Effect of screw insertion angle and speed on the incidence of transcortical fracture development in a canine tibial diaphyseal model.

OBJECTIVE: To assess the incidence of transcortical fracture (TCF) development based on screw insertion angle and screw insertion speed. STUDY DESIGN: Cadaveric experimental study. SAMPLE POPULATION: Sixty-six canine tibiae. METHODS: Sixty-six cadaveric tibiae were randomly assigned to one of six groups that varied based on screw insertion angle relative to the pilot hole (0, 5, or 10°) and screw insertion speed (650 or 1350 revolutions per minute [rpm]). Each tibia was mounted in a custom jig. Locking self-tapping screws (3.5 mm) were inserted at varying speeds and insertion angles, based on group assignment. Orthogonal radiographs were evaluated for TCFs. Fisher's exact tests with a Bonferroni correction were performed to evaluate differences in the frequency of TCF between groups. RESULTS: In Group A (0°/650 rpm: control), a 0% TCF rate was observed (n = 0/80). Group B (5°/650 rpm) had a 3.75% TCF rate (n = 3/80). Group C (10°/650 rpm) had a 12.5% TCF rate (n = 10/80). Group D (10°/hand insertion) had a 3.75% TCF rate (n = 3/80). Group E (10°/1350 rpm) had a 17.5% TCF rate (n = 14/80). Group F (0°/1350 rpm) had a 0% TCF rate (n = 0/80). Groups C and E had the highest TCF rates with a difference in TCF rates observed between the control group and Group C (p = .001) and between the control group and Group E (p < .001). CONCLUSION: Increased screw insertion angle and insertion speed appear to be predisposing factors for TCF development in cadaveric bone. CLINICAL SIGNIFICANCE: Ensuring screw insertion is coaxial with the pilot hole and using slower screw insertion speeds may help reduce the risk of TCF development.

The effect of two platelet-rich plasma aspiration techniques on plasma cellular concentrations using a double syringe gravitational centrifugation system.

OBJECTIVE: To identify which aspiration technique increased plasma platelet concentration and which technique minimized plasma leukocyte and erythrocyte concentrations using a gravitational double-syringe platelet rich plasma (PRP) system. STUDY DESIGN: Controlled laboratory study. ANIMALS: Thirty adult dogs. METHODS: Whole blood was collected into two autologous conditioned plasma (ACP) syringes and an ethylenediaminetetraacetic acid (EDTA tube) (control samples). The ACP syringes were centrifuged for 5 min at 1500 rpm. The proximal 2 mL of plasma from one ACP syringe was deposited in an EDTA tube (preflash samples). Plasma from the second ACP syringe was withdrawn until the buffy coat was pierced, producing a "flash" of red blood cells, agitated and deposited into an EDTA tube (flash samples). Complete blood counts were performed. RESULTS: Mean plasma platelet concentrations of the control, preflash, and flash samples were 2.4 × 105 /dL, 3.3 × 105 /dL and 4.1 × 105 /dL, respectively. The mean platelet concentration of the flash samples was 7.9 × 104 /dL higher than the preflash samples (p = .005). The mean platelet concentration was lower in the control samples than the preflash (p = .002) and flash (p < .0001) samples. The median plasma leukocyte concentration of the preflash samples (0/dL) was lower than in the flash samples (2.4 × 103 /dL) (p = .001). The median plasma hematocrit value of the preflash samples (0%) was lower than in the flash samples (1.0%) (p = .002). CONCLUSION: The flash method is not necessary to produce a PRP sample. CLINICAL SIGNIFICANCE: Both methods produced PRP. However, clinicians should avoid aspirating the buffy coat when processing PRP for therapies where leukocytes and erythrocytes are contraindicated.

The effect of grip location on Kirschner wire bend characteristics: An in vitro study.

