The porcine stifle joint is an appropriate model for understanding ACL biomechanics in the skeletally immature demographic. The results emphasize the ligament's susceptibility to injury under high-impact loads pertinent to sports activities. The study advocates for further research into different loading scenarios and the protective role of muscle co-activation in ACL injury prevention.

Radiographic analysis in Thoroughbreds reveals morphological changes in healthy maturing stifle joints and possible association between subchondral lesions and femoral condyle width.

OBJECTIVE: Assess femorotibial features in foals with and without medial femoral condyle (MFC) subchondral radiolucencies (SR+ and SR-). METHODS: 3 independent, sequential radiographic studies were performed. Study 1 retrospectively measured femorotibial morphological parameters in repository radiographs (SR- and SR+). Study 2 qualitatively compared drawings of intercondylar notch shape in postmortem radiographs (SR-). Study 3 prospectively measured femorotibial parameters in 1-month-old foals (SR-). In studies 1 and 3, 13 morphologic parameters were measured. Limb directional asymmetry was assessed in 2 age groups (< 7 or ≥ 7 months). RESULTS: Study 1 (SR- group; n = 183 radiographs) showed increased femoral measurements with maturation, except the distal femoral intercondylar notch width (FINwal), which decreased. In contrast, in SR+ stifles (53 radiographs), 3 femoral parameters (MFC width [MFCwpf], MFC height, or FINwal) showed no changes. Tibial plateau width alone increased with maturation in both groups. Interobserver reliability was good to excellent. Study 2 (n = 53 radiographs) confirmed a distal FINw decrease in SR- foals. In study 1, left SR- stifles in greater than or equal to 7-month-old fillies had significantly larger femoral bicondylar width and FINw, while right SR+ stifles in fillies greater than or equal to 7 months had a significantly larger MFCw. In study 3 of 1-month-old foals (n = 94 SR- radiographs), the MFCw, femoral condyle bicondylar width, and lateral femoral condyle height were all greater on the left, whereas the intercondylar intereminence space width was larger on the right. CLINICAL RELEVANCE: In SR+ stifles, the distal femur exhibited divergent maturation, indicating a wider MFC in the right stifle in older foals. As SR lesions are more common on the right, this suggests a potential association with MFC morphology.

Short-term outcomes of 43 dogs treated with arthroscopic suturing for meniscal tears associated with cranial cruciate ligament disease.

OBJECTIVE: To describe short-term outcomes and complications in dogs receiving meniscal suturing and concurrent tibial plateau leveling osteotomy (TPLO) with or without augmentation with an extracapsular suture. STUDY DESIGN: Retrospective case series. ANIMALS: Forty-three client-owned dogs submitted for cruciate ligament disease. METHODS: Dogs were included if meniscal suturing was performed during or after a TPLO procedure. Criteria included an unstable medial meniscus without evidence of a tear, a caudal vertical longitudinal tear with or without displacement, or if a bucket-handle tear was debrided and the remaining rim was unstable. Stifle stabilization was performed by either a standard TPLO or an augmented TPLO (TPLO + internal brace [IB]). Outcome measures included physical examination findings, radiographs, subjective gait examination, Liverpool Osteoarthritis in Dogs (LOAD) scores, and second-look arthroscopy. RESULTS: Forty-four meniscal repairs were performed in 43 dogs. Five types of meniscal tears were treated employing eight suture materials. Complications were documented in 15 cases (34%). The stabilization technique had a significant impact on the outcome (p = .049): TPLO + IB had a 93.3% success rate and the success rate was 71.4% in the TPLO-only group. CONCLUSION: Five types of meniscal pathology were addressed successfully in the study, indicating that currently accepted criteria for meniscal suturing in dogs may be overly conservative. The majority of complications were not related to the meniscal suturing itself and did not compromise the outcome. The stifle stabilization technique had an impact on outcome. CLINICAL SIGNIFICANCE: The authors found arthroscopic meniscal suturing to be practical and successful in this patient population. Postoperative stifle stability had an impact on successful treatment.

Surgical Repair of Psittacine Femorotibial Luxation: A Case Series.

