Case factors for selection of femoral component type in canine hip arthroplasty using a modular system.

OBJECTIVE: To describe a femoral stem selection process based on case features in dogs treated with total hip replacement (THR) by an expert surgeon, compare complications between implant types, and develop an algorithm for stem type selection. STUDY DESIGN: Retrospective study. ANIMALS: 128 dogs, 135 THR. METHODS: Data collected included breed, age, weight, canal flare index (CFI), and implant type: cementless (BFX), cementless with a collared stem (BFX-C), hybrid (cementless acetabular component with cemented stem), and cemented (CFX). RESULTS: Of the 135 THRs, 69 BFX, 47 hybrid, and 18 BFX-C were performed. Dogs receiving hybrid (mean 5.5 years) were older than those receiving BFX (2.5 years, p < .0001) and BFX-C implants (2.5 years, p = .0014). The mean weights of dogs with hybrid, BFX, and BFX-C implants were 40.0, 31.0, and 35.3 kg, respectively, with dogs receiving hybrid heavier than those receiving BFX (p < .0001). Mean CFI for hybrid (1.52) was lower than for BFX (1.79, p < .0001) and BFX-C (1.76, p = .0021). Total complication rate was 14.0% with catastrophic complications in 1.5% and no association between implant type and risk of complications (p = .36). Femur fractures occurred in 2.9% of all cases and 1.1% of cementless THR cases. CONCLUSIONS: Dogs receiving hybrid THR were older with lower CFI than dogs receiving BFX and BFX-C and heavier than dogs receiving BFX. There was no difference in complications between groups. Catastrophic complications and femur fractures occurred less frequently compared to recent studies of BFX THR. CLINICAL SIGNIFICANCE: Careful preoperative assessment and implant selection can reduce complications of canine THR.

Effects of low-intensity pulsed ultrasound on radiographic healing of tibial plateau leveling osteotomies in dogs: a prospective, randomized, double-blinded study.

OBJECTIVE: To determine the influence of low-intensity pulsed ultrasound (LIPUS) on radiographic healing and limb function after uncomplicated, stable osteotomies in dogs. STUDY DESIGN: In vivo, prospective, randomized, double-blinded, placebo-control study. SAMPLE POPULATION: Fifty client-owned dogs. METHODS: Fifty client-owned dogs with naturally occurring unilateral cranial cruciate ligament rupture were enrolled prior to tibial plateau leveling osteotomy. Dogs were assigned to an active (LIPUS) treatment group or a placebo control (SHAM) treatment group via block randomization on the basis of age, weight, and affected limb. Dogs in the LIPUS treatment group underwent LIPUS treatments for 20 minutes daily: 1.5-MHZ ultrasound wave pulsed at 1 kHZ with a 20% duty cycle at an intensity of 30 mW/cm2 for the duration of the study (12 weeks). Radiographic evaluation was performed at 4, 8, 10, and 12 weeks postoperatively to evaluate bone healing. Limb function was assessed with temporal-spatial gait analysis preoperatively and at 4, 8, and 12 weeks postoperatively by using a pressure-sensitive walkway system. RESULTS: Both groups had significant improvement in radiographic score and limb use over time. However, there was no significant difference in radiographic bone healing, or limb use as measured by objective gait analysis detected between the LIPUS treatment group and SHAM treatment group at any point in the study. CONCLUSION: LIPUS treatment did not improve healing in this stable osteotomy model. CLINICAL SIGNIFICANCE: This study does not provide evidence to support the clinical application of LIPUS to stimulate the healing of stable, uncomplicated osteotomies to accelerate bone healing.

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).

Hip toggle stabilization using the TightRope® system in 17 dogs: technique and long-term outcome.