OBJECTIVE: To determine the effect of Kirschner wire (K-wire) grip location on bend angle, bend radius, and torque when performing a Z-bend technique. STUDY DESIGN: Experimental study. SAMPLE POPULATION: Ten samples at each of five grip locations for each of three K-wire diameters. METHODS: K-wires of three diameters (0.9, 1.1, 1.6 mm) were drilled into PVC pipe, and a Jacob's chuck was used to bend the wires at five periodic grip locations (distance from the bone model). Torque, bend angle, and bend radius were determined for each sample. Outcome variables were statistically analyzed by grip location to determine significant relationships. RESULTS: A grip location of 2.0 cm in the 0.9 mm K-wire group minimized bend angle (mean ± SD: 75.92° ± 0.81) and bend radius (2.89 mm ± 0.08). A grip location of 3.0 cm in the 1.1 mm K-wire group minimized bend angle (72.88° ± 0.98) and bend radius (2.47 mm ± 0.20). A grip location of 3.0 cm minimized bend angle (74.38° ± 1.93) and bend radius (2.71 mm ± 0.27) in the 1.6 mm K-wire group. Torque at these grip locations for the 0.9, 1.1, and 1.6 mm K-wires was 6.50 N-m ± 0.0, 11.00 N-m ± 0.0, and 19.05 N-m ± 0.16, respectively. CONCLUSION: Bend angle and bend radius can be minimized by bending K-wires at specific grip locations, though torque is not minimized at these locations. Clinical significance These findings provide an evidence-based recommendation of where surgeons should grip K-wires when bending them.

Evaluation of the clinical value of routine radiographic examination during convalescence for tibial plateau-leveling osteotomy.

OBJECTIVE: To determine how frequently routine follow-up radiographic findings would result in a change to the postoperative plan following tibial plateau-leveling osteotomy (TPLO) in dogs. STUDY DESIGN: Retrospective study SAMPLE POPULATION: Short-term group: 100 cases; intermediate-term group: 50 cases. METHODS: Medical records of 100 consecutive cases meeting the inclusion criteria were reviewed (the short-term group). The cases had no owner-perceived issues and underwent routinely prescribed radiographic follow up between 40 and 60 postoperative days after TPLO performed by one experienced surgeon. Complications identified on physical examination (PE) and radiographic examination (RE) were recorded, along with any changes to the postoperative plan. Medical records of 50 consecutive cases that had short-term and intermediate-term (≥180 days) REs and PEs were reviewed similarly (intermediate-term group). RESULTS: Fifty-one cases in the short-term group had no complications on PE or RE. Forty-nine dogs were diagnosed with minor complications (patellar ligament desmitis, patella or fibula fracture, gait abnormalities): 42 on RE only; 6 on PE and RE; 1 on PE only. Exercise restriction was extended for 2 weeks in 2 cases with radiographic patellar ligament desmitis. Two cases in the intermediate-term group had minor complications at intermediate-term RE. No new PE or RE complications developed between short-term and intermediate-term evaluations. CONCLUSION: At routine rechecks of dogs with no owner-perceived issues after TPLO, 49% had minor complications but only 2% were deemed significant enough to alter patient management. The likelihood of new radiographic complications developing after short-term evaluation is low. CLINICAL SIGNIFICANCE: Routine radiographic recheck examinations rarely altered the postoperative plan in TPLO cases with unremarkable clinical recoveries.

Evaluation of the risk of patella fracture as the result of decreasing tibial plateau angle following tibial plateau leveling osteotomy.