Luxation of the psittacine femorotibial joint most commonly occurs following trauma or as a development abnormality. Historically, this injury is considered to have a poor prognosis in birds; however, surgical management may result in acceptable and functional outcomes. This case series describes the surgical techniques, complications, and outcomes of 7 cases of femorotibial luxation in psittacine birds. Of the 7 cases, 6 were chronic injuries. Surgical repair methods included conjoined intramedullary pinning, transarticular pinning with an external skeletal fixator (ESF), a combination of extracapsular stabilization and ESF, ESF alone, and a combination of conjoined intramedullary pins with an ESF. An acceptable outcome was achieved in 75% (6/8) of luxated femorotibial joints managed with surgical methods. All cases were female birds of various species, suggesting a possible sex predisposition for stifle luxation.

Outcome of surgical correction of medial patellar luxation in dogs weighing less than 10 kg.

BACKGROUND: Various trochleoplasty techniques, including trochlear wedge recession (TWR) and trochlear block recession (TBR), are used to treat dogs with medial patellar luxation (MPL). However, the objective outcomes of these surgical procedures are underreported. METHODS: Medical records were obtained for dogs weighing less than 10 kg that underwent either TWR or TBR and tibial tuberosity transposition to address grade I-III MPL. Long-term (at least 1 year after the last procedure) follow-up included orthopaedic and radiographic examinations, such as osteoarthritis score (OAS), ground reaction force (GRF) analysis and canine brief pain inventory (CBPI). RESULTS: Overall, 20 dogs (26 stifles) were followed up in the long term. Minor postoperative complications, medial patellar reluxation (MPR) and intermittent lameness occurred in 46.15%, 19.23% and 15% of the dogs, respectively. MPR occurred only in TWR-treated stifles, while mean OAS increased in all groups. Using the CBPI, the owners perceived an excellent or very good outcome in 95% of dogs. LIMITATIONS: The limitations of the study include its retrospective observational nature, a lack of randomisation and a small sample size. CONCLUSION: Surgical treatment resulted in a favourable outcome. GRF analysis could detect subtle differences in weight bearing in dogs treated for MPL, which might not be apparent clinically. There might be a higher risk for reluxation for TWR. However, a larger-scale prospective study would be required to find which treatment is superior.

Cadaveric comparison of two techniques for intraoperative placement of tibial plateau levelling osteotomies in dogs.

BACKGROUND: Both tibial tuberosity fractures and deviation from the planned postoperative tibial plateau angle have been associated with poor centring of tibial plateau levelling osteotomies (TPLOs). The aim of this cadaveric study was to compare two techniques for centring the osteotomy and preserving the tibial tuberosity width (TTW). METHODS: Stifle radiographs were obtained from 20 limbs of 10 dogs. TPLO was planned on each stifle, and a two-wire technique (TWT) and a technique using the medial collateral ligament (MCL) as an intraoperative landmark were planned. The techniques were executed and marked with radiopaque pins. Further radiographs were obtained and analysed. RESULTS: On average, TWT resulted in a 20.4% increase in TTW and medial collateral ligament technique (MCLT) resulted in a 13.4% decrease. Expressed as a percentage of the radial saw size, the average error in the centring of the osteotomy arising from the TWT was 13.4% and that from the MCLT was 14.2%. LIMITATIONS: This study had a small sample size and involved a single surgeon. CONCLUSION: Neither technique reliably identified the desired centre of the osteotomy, and both had a similar magnitude of error. MCLT resulted in reduced TTW, while TWT resulted in increased TTW. A reduced TTW has been associated with an increased risk of tibial tuberosity fracture, so MCLT is not recommended for clinical use.

Short-term outcomes of cranial cruciate ligament rupture treated surgically with tibial plateau leveling osteotomy or non-surgically in small-breed dogs weighing less than10 kg.

Cranial cruciate ligament rupture (CCLR) is a common cause of stifle joint pain in dogs. This study assessed the short-term outcomes in the management of CCLR, with or without concurrent medial patellar luxation (MPL), in small-breed dogs, comparing surgical intervention using tibial plateau leveling osteotomy (TPLO) with non-surgical approaches. Dogs weighing less than 10 kg and suffering from CCLR were divided into two groups: surgical and non-surgical (nine stifles per group). Both groups followed the same rehabilitation protocol. Measurements were taken on days 0, 14, 28, 42, 56, 70, and 84. These measurements included the mean difference in orthopedic assessment score (diffOAS) and thigh muscle circumference (TMC) assessed by veterinarians, as well as the Canine Brief Pain Inventory score (CBPI) evaluated by the owners. Six stifles had concurrent MPL in the surgical group and five in the non-surgical group. No significant differences were observed in diffOAS (P=0.685), TMC (P=0.557), CBPI pain severity score (P=0.062), and CBPI pain interference score (P=0.29) between the two groups. However, both groups showed a significant decrease (P<0.05) in diffOAS and CBPI. The TMC remained relatively stable in the non-surgical group (P>0.05), but it significantly increased in the surgical group (P<0.05). Both groups demonstrated improved clinical outcomes in the short term, with no significant differences. However, cautious consideration should be given to a conservative treatment in small-breed dogs, particularly when considering the exclusive improvement observed in TMC within the TPLO group.