OBJECTIVE: To describe the technique for, and long-term clinical outcome of, a modified hip toggle stabilization using the TightRope® system for coxofemoral luxation repair. STUDY DESIGN: Retrospective case series. METHODS: Medical records (July 2008-July 2010) including radiographs (17 limbs) of dogs that had coxofemoral luxation repaired with the TightRope system were reviewed. Follow-up (≥12 months) was obtained by telephone interview of owners. Six dogs were available for re-evaluation, radiographs, and objective gait analysis. RESULTS: Follow-up (mean, 24 months; range, 12-43 months) by telephone interview was available for 17 dogs. Of these, 6 dogs were re-evaluated (mean, 7.5 months; median 12.5 months: range, 4-24 months) and had gait analysis. Mean duration of luxation before surgical intervention was 7.5 days (median, 7 days; range, 2-44 days). There was a single case of relaxation 27 months postoperatively. One dog died from non-surgical related circumstances. Objective gait analysis showed equal pelvic limb use in all 6 dogs available for re-evaluation. All owners of living dogs reported limb function as being good to excellent, and perceived that their dogs were pain free. Radiographs (mean, 7.5 months; median, 12.5 months; range, 4-24 months post surgery) of 6 dogs showed no progression of osteoarthritis in comparison to immediate postoperative radiographs. CONCLUSIONS: Hip toggle with the TightRope system as a prosthetic ligament of the head of the femur produces a favorable clinical outcome with high owner acceptance.

Corrigendum: Internet-based survey evaluating the impact of ground substrate on injury and performance in canine agility athletes.

[This corrects the article DOI: 10.3389/fvets.2022.1025331.].

Iliopsoas strain demographics, concurrent injuries, and grade determined by musculoskeletal ultrasound in 72 agility dogs.

The objective of this study was to describe patient demographics associated with iliopsoas strains, frequency of common concurrent injuries, and associated strain grades based on musculoskeletal ultrasound. The medical records of 72 client-owned agility dogs that had an iliopsoas musculoskeletal ultrasound (MSK-US) between 2009 and 2015 were retrospectively reviewed. Analyses included patient signalment, physical examination, and diagnostic findings. Twenty-four breeds of canine athletes from 1.5 to 10 y old (median: 5 y, SD: 2.2 y) were included in the study. Of the 72 records reviewed, border collies were the most common breed (27.8%, 20/72) reported. Isolated iliopsoas strains occurred in 26.4% (19/72) of cases. Concurrent pathology was noted in 73.6% (53/72) of cases. Cranial cruciate ligament (CCL) instability was the most common concurrent pathology, representing 27.8% (20/72) of all cases, with hip (8.3%, 6/72), lumbosacral (23.6%, 17/72), other non-CCL hind limb (6.9%, 5/72), and forelimb (6.9%, 5/72) pathologies making up the remainder of cases with concurrent pathology. In patients with a concurrent hind limb injury, 96.7% (30/31) of dogs had their most severe iliopsoas strain grade on the same limb. MSK-US revealed Grade I strains in 54.2%, Grade II strains in 22.2%, Grade III strains in 5.2%, and chronic changes in 18.1% of cases. There were no statistically significant associations between iliopsoas strain grade and age, body weight, sex, breed, concurrent pathology, anatomic location of concurrent pathology, or sidedness of concurrent pathology. Iliopsoas strains are one of the most common agility dog injuries; however, patient demographics, prevalence of concurrent injury and correlation with MSK-US findings have not been previously reported. To the authors' knowledge, this is the first retrospective analysis reporting iliopsoas strain demographics, concurrent injury frequency and correlation with MSK-US evaluation in agility dogs. Although 26.4% of iliopsoas strains occurred as isolated injuries, 73.6% had concurrent injuries, with CCL instability present most commonly, occurring in 27.8% of cases. Dogs should be thoroughly evaluated for concurrent injuries when presenting with an iliopsoas strain.