OBJECTIVE: To evaluate the effect of postoperative tibial plateau angle (TPA) following tibial plateau leveling osteotomy (TPLO) on the risk of patella fracture during the convalescent period. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Fracture group: 20 stifles; reference group: 65 stifles. METHODS: Medical records were reviewed for stifles with patellar fractures after a TPLO procedure (fracture group) and stifles with >180 days radiographic examination with no complications following TPLO (reference group). Stifle radiographs were masked to group and final TPA (fTPA) was measured, at the time of fracture diagnosis (fracture group) and at last follow-up (reference group), using PACS software. TPAs in the fracture and reference groups were compared using the Wilcoxon rank-sum test. Statistical significance was set at .05. RESULTS: Patellar fractures were diagnosed at a median of 69 days (range 31-189) after surgery. The median duration of follow-up time for the reference group was 471 days (range 180-1868). Median fTPA for the fracture group was 1.4° (range [-10.3]-7.1). Median fTPA for the reference group was 4.1° (range [-3.9]-14.1). The odds of patellar fractures increased by 21.7% (95% CI: 8.6%-35.6%) for every 1° decrease in fTPA. CONCLUSION: The risk of patella fractures increased as TPAs after TPLOs decreased. CLINICAL SIGNIFICANCE: Care should be taken to avoid excessive rotation during TPLO to decrease the likelihood of postoperative patellar fractures.

Evaluation of a Fixed-Angle Wedge Osteotomy Guide.

OBJECTIVE: The aim of this study was to evaluate a fixed-angle cutting guide designed to aid in the performance of coplanar wedge osteotomies using a proximal tibial cranial closing wedge ostectomy model. STUDY DESIGN: A 30-degree cranial closing wedge ostectomy was created using canine tibia models with either a standard template (method T) or a wedge osteotomy guide (method G) by two surgeons. One surgeon was experienced with both procedures, and one surgeon had no previous experience with the wedge guide. The ostectomy wedges were evaluated for wedge angle, using a digital protractor, and coplanarity by using digital photographs and screen-measuring software. RESULTS: The mean (standard deviation) wedge angles of the T and G groups were 28.16 (1.33) and 28.4 degrees (1.46) respectively. The mean (standard deviation) divergence angles of the T and G groups were 3.21 (1.86) and 2.22 degrees (1.69) respectively. The measured reference angles of the template and cut guides were 31.27 and 29.60 degrees respectively. Individual and cross-surgeon analysis of outcomes found no significant differences when comparing wedge angle or coplanarity with either method regardless of surgeon experience. However, mean wedge angle of group G was significantly closer to the measured reference angles than group T (p < 0.01). CONCLUSION: Use of a fixed-angle surgical wedge guide was successful in consistently producing accurate closing wedge ostectomies regardless of surgeon experience. These results show that use of the guide is a valid method for performing wedge ostectomies.

The effect of extracorporeal shockwave on liposomal bupivacaine in a tibial plateau leveling osteotomy model.

OBJECTIVE: To determine the effect of extracorporeal shock wave (ESWT) on liposomal bupivacaine in a tibial-plateau-leveling osteotomy model. STUDY DESIGN: In vitro study. SAMPLE POPULATION: Ten samples per group. METHODS: In addition to a control group (sham treatment), five treatment groups were defined as A, energy (E) 3 (0.22 mJ/mm2 ), 360 pulses per minute (p/m); B, E6 (0.29 mJ/mm2 ), 360 p/m; C, E8 (0.39 mJ/mm2 ), 360 p/m; D, E6, 480 p/m; E, E8 480 p/m. Two-milliliter aliquots of liposomal bupivacaine were placed in a gelatin chamber and treated with 1000 pulses according to group. All samples remained in the chamber for 170 seconds to reflect the longest treatment group. Free bupivacaine concentrations were determined after treatment with high-performance liquid chromatography. RESULTS: The median free bupivacaine concentration was reported as control, 1.90 mg/mL; A, 2.10 mg/mL; B, 2.03 mg/mL; C, 2.94 mg/mL; D, 2.71 mg/mL; E, 4.35 mg/mL. Groups C (P = .027), D (P = .034), and E (P = .002) were different from the control group. Groups C (P = .0025) and D (P = .0025) were different from group E. Additional intertreatment group differences were found. CONCLUSION: Extracorporeal shock wave therapy caused a dose-dependent release of bupivacaine; however, there was no significant release of bupivacaine from liposomes when ESWT was applied at currently recommended therapeutic settings in this model. CLINICAL SIGNIFICANCE: This in vitro study provides evidence that concurrent electrohydraulic ESWT and liposomal bupivacaine is likely safe at currently recommended settings, however, higher energy and pulse frequency settings should be avoided.