Biomechanical effects of cranial closing wedge osteotomy on joint stability in normal canine stifles: an ex vivo study.

BACKGROUND: Cranial closing wedge osteotomy (CCWO) is a functional stabilisation technique for cranial cruciate ligament (CrCL) ruptures. This biomechanical study aimed to evaluate the influence of CCWO on the stability of the stifle joint. Eighteen Beagle stifle joints were divided into two groups: control and CCWO. The stifle joints were analyzed using a six-degree-of-freedom robotic joint biomechanical testing system. The joints were subjected to 30 N in the craniocaudal (CrCd) drawer and proximal compression tests and 1 Nm in the internal-external (IE) rotation test. Each test was performed with an extension position, 135°, and 120° of joint angle. RESULTS: The stifle joints were tested while the CrCLs were intact and then transected. In the drawer test, the CCWO procedure, CrCL transection, and stifle joint flexion increased CrCd displacement. The CCWO procedure and CrCL transection showed an interaction effect. In the compression test, the CCWO procedure decreased and CrCL transection and stifle joint flexion increased displacement. In the IE rotation test, CCWO, CrCL transection, and stifle joint flexion increased the range of motion. CONCLUSIONS: CCWO was expected to provide stability against compressive force but does not contribute to stability in the drawer or rotational tests. In the CCWO-treated stifle joint, instability during the drawer test worsened with CrCL transection. In other words, performing the CCWO procedure when the CrCL function is present is desirable for stabilizing the stifle joint.

Estimation of footprints of the canine stifle ligaments using deformable shape templates of bones.

Knowledge regarding the ligament footprints in the canine stifle is essential for biomechanical modeling of the joint and patient-specific surgical planning for anatomical ligament reconstruction. The present study aimed to establish and evaluate deformable shape templates (DSTs) of the femur and tibia with footprints of the cruciate and collateral ligaments embedded for the noninvasive estimation of ligament footprint positions. To this end, a data set of computed tomography (CT)-derived surface models of the femur and tibia were established and used to build statistical shape models (SSMs). The contours of the stifle ligaments were obtained from CT scans of 27 hindlimb specimens with radio-opaque markings on the ligament footprints. The DST, constructed by embedding averaged footprint contours into the SSM, was used to estimate subject-specific ligament footprints in a leave-one-out cross-validation framework. The DST predictions were compared with those derived from radio-opaque-marked footprints. The results showed that the averaged Euclidean distances between the estimated and reference footprint centroids were less than 1.2 mm for the cruciate ligaments and 2.0 mm for the collateral ligaments. The DST appeared to provide a feasible alternative approach for noninvasively estimating the footprints of the stifle ligaments in vivo.

Delayed Life-Threatening Hemorrhage Caused by Cranial Tibial Artery Pseudoaneurysm in Two Dogs.

Two adult dogs were presented at 25 and 30 days following tibial external skeletal fixator placement (case 1) and tibial plateau leveling osteotomy (case 2), respectively. Clinical signs at presentation for each of them included acute onset lethargy, non-weight-bearing lameness, and hemorrhage at the surgical site with large hematoma formation. On admission, emergency whole blood transfusion was required in case 2 with a preoperative packed cell volume of 13%. Both dogs were diagnosed with pseudoaneurysm of the cranial tibial artery based on color Doppler ultrasonography. Additionally, computed tomography angiography was performed in one dog. Surgical treatment of the dogs included ligation of the cranial tibial artery supplying the pseudoaneurysm and curettage of hematoma. The surgery was completed without complications in case 1, but case 2 experienced inadvertent rupture of pseudoaneurysm with significant blood loss, which required another whole blood transfusion during the procedure. Both dogs had excellent functional recovery with no recurrence of clinical signs. We hypothesized that pseudoaneurysms were primarily caused by trauma secondary to placement of surgical implants or osteotomy. For orthopedic surgeons, it is important to recognize clinical signs of a potential tibial arterial pseudoaneurysm, as early surgical intervention may prevent loss of limb or life.