L'objectif était de décrire les données démographiques des patients associées aux douleurs de l'iliopsoas, la fréquence des blessures concomitantes courantes et les degrés de douleur associés sur la base d'une échographie musculosquelettique.Les dossiers médicaux de 72 chiens d'agilité appartenant à des clients qui ont subi une échographie musculosquelettique de l'iliopsoas (MSK-US) entre 2009 et 2015 ont été examinés rétrospectivement. L'analyse comprenait le signalement du patient, l'examen physique et les résultats de diagnostic.Vingt-quatre races d'athlètes canins âgés de 1,5 à 10 ans (médiane 5, SD 2,2) ont été incluses dans l'étude. Sur les 72 enregistrements examinés, les border collies étaient la race la plus fréquemment signalée (27,8 %, 20/72). Des douleurs isolées du psoas iliaque sont survenues dans 26,4 % (19/72) des cas. Une pathologie concomitante était notée dans 73,6 % (53/72) des cas. L'instabilité du ligament croisé crânien (CCL) était la pathologie concomitante la plus fréquente, représentant 27,8 % (20/72) de tous les cas, avec hanche (8,3 %, 6/72), lombo-sacrée (23,6 %, 17/72), autres pathologies des membres postérieurs du CCL (6,9 %, 5/72) et des membres antérieurs (6,9 %, 5/72) constituent le reste des cas avec une pathologie concomitante. Chez les patients présentant une lésion concomitante du membre postérieur, 96,7 % (30/31) des chiens présentaient leur degré de douleur de l'iliopsoas le plus grave sur le même membre. MSK-US a révélé des douleurs de grade I dans 54,2 %, des douleurs de grade II dans 22,2 %, des douleurs de grade III dans 5,2 % et des modifications chroniques dans 18,1 % des cas. Aucune association statistiquement significative n'a été trouvée entre le degré de douleur de l'iliopsoas et l'âge, le poids corporel, le sexe, la race, la pathologie concomitante, la localisation anatomique de la pathologie concomitante ou le caractère latéral de la pathologie concomitante.Les douleurs d'iliopsoas sont l'une des blessures les plus courantes chez les chiens d'agilité; cependant, la démographie des patients, la prévalence des blessures concomitantes et la corrélation avec les résultats MSK-US n'ont pas été rapportées auparavant. À la connaissance de l'auteur, il s'agit de la première analyse rétrospective faisant état de la démographie de la douleur de l'iliopsoas, de la fréquence des blessures concomitantes et de la corrélation avec l'évaluation MSK-US chez les chiens d'agilité. Bien que 26,4 % des douleurs de l'iliopsoas se soient produites sous forme de blessures isolées, 73,6 % avaient des blessures concomitantes. L'instabilité du CCL était présente le plus souvent, survenant dans 27,8 % des cas.Les chiens doivent être soigneusement évalués pour les blessures concomitantes lorsqu'ils présentent une douleur de l'iliopsoas.(Traduit par les auteurs).

Internet-based survey evaluating the impact of ground substrate on injury and performance in canine agility athletes.

Agility is a rapidly growing canine performance sport worldwide, yet the literature is sparse regarding the impact of ground substrate on performance and injury. Approximately 1/3 of dogs participating in agility trials will experience a performance-related injury. The impact of ground material has been well-documented in racing greyhounds, equine athletes, and humans, but has been minimally investigated in agility dogs. In this retrospective, cross-sectional study, 300 respondents (handlers, owners, and trainers) of 308 agility dogs completed an online survey regarding their dog's training and competition regimen, history of injury, perceived association between injury and substrate and/or agility obstacle, markers of decreased performance (MDPs) observed on different substrates, and changes to routine following injury. 35.7% of dogs sustained a training injury (TI) and 11.2% sustained a competition injury (CI). The most commonly reported sites of injury were the shoulder (TI: 33.9%, CI: 25.4%), forelimb digits (TI: 14.7%, CI: 11.9%) and iliopsoas muscle (TI: 11.9%, CI: 13.6%). Dogs most commonly trained on natural grass (85.3%), artificial turf (50.8%), and dirt (34.5%). Significantly fewer MDPs were observed on natural grass than any other substrate except dirt. Significantly more MDPs were noted on rubber mat compared to natural grass, artificial turf, dirt, sand, or foam mat. Rubber mat had the highest Incidence Proportion (IP) (32.0%) of TI and was perceived to be related to TI in 87.5% of cases. Obstacles perceived to be associated with injuries included jumps (TI: 37.5%, CI: 27.8%), contacts (TI: 29.7%, CI: 22.2%), weaves (TI: 11.9%, CI: 13.9%), and tunnels (CI: 25.0%). Overall, agility dogs were perceived to perform best on natural grass and dirt, while rubber mat was associated with injury and decreased performance. Respondents were willing to make significant alterations to their dog's routine due to a perceived association between substrate, injury, and performance. Further prospective studies are needed to assess the impact of substrate composition and maintenance, and inform evidence-based recommendations to maximize performance and minimize performance-related injury in agility dogs.