Brucella canis sacroiliitis and discospondylitis in a dog.

A 1.5-year-old neutered male Labrador retriever dog was presented with a 1-month history of pelvic limb lameness. Physical examination revealed lumbosacral and pelvic pain. Diagnostic imaging findings were consistent with discospondylitis and bilateral sacroiliitis. Brucellosis was definitively diagnosed with rapid slide agglutination (RSAT) and agar gel immunodiffusion (AGID) tests. Brucella canis has not been associated with sacroiliitis and should be included as a differential diagnosis for dogs presented with clinical or radiographic signs of sacroiliitis.

Sacro-iliite et discospondylite à Brucella canis chez un chien. Un chien mâle castré de race Labrador âgé de 1,5 ans fut présenté avec une histoire de boiterie du membre pelvien ayant débuté 1 mois plus tôt. L'examen physique révéla une douleur lombo-sacrée et pelvienne. Les trouvailles d'imagerie étaient cohérentes avec une discospondylite et une sacro-iliite bilatérale. La brucellose fut diagnostiquée de manière définitive par un test d'agglutination rapide sur lame (RSAT) et un test d'immunodiffusion en gel (AGID). Brucella canis n'a pas été associé avec une sacro-iliite et devrait être inclus dans le diagnostic différentiel de chiens présentant des signes cliniques ou radiographiques de sacro-iliite.(Traduit par Dr Serge Messier).

Use of an amikacin-infused collagen sponge concurrent with implant removal for treatment of tibial plateau leveling osteotomy surgical site infection in 31 cases.

OBJECTIVE: To report the use and long-term outcome of dogs with surgical site infection (SSI) after tibial plateau leveling osteotomy (TPO), treated with an amikacin-infused collagen sponge and implant removal. STUDY DESIGN: Retrospective study. ANIMALS: Thirty-one client-owned dogs. METHODS: Medical records were reviewed for dogs with SSI after a TPLO that were treated with surgical implant removal and concurrent implantation of an amikacin-infused collagen sponge. Relevant clinical and surgical data were recorded. The TPLO implants were routinely removed; the surgical site was swabbed for culture. The sponge was aseptically infused with amikacin prior to implantation. Postprocedure examinations consisted of visual inspection of the incision by the surgeon and lameness scoring. RESULTS: Thirty-one dogs met all inclusion criteria. Median follow-up time was 687 days. Short-term examination after implant removal and sponge implantation revealed uneventful incisional healing in 24 dogs. Six (19.4%) dogs exhibited inflamed incision sites a median of 4 days (range, 3-9) postoperatively that resolved without additional treatment. One (3.2%) dog required empirical antibiotic treatment 7 days postoperatively but was lost to long-term follow-up. Long-term follow-up examination revealed no clinical evidence of SSI recurrence and no lameness in the remaining 30 cases. CONCLUSION: Surgical implant removal and implantation of an absorbable collagen sponge infused with amikacin alone was an effective treatment for postoperative TPLO SSI. CLINICAL SIGNIFICANCE: This procedure had a 96.8% long-term resolution of SSI. It should be considered as a treatment option for TPLO SSI.

SURGICAL MANAGEMENT OF APPENDICULAR LONG-BONE FRACTURES IN FREE-RANGING FLORIDA PANTHERS ( PUMA CONCOLOR CORYI): SIX CASES (2000-2014).