Effect of intra-articular platelet-rich plasma or hyaluronic acid on limb function recovery in dogs with TPLO for cranial cruciate ligament rupture: a randomised controlled trial.

OBJECTIVES: This study aimed to investigate the recovery of limb function following a single intra-articular injection of platelet-rich plasma or hyaluronic acid in dogs with cranial cruciate ligament rupture treated with tibial plateau levelling osteotomy compared to dogs receiving no injection intraoperatively. MATERIALS AND METHODS: Sixty-two dogs with cranial cruciate ligament rupture, body weights of 20 to 40 kg, and no other orthopaedic conditions were enrolled in this prospective, randomised, double-blind, controlled study at the small animal clinic at LMU Munich. All dogs underwent tibial plateau levelling osteotomy. Based on random allocation, they received either a single intra-articular injection of platelet-rich plasma, hyaluronic acid or no injection intraoperatively. Gait analysis, clinical examinations, radiography of the stifle joint for osteoarthritis progression and two validated owner questionnaires were compared among groups at three timepoints postoperatively (6 weeks, 3 and 6 months). Limb function was primarily assessed by measuring the ground reaction forces. RESULTS: At all times postoperatively, no differences were observed among groups regarding clinical examinations, osteoarthritis score values, ground reaction forces or owner questionnaires. All dogs showed significant improvement in limb function clinically, in all ground reaction forces and in the validated questionnaires. Osteoarthritis progressed minimally during rechecks in all dogs regardless of the additional injection or not. CLINICAL SIGNIFICANCE: All dogs treated with tibial plateau levelling osteotomy for cranial cruciate ligament rupture showed improvements in limb function. No additive effect on faster recovery was demonstrated with the additional intra-articular injection of platelet-rich plasma or hyaluronic acid. Addition of platelet-rich plasma/hyaluronic acid injections during tibial plateau levelling osteotomy is unnecessary considering the lack of benefit observed up to 6 months postoperatively.

Adipocytes in synovial fluid cytology: An approach for diagnosing synovial lipomatosis.

A 2-year-old neutered male bullmastiff dog was presented with chronic left hind limb lameness. Physical examination revealed left stifle effusion and medial buttress without cranial tibial thrust. Radiographs showed joint effusion and new bone formation at the patella apex. Magnetic resonance imaging showed increased synovial fluid, widening of the joint space, abnormal infrapatellar fat body and thinning of the cranial cruciate ligament. Synoviocentesis and cytologic evaluation of synovial fluid revealed marked mononuclear inflammation with abundant fatty tissue, suggesting synovial lipomatosis in conjunction with the imaging findings. The disease was confirmed histologically after sampling the lesion during arthrotomy. Synovial lipomatosis, characterized by extensive synovial adipose tissue proliferation of the synovial membrane, is a rare "tumor-like" disorder that usually affects the stifle. Although the etiology remains unclear, joint trauma, inflammation, instability, and lipid abnormalities have been proposed as causes. Inflammatory factors may promote synoviocyte and adipocyte hyperplasia that perpetuate the process. Surgical removal may be suggested to eliminate triggers and prevent future recurrences. The report provides the first cytological description of adipocytes in synovial fluid associated with the diagnosis of synovial lipomatosis in dogs. This case report underscores the potential effectiveness of cytologic analysis of synovial fluid smears, in combination with magnetic resonance imaging (MRI), for diagnosing this condition and reducing complications associated with arthrotomy for sampling purposes. Additionally, the case highlights that synovial lipomatosis should be considered as a potential differential diagnosis for synovial masses in dogs. Further cases are needed to validate these observations in veterinary medicine.

Evaluation of viscoelastic coagulation monitoring parameters and fibrinogen concentrations in healthy dogs undergoing stifle arthroscopy and tibial plateau leveling osteotomy.