Ultrasonography Findings in the Proximal Sciatic Nerve and Deep Gluteal Muscles in 29 Dogs With Suspected Sciatic Neuritis.

The present study aimed to describe the ultrasonography technique and analyze the ultrasonographic findings of the proximal sciatic nerve and deep gluteal muscles in dogs with suspected sciatic neuritis. The records of 29 dogs that underwent musculoskeletal ultrasound of the sciatic nerve and deep gluteal muscles were retrospectively evaluated. Both right and left sides were evaluated. Abnormal findings were unilateral in 28/29 (97%) of the dogs. The muscles examined included the piriformis muscle, gemelli muscles, internal obturator muscle, and medial gluteal muscle. Data included signalment, purpose of the dog, orthopedic examination findings, lameness examination findings, other diagnostic imaging findings, and ultrasonography findings. Irregular margins of the sciatic nerve were recorded in 76% of the dogs. The diameter of the sciatic nerve on the affected limb was significantly larger than the nerve on the contralateral, unaffected side (p < 0.00001). The mean ± standard deviation (SD) of the sciatic nerve inner diameter between the unaffected and affected limbs was 15 ± 14.66%. The mean ± SD in sciatic nerve outer diameter was 12 ± 7.71%. Abnormal ultrasonographic findings in at least one of the examined muscles were found in 28/29 (97%) of the dogs and included changes in echogenicity in 28/29 (97%) of the dogs, loss of detail in muscle fiber pattern in 5/29 (17%) of the dogs, and impingement between the sciatic nerve and piriformis muscle in 6/29 (21%) of the dogs. The most common underlying diagnosis was lumbosacral stenosis in 9/29 (31%) of the dogs. The most common sport was agility for 21/29 (71%) of the dogs. Repetitive jumping may predispose to both lumbosacral disease, through dynamic compression, and changes within the piriformis muscle, due to overuse of the muscle leading to irritation to sciatic nerve. Ultrasonography is considered a safe and non-invasive diagnostic method to evaluate the sciatic nerve and deep gluteal muscles of dogs, and provides additional guidance for diagnostics and rehabilitation planning. This is the first study documenting ultrasonography findings in a case series of the sciatic nerve and deep gluteal muscles and their pathology in dogs.

The Stryker Regenkit PRP Kit Does Not Concentrate Canine Platelets.

Platelet Rich Plasma (PRP) works to recruit growth factors, anti-inflammatory mediators, and blood supply to an area that may not heal well under normal conditions (e.g., joints, tendons, ligaments). Previous research has demonstrated that various PRP systems create vastly different final products. The objective of this study was to evaluate the cellular composition of the final plasma product using the Stryker RegenKit system in dogs. A peripheral blood sample was obtained from ten healthy adult dogs and compared to the final plasma product. A standard CBC was performed prior to testing and an additional sample was processed according the manufacturing guidelines for obtaining PRP (10 ml total blood). Comparisons of mean platelet count, erythrocyte count, and leukocyte count were made between the peripheral blood sample and the final plasma product. Results showed that there was no significant difference in platelet count between the peripheral blood CBC and final PRP CBC (p = 0.349). There were significantly fewer erythrocytes and leukocytes in the final plasma product when compared with peripheral blood (p = < 0.0001, p = 0.0318, respectively). These results indicate that the Stryker Regenkit PRP Kit decreases leukocyte and erythrocyte concentrations but does not consistently change platelet concentrations in its final plasma product. This study, in combination with results from similar studies, may allow clinicians to better choose the appropriate PRP system to treat various musculoskeletal conditions in dogs.

Validation and Characterization of Platelet-Rich Plasma in the Feline: A Prospective Analysis.