The clinical outcomes of six free-ranging Florida panthers ( Puma concolor coryi) that underwent surgical stabilization of appendicular long-bone fractures (three femoral fractures, one tibial and one tibial and fibular fracture and two radial and ulnar fractures) were evaluated. These panthers presented to the University of Florida from 2000-2014. Estimated age of the panthers ranged from 0.5 to 4.5 yr, and weights ranged from 22 to 65 kg. Causes of injuries were vehicular collision ( n = 4) and capture related ( n = 2). All panthers underwent open reduction and fracture stabilization. Fixation failure necessitated three subsequent surgeries in one panther. Five panthers survived the immediate postoperative period, and all of these panthers' fractures obtained radiographic union (range, 8-36 [mean, 22] wk). The five surviving panthers underwent convalescence for 7-14 mo at White Oak Conservation Center before being released back into the wild; however, one panther was killed when hit by a car 3 days after release. The remaining four panthers were tracked for up to 106 mo in the wild and successfully integrated back into the native population. Surgical stabilization of appendicular long-bone fractures in free-ranging Florida panthers can be successful, but must take into account the stress that a large, undomesticated felid will place on the stabilized limb during convalescence as well as the difficulties involved in rehabilitating a wild panther in captivity.

Modified cranial closing wedge osteotomy for treatment of cranial cruciate ligament insufficiency in dogs with excessive tibial plateau angles: Technique and complications in 19 cases.

OBJECTIVE: To describe short-term outcomes of a modified cranial closing wedge osteotomy (CCWO) for treatment of dogs with cranial cruciate ligament disease and excessive tibial plateau angle (eTPA). STUDY DESIGN: Retrospective clinical study. ANIMALS: 18 client-owned dogs (19 stifles) with cranial cruciate ligament disease and eTPA (>34°). METHODS: A modified CCWO was performed with Kirschner wires as osteotomy alignment aids. A juxta-articular neutral wedge osteotomy equal in angle to the preoperative TPA was performed. Fixation was achieved with a tibial plateau leveling osteotomy (TPLO) plate and tension band wire apparatus (89%) or a TPLO plate (11%). Preoperative and postoperative, and recheck TPA, cranial tibial long axis shift, and major and minor complications were recorded. RESULTS: The mean preoperative TPA (49.5° ± 6.7°) was reduced postoperatively (8.3° ± 4.8°). Four of 19 joints (21%) developed 2 major and 3 minor complications during the intraoperative and follow-up period (577 day mean in-hospital recheck). Two cases were diagnosed with surgical site infections requiring implant removal for resolution. Fixation failure or implant complications were not observed in any dog during the limited radiographic follow-up period. All dogs were sound or recovering as expected, with 15/19 dogs (79%) showing complete radiographic osteotomy healing at their final in-hospital follow-up examination. CONCLUSION: Modified CCWO should be considered for the treatment of cranial cruciate ligament disease in dogs with eTPA. In this case series, the described technique was associated with uneventful osteotomy healing without implant failures in all dogs, although radiographic follow-up was limited in some cases.

Closed reduction and fluoroscopic-assisted percutaneous pinning of 42 physeal fractures in 37 dogs and 4 cats.

OBJECTIVE: To report complications and clinical outcome of dogs and cats that underwent fluoroscopic-assisted percutaneous pinning (FAPP) of physeal fractures. STUDY DESIGN: Retrospective study. ANIMALS: Client-owned dogs (n = 37) and cats (n = 4). MATERIALS AND METHODS: Records (August 2007-August 2014) of physeal fractures treated with FAPP in 3 hospitals were evaluated. Data collected included signalment, fracture characteristics (etiology, location, duration, Salter-Harris classification, preoperative and postoperative displacement), surgical information (implant size, surgical duration), and outcome assessment information (functional outcome, radiographic outcome, and complications). RESULTS: The majority of animals (92%) were classified as full functional outcome. No significant predictors of functional outcome were identified. The overall complication rate was 15% (n = 6). Elective pin removal rate was 41% (n = 17). Goniometry and limb circumference measurements of the affected and contralateral limbs were not significantly different in dogs for which measurements were obtained. Seventeen of 18 animals (16 dogs, 2 cats) measured had bone length changes on follow-up radiographs. CONCLUSION: FAPP is associated with an excellent functional outcome in a narrow selection of fracture configurations, specifically those with minimal displacement and for which anatomical alignment can be achieved with closed reduction.