OBJECTIVE: Evaluation of viscoelastic parameters along with Hct percentages, platelet numbers, and fibrinogen concentrations in healthy dogs undergoing elective stifle arthroscopy and tibial plateau leveling osteotomy (TPLO). These results determine if dogs are in a normal, hypocoagulable, or hypercoagulable state at 4 different time points. ANIMALS: Prospective study of 37 client-owned dogs enrolled between February 2, 2022, and November 10, 2022. METHODS: All dogs received a standardized anesthetic protocol. Patients enrolled in the study underwent stifle arthroscopy using a 3-portal technique with a TPLO performed by board-certified surgeons. Viscoelastic testing, Hct percentage, fibrinogen concentration, and platelet numbers were measured preoperatively, immediately postoperatively, 24 hours postoperatively, and 14 days postoperatively. RESULTS: Stifle arthroscopy and TPLO surgery was not associated with significant effects on viscoelastic coagulation monitoring and fibrinogen concentrations in healthy dogs when comparing the time points. CLINICAL RELEVANCE: Humans have a high risk of thrombotic events when undergoing elective orthopedic surgery and are often placed on prophylactic antithrombotic medication prior to surgery. Viscoelastic coagulation monitoring in dogs undergoing similar orthopedic procedures has been evaluated in veterinary medicine, but the effects on platelets and fibrinogen concentrations from similar orthopedic procedures and uniform anesthesia protocols have not been documented. Cranial cruciate ligament insufficiency is the most common orthopedic injury in dogs. Treatment requires elective surgical correction for the best results and improved long-term prognosis. The findings of this study suggest that similar preoperative prophylactic antithrombotic intervention is not needed for canine patients.

TTA-Rapid for treating the canine cruciate deficient stifle: Medium to long-term outcome and analysis of risk factors.

BACKGROUND: This study aimed to evaluate medium to long-term outcomes following treatment of lameness associated with cranial cruciate ligament insufficiency using the tibial tuberosity advancement (TTA)-Rapid technique and to investigate risk factors associated with outcome, including tibial plateau angle (TPA). METHODS: Patient records for cases treated over an 80-month period were examined retrospectively. An owner postal questionnaire using a clinical metrology instrument (Liverpool Osteoarthritis in Dogs) evaluated the outcome at least 6 months after surgery. RESULTS: A total of 149 procedures were carried out in 120 dogs. Questionnaires were received for 64 dogs (53.3%), with a median follow-up time of 37.5 months. Outcome was judged to be satisfactory, based on frequency of lameness, in 63 (98.4%), while satisfactory outcomes were achieved in 61 (95.3%) based on severity of lameness and in 50 (78.1%) based on mobility score. Statistical analysis showed that age, bodyweight, TPA, meniscal injury and concurrent patellar surgery did not influence outcome, but time to follow-up positively correlated with mobility score. LIMITATIONS: This study involved one surgeon in one centre with outcome data based on the completion of an owner questionnaire, although this used a validated clinical metrology instrument. CONCLUSION: TTA-Rapid offers a treatment option for cranial cruciate-deficient stifles with a good medium to long-term outcome, and no risk factors were identified to suggest any limitations to its use.

In Vitro Assessment of Compression Patterns Using Different Methods to Achieve Interfragmentary Compression during Tibial Plateau Levelling Osteotomy.

OBJECTIVES: The aim of this study was to evaluate and characterize different methods to achieve interfragmentary compression during tibial plateau levelling osteotomy (TPLO). STUDY DESIGN: TPLO was performed in 20 canine tibia models (Sawbones, Vashon, Washington, United States) using 3D-printed guides for standardization. Interfragmentary compression was assessed using pressure-sensitive films (Prescale, Fujifilm, Atherstone, United Kingdom). Seven compression methods were tested: (1) Kern bone holding forceps clamping the craniodistal aspect of the TPLO plate to the caudal aspect of the tibia (K); (2) using the distal TPLO plate dynamic compression hole (P); (3) pointed bone reduction forceps engaging the caudal aspect of the proximal bone fragment and the cranial aspect of the tibial crest (F); (4) K + P; (5) K + F; (6) F + P; and (7) K + F + P. Five measurements were obtained for each method, and each bone model was used for two measurements (single method, ± plate). The interfragmentary surface was digitalized and divided into quadrants for standardization and pixel density calculation: Q1, craniomedial; Q2, craniolateral; Q3, caudomedial; and Q4, caudolateral. One-way analysis of variance (ANOVA) and post hoc tests were used for statistical analysis. RESULTS: Mean pressures per quadrant differed significantly between methods (p < 0.001). Methods K, F, and P produced more craniomedial, craniolateral, and caudal compression, respectively. Method K resulted in loss of caudal compression (p < 0.001). Method F + P provided the most even distribution of high interfragmentary compression forces. The addition of method K to this construct (K + F + P) marginally increased cranial compression (p = 0.189 for Q1; p < 0.001 for Q2), but reduced compression caudally (p < 0.001). CONCLUSION: Method F + P provided more even interfragmentary compression. If method K were used, then combined use with method F + P would be recommended.