Dome trochleoplasty for correction of patella alta and patella luxation in dogs > 20 kg.

OBJECTIVE: To describe the dome trochleoplasty procedure and report the short-term outcomes and complications associated with a novel technique to correct patellar luxation and patella alta. ANIMALS: 13 dogs (16 stifle joints) diagnosed with medial patellar luxation with concurrent patella alta in dogs > 20 kg. CLINICAL PRESENTATION: Medical records of dogs weighing > 20 kg that underwent a dome trochleoplasty for correction of a medial luxating patella were prospectively evaluated. The procedure described involves an osteotomy of the femoral trochlea, which is then translated and/or rotated to correct patellar luxation. Clinical results were assessed using subjective lameness scoring, radiographic evaluation, and the Canine Brief Pain Inventory (CBPI) tool. RESULTS: 16 stifle joints were included in this study. The overall complication rate was 50%. Major complications occurred in 43.8% of stifle joints due to pin migration and recurrent luxation of the patella. One dog experienced a catastrophic complication 4 months postoperatively. Uncomplicated osteotomy healing was present in 94% of dogs. The median initial lameness score was 2 (mean, 1.81; range, 0 to 4) and at the final recheck was 0 (mean, 0.31; range, 0 to 2). The CBPI scores were available for 50% of stifle joints. The median initial CBPI score was 45.5 (mean, 48.8; range, 32 to 74) and at the final recheck was 17.5 (mean, 20.5; range, 0 to 43). CLINICAL RELEVANCE: The dome trochleoplasty procedure offers an alternative technique for surgical correction of patellar luxation secondary to patella alta in large-breed dogs, but due to its higher complication and reluxation rates, it should be used cautiously and probably in combination with other corrective procedures, such as tibial tuberosity transposition, soft tissue imbrication, and/or soft tissue release rather than as a stand-alone procedure.

Single high-dose radiation therapy and liquid fiducial markers can be used in dogs with incompletely resected soft tissue sarcomas.

OBJECTIVE: To evaluate the outcome and effects of single high-dose radiation therapy with the aid of liquid fiducial markers in dogs following resection of soft tissue sarcomas (STSs). ANIMALS: 36 client-owned dogs. METHODS: Dogs with a histologic diagnosis of a grade II or III STS that underwent liquid fiducial guided single fraction, 20-Gy stereotactic radiation therapy following surgical excision of an STS between May 2017 and March 2019 were prospectively enrolled in this study. Data collected from the medical records included patient signalment, tumor-related information, treatment details, and outcome. Kaplan-Meier survival analysis was performed for overall survival time (OST) and disease-free interval (DFI). The median OST and DFI were not reached, so restricted mean OST and DFI were also calculated. RESULTS: 36 dogs were included in the study. All dogs underwent radiation therapy a mean of 36.1 days (range, 20 to 59 days) after surgery. Acute and delayed radiation toxicity effects occurred in 80.5% and 36.1% of dogs, respectively, all of which affected the skin. Tumor recurrence was noted in 24.3% of dogs with a median time to recurrence of 272 days (range, 14 to 843 days). The restricted mean OST was 1,556 days (range, 1,383 to 1,728 days) and restricted mean DFI was 1,330 days (range, 1,101 to 1,559 days). CLINICAL RELEVANCE: The results of this study showed that administering a single 20-Gy fraction of radiation in combination with a liquid fiducial marker to treat marginally or incompletely resected STS in the absence of gross disease resulted in similar OST and DFI compared to other previously reported radiation protocols.