Clinical outcomes associated with the initial use of the Canine Unicompartmental Elbow (CUE) Arthroplasty System(®).

We evaluated mid- to long-term outcomes with respect to function and complications in dogs undergoing canine unicompartmental elbow (CUE) arthroplasty for treatment of medial compartment disease of the elbow. This prospective multicenter case series is the first group of clinical cases to receive CUE arthroplasty. Cases (each elbow that underwent CUE performed by a participating surgeon) were enrolled into an electronic database and prospectively followed to determine and record all associated complications, as well as functional outcomes. There were 103 cases from 18 surgeons. Final follow-up time ranged from 6 to 47 mo with a mean and median of 10 mo. Canine unicompartmental elbow was associated with 1 catastrophic (1%), 11 major (10.7%), and 28 minor (27.2%) complications. Outcomes following CUE were reported as full function in 49 cases (47.6%), acceptable function in 45 cases (43.7%), and unacceptable function in 9 cases (8.7%). We conclude that CUE arthroplasty is an appropriate consideration for treatment of medial compartment disease of the elbow in dogs.

Résultats cliniques associés à l'utilisation initiale du système d'arthroplastieCanine Unicompartmental Elbow (CUE) Arthroplasty SystemMD. Nous avons évalué les résultats à long et à moyen terme relativement à la fonction et aux complications chez les chiens subissant une arthroplastie du coude unicompartimental canin (CUC) pour le traitement de la maladie compartimentale médiale du coude. Cette série prospective de cas multicentres représente le premier groupe de cas cliniques à recevoir une arthroplastie CUC. Les cas (chaque coude qui a subi une CUC réalisée par un chirurgien participant) étaient inscrits dans une base de données électroniques et suivis de manière prospective afin de déterminer et de consigner toutes les complications connexes ainsi que les résultats fonctionnels. Il y avait 103 cas provenant de 18 chirurgiens. Le temps de suivi final s'échelonnait de 6 à 47 mois avec une moyenne et une médiane de 10 mois. Le coude compartimental canin a été associé à 1 complication catastrophique (1 %), à 11 complications majeures (10,7 %) et à 28 complications mineures (27,2 %). Les résultats après l'arthroplastie CUC ont été signalés comme une fonction complète dans 49 cas (47,6 %), une fonction acceptable dans 45 cas (43,7 %) et une fonction inacceptable dans 9 cas (8,7 %). Nous avons conclu que l'arthroplastie CUC est une considération appropriée pour le traitement de la maladie compartimentale médiale du coude chez les chiens.(Traduit par Isabelle Vallières).

Axial stiffness and ring deformation of complete and incomplete single ring circular external skeletal fixator constructs.

OBJECTIVE: To compare the axial stiffness, maximum axial displacement, and ring deformation during axial loading of single complete and incomplete circular (ring) external skeletal fixator constructs. SAMPLE: 32 groups of single ring constructs (5 constructs/group). PROCEDURES: Single ring constructs assembled with 2 divergent 1.6-mm-diameter Kirschner wires were used to stabilize a 60-mm-long segment of 16-mm-diameter acetyl resin rod. Construct variables included ring type (complete or incomplete), ring diameter (50, 66, 84, or 118 mm), and fixation wire tension (0, 30, 60, or 90 kg). Axial loading was performed with a materials testing system. Construct secant stiffness and maximum displacement were calculated from the load-displacement curves generated for each construct. Ring deformation was calculated by comparing ring diameter during and after construct loading to ring diameter prior to testing. RESULTS: Complete ring constructs had greater axial stiffness than did the 66-, 84-, and 118-mm-diameter incomplete ring constructs. As fixation wire tension increased, construct stiffness increased in the 66-, 84-, and 118-mm-diameter incomplete ring constructs. Maximum axial displacement decreased with increasing fixation wire tension, and complete ring constructs allowed less displacement than did incomplete ring constructs. Incomplete rings were deformed by wire tensioning and construct loading. CONCLUSIONS AND CLINICAL RELEVANCE: Mechanical performance of the 66-, 84-, and 118-mm-diameter incomplete ring constructs improved when wire tension was applied, but these constructs were not as stiff as and allowed greater displacement than did complete ring constructs of comparable diameter. For clinical practice, tensioning the wires placed on 84- and 118-mm-diameter incomplete rings to 60 kg is recommended.