Objective: To quantitate key parameters of the platelet-rich plasma (PRP) product from a commercially available system in healthy, adult felines. Materials and methods: A prospective study was performed from January 2019 to April 2019. 11 adult, healthy cats were used to prospectively analyze a commercially available PRP system. A whole blood sample and a PRP sample that was processed immediately following blood draw according to the manufacturer's protocol were collected from each cat. The mean whole blood and PRP product platelet, RBC, WBC, neutrophil, monocyte, and lymphocyte concentrations were determined. The mean PRP product values were compared to the mean whole blood baseline values using a paired t-test with significance established at p = 0.05. Results: Mean platelet concentration was significantly increased (p = 0.0155). Mean RBC concentration was significantly decreased (p < 0.0001). Mean neutrophil concentration was significantly decreased (p < 0.0001). There was no statistically significant difference in mean WBC, monocyte, and lymphocyte concentrations. Clinical Relevance: The analyzed PRP system increased platelet concentration, while significantly reducing the RBC and neutrophil concentrations. Further study is warranted to determine the clinical applications and efficacy of PRP in felines, and the ideal concentrations of and relationships between platelets, red blood cells, and leukocytes needed for therapeutic effect.

Average Tibial Plateau Angle of 3,922 Stifles Undergoing Surgical Stabilization for Cranial Cruciate Ligament Rupture.

OBJECTIVE: The aim of this study was to report the average tibial plateau angle (TPA) from a large sample of dogs and to determine if breed or gonadectomy had a significant association with abnormal TPA. STUDY DESIGN: This was a retrospective case study. MATERIALS AND METHODS: Medical records from 2006 to 2015 were reviewed for dogs that were diagnosed with cranial cruciate ligament (CrCL) rupture and underwent dynamic surgical stabilization. Signalment, examination findings, preoperative TPA and surgical report were reviewed. RESULTS: A total of 3,249 dogs underwent CrCL stabilization surgery from 2006 to 2015. Of the 3,249 dogs, 3,054 dogs met the inclusion criteria for a total of 3,922 stifles to be evaluated. The average preoperative TPA was 29° ± 3.7°. Average breed-specific preoperative TPA ranged from 27° to 35.1°, with four breeds having significantly lesser TPA and four breeds significantly greater TPA than the overall mean of dogs. Neutered dogs had a higher TPA of 28.87° ± 3.8° than non-neutered dogs with an average TPA of 26.88° ± 4.0°, p < 0.001. There was not a significant difference in average TPA between females and males, regardless of the neuter status. CONCLUSION AND CLINICAL RELEVANCE: Our reported preoperative TPA in a large sample of dogs is higher than what has been previously published. In reviewing 3,922 stifles, the average preoperative TPA was 29°. We report the average preoperative TPA in specific breeds and report that neutered dogs have a significantly higher TPA than intact dogs. This updated information may guide clinicians in management decisions regarding treatment for CrCL rupture.

Ultrasonographic Findings in 41 Dogs Treated with Bone Marrow Aspirate Concentrate and Platelet-Rich Plasma for a Supraspinatus Tendinopathy: A Retrospective Study.

OBJECTIVE: To report sonographic findings for dogs with a supraspinatus tendinopathy (ST) treated with an ultrasound-guided intratendinous injection of bone marrow aspirate concentrate (BMAC) and platelet-rich plasma (PRP). METHODS: Medical records for dogs diagnosed with an ST and treated with a BMAC-PRP injection were reviewed. Data collected included patient signalment, radiographic findings at the time of initial evaluation, and sonographic findings, including cross-sectional area (CSA), fiber pattern, and echogenicity. RESULTS: Of 70 records reviewed, 41 met the inclusion criteria. Mean CSA of the supraspinatus tendon decreased by 0.06 cm2 between baseline and 45 days post-treatment (p = 0.0025), and 0.09 cm2 between baseline and 90 days post-treatment (p < 0.0001). Analysis of CSA in dogs with a unilateral ST at baseline revealed a difference of 0.08 cm2 between the affected and unaffected tendon at baseline, with the affected tendon measuring larger than the contralateral tendon (p < 0.0001). This difference became statistically insignificant by 45 days after treatment (u1-u0 = 0.04 cm2, p = 0.2855) and remained so 90 days post-treatment (u1-u0 = 0.03 cm2, p = 0.1910). In most cases (90.6%), the fiber pattern and echogenicity was considered improved 90 days post treatment. In a minority of these cases (13.8%) the fiber pattern and echogenicity abnormalities were considered resolved. CONCLUSIONS: Using qualitative and quantitative sonographic measures, BMAC-PRP was associated with an improvement in supraspinatus tendon size, fiber pattern, and echogenicity. Given the protracted nature of tendon healing, long-term evaluation may reveal continued improvements in chronic structural changes not captured during the current study. Functional studies are required to evaluate the clinical benefits of BMAC-PRP in the treatment of STs in dogs. CLINICAL SIGNIFICANCE: An ST is a common contributor to forelimb lameness in dogs and remains notoriously difficult to treat. Previous studies have been associated with inconsistent treatment outcomes. In the current study, BMAC-PRP is investigated as a minimally invasive treatment option, revealing positive sonographic results.