A biomechanical comparison of three hybrid linear-circular external fixator constructs.

OBJECTIVE: To evaluate the stiffness, displacement, ring deformation and bone model motion of 3 configuations of linear-circular hybrid fixator constructs loaded in axial compression, craniocaudal and mediolateral bending, and torsion. STUDY DESIGN: Biomechanical evaluation. SAMPLE POPULATION: Three hybrid construct configurations with 8 replicates/configuration. METHODS: Construct Ia used a single, 84 mm, incomplete ring and 2 tensioned olive wires to stabilize 1 bone segment and a primary hybrid rod with 3 fixation pins to stabilize the other bone segment. Constructs Ia(d) and Ib were similar to Ia with the addition of a secondary diagonal hybrid rod. Construct Ib had a fixation pin inserted orthogonally from the diagonal rod. Constructs were loaded for 10 cycles in each mode of loading using a materials testing machine. Ring deformation was assessed by obtaining serial ring measurements. Bone model motion at the fracture gap as a result of loading was also calculated. RESULTS: Axial compression: constructs Ia(d) and Ib were significantly stiffer than construct Ia. Craniocaudal bending: Construct Ib was significantly stiffer than construct Ia. Mediolateral bending: there were no significant differences between constructs. Torsion: Construct Ib was significantly stiffer than constructs Ia and Ia(d) . Permanent ring deformation did not occur. Bone model translational motion decreased in constructs Ia(d) and Ib compared to construct Ia. CONCLUSIONS: Addition of a secondary hybrid rod as well as biplanar fixation pin placement improved construct stiffness in several loading modes.

The effect of shock wave therapy on patellar ligament desmitis after tibial plateau leveling osteotomy.

OBJECTIVE: To determine if shock wave therapy (SWT) after tibial plateau leveling osteotomy (TPLO) has a beneficial effect on patellar ligament inflammation assessed by thickening of the ligament and ligament fiber disruption. STUDY DESIGN: Prospective, randomized, controlled clinical trial. ANIMALS: Dogs (n = 30). MATERIALS AND METHODS: Dogs that had TPLO (July 1, 2009 to June 1, 2010) were enrolled. The affected stifle was examined by radiographs and ultrasonography preoperatively and 4, 6, and 8 weeks after TPLO. At 4 and 6 weeks, dogs in the treatment group were briefly anesthetized and treated with SWT. Patellar ligament thickness on a lateral radiographic projection was measured at 1/4, 1/2, 3/4 of the distance from origin to insertion. Ultrasound images were evaluated for patellar ligament disruption and periligament edema. RESULTS: There was significant difference in thickness (P = .0264) only at the distal point; therefore, only this point was used to measure difference between the control and treatment groups. A significant difference between groups was reached at 6 and 8 weeks (P = .0059 and P = .0095, respectively) postoperatively. No significant ultrasonographic differences were found. CONCLUSION: Based on these results, SWT decreases the radiographic signs of patellar ligament desmitis.

Evaluation of the effects of dietary supplementation with fish oil omega-3 fatty acids on weight bearing in dogs with osteoarthritis.

OBJECTIVE: To evaluate the effects of a food supplemented with fish oil omega-3 fatty acids on weight bearing in dogs with osteoarthritis. DESIGN: Randomized, double-blinded, controlled clinical trial. ANIMALS: 38 client-owned dogs with osteoarthritis examined at 2 university veterinary clinics. PROCEDURES: Dogs were randomly assigned to receive a typical commercial food (n = 16) or a test food (22) containing 3.5% fish oil omega-3 fatty acids. On day 0 (before the trial began) and days 45 and 90 after the trial began, investigators conducted orthopedic evaluations and force-plate analyses of the most severely affected limb of each dog, and owners completed questionnaires to characterize their dogs' arthritis signs. RESULTS: The change in mean peak vertical force between days 90 and 0 was significant for the test-food group (5.6%) but not for the control-food group (0.4%). Improvement in peak vertical force values was evident in 82% of the dogs in the test-food group, compared with 38% of the dogs in the control-food group. In addition, according to investigators' subjective evaluations, dogs fed the test food had significant improvements in lameness and weight bearing on day 90, compared with measurements obtained on day 0. CONCLUSIONS AND CLINICAL RELEVANCE: At least in the short term, dietary supplementation with fish oil omega-3 fatty acids resulted in an improvement in weight bearing in dogs with osteoarthritis.

Closed fluoroscopic-assisted spinal arch external skeletal fixation for the stabilization of vertebral column injuries in five dogs.

OBJECTIVE: To evaluate outcome after closed fluoroscopic-assisted application of spinal arch external skeletal fixators in dogs with vertebral column injuries. STUDY DESIGN: Retrospective case series. ANIMALS: Dogs with traumatic vertebral column injuries (n=5). METHODS: Medical records of dogs with vertebral column fractures and/or luxations stabilized with spinal arch external skeletal fixator frames applied using a closed fluoroscopic-assisted technique were reviewed. Owners were contacted to obtain long-term clinical outcomes. RESULTS: Five dogs (age range, 6-72 months; weight, 10-54 kg) had traumatic vertebral column injuries stabilized with spinal arch external skeletal fixators applied in closed fashion. Injuries involved vertebral segments of the thoracolumbar junction, lumbar spine, and lumbosacral junction. Immediately postoperatively, 4 dogs had anatomic alignment of their vertebral fracture/luxation; 1 dog had 1 mm of vertebral canal height compromise. Time to fixator removal ranged from 65 to 282 days (141+/-87 days). All dogs had regained satisfactory neurologic function by 3 months. At long-term follow-up (range, 282-780 days; mean 445+/-190 days) all dogs were judged to have good to excellent return of function by their owners. CONCLUSION: Successful closed fluoroscopic-assisted application of external skeletal fixators using spinal arches provided satisfactory reduction with few complications in 5 dogs. Return to function was judged to be good to excellent in all dogs at long-term evaluation. CLINICAL RELEVANCE: Closed fluoroscopic-assisted application of ESF using spinal arches provided satisfactory reduction and effective stabilization of spinal fractures with few complications and should be considered as a treatment approach.

Change in tibial plateau angle after tibial plateau leveling osteotomy in dogs.

OBJECTIVE: To determine the change in tibial plateau angle (TPA) during healing after tibial plateau leveling osteotomy (TPLO) performed for cranial cruciate ligament insufficiency in dogs and to examine factors that may be associated with the change. STUDY DESIGN: Retrospective study. STUDY POPULATION: One hundred and forty-nine canine stifles after TPLO procedure. METHODS: Records of dogs that had TPLO were reviewed. Patient age, weight, sex, breed, pre- and postoperative TPA, recheck TPA, time to recheck, type of implant used, and radiographic evidence of healing were analyzed. RESULTS: Mean time to recheck evaluation was 46 days (range, 28-65 days). Mean difference between immediate postoperative and recheck TPA measurements was 1.5 degrees (range, -3 to 9 degrees). Recheck TPA was a significantly greater (numerically higher) than immediate postoperative TPA (P<.0001). There was no significant effect of patient weight, type of plate used, or healing status of the osteotomy at the time of recheck. No correlation between pre- or postoperative TPA angles and change in TPA angle was detected. CONCLUSIONS: TPA changes during osteotomy healing after TPLO, but factors influencing this change were not identified. CLINICAL RELEVANCE: TPA may increase during healing after TPLO despite apparently adequate osteotomy fixation. The clinical relevance of this increase is unknown but is likely minimal.