Sensitivity and Specificity of a Weight Distribution Platform for the Detection of Objective Lameness and Orthopaedic Disease.

INTRODUCTION: Weight distribution and off-loading at the stance are commonly used subjective assessments during the orthopaedic examination. The clinical relevance, sensitivity and specificity of limb off-loading have not yet been established. The aim of the study was to assess off-loading on a weight distribution platform (WDP) and determine the sensitivity and specificity at various cut-off points for the detection of objective lameness (OL) and orthopaedic disease (OD). MATERIALS AND METHODS: The total pressure index was used to determine OL on a pressure-sensitive walkway (PSW). Normal weight distribution on both the PSW and WDP was considered 30/30/20/20. A total pressure index standard deviation of 2 was used. The sensitivity and specificity of the WDP for the identification of OL and OD was determined at cut-off points 1 to 6 below normal weight distribution values. RESULTS: All patients in the study (n = 50) had confirmed OD. The PSW identified 36/50 (74%) patients as OL; these were deemed to be OL for sensitivity and specificity analysis of WDP data. At cut-off point 1, the WDP had the highest sensitivity for OD (84%) and OL (97%). At cut-off point 6, the WDP had the highest specificity for OD (98%) and OL (98%). The highest combination of sensitivity and specificity for both OD (1.65) and OL (1.80) was at cut-off point 2. DISCUSSION/CONCLUSION: The WDP provided the highest combined sensitivity and specificity at cut-off point 2 below the normal value for the detection of both OL and OD.

Rate of return to agility competition for dogs with cranial cruciate ligament tears treated with tibial plateau leveling osteotomy.

OBJECTIVE To determine rate of and factors associated with return to agility competition for dogs with cranial cruciate ligament (CrCL) rupture treated with tibial plateau leveling osteotomy (TPLO). DESIGN Retrospective case series with nested case-control study. ANIMALS 31 dogs involved in agility competition with CrCL tears treated by TPLO at a private veterinary clinic from 2007 through 2013. PROCEDURES Medical records were reviewed to collect information on dog signalment, lesion characteristics, and surgical data. Owners completed a survey regarding whether and when their dog returned to agility competition after TPLO and, if so, how the dog performed. Performance data before and after TPLO were compared. RESULTS 20 of 31 (65%) dogs returned to agility competition after TPLO, 16 (80%) of which returned within 9 months after TPLO. The mean convalescent period for returning dogs was 7.5 months (range, 3 to 12 months). No dog that returned to competition sustained an injury to the affected limb during the follow-up period. No significant difference was identified between dogs that returned or did not return to agility competition regarding severity of osteoarthritis or proportions with meniscal injury or partial (vs complete) CrCL tears. CONCLUSIONS AND CLINICAL RELEVANCE These data suggested that the prognosis for returning to agility competition was good for dogs undergoing TPLO. None of the evaluated lesion characteristics were associated with return to competition. Rate of return to competition and duration of the convalescent period may be useful outcome variables for future investigations involving orthopedic procedures in dogs.

The canine stifle.

Cranial cruciate ligament (CCL) injury is a leading cause of lameness in dogs. Recent advances in diagnostic visualization and surgical treatments for CCL injury have stimulated an increased emphasis on early clinical recognition and an early return to function. Many surgical treatments have been described that aim to restore stifle joint stability and minimize the progression of osteoarthritis. Major advances have occurred not only in the treatment of CCL injury, but also in postoperative recovery, specifically, rehabilitation therapy. The benefits of rehabilitation therapy following CCL surgery are multifaceted including pain relief, decreased inflammation and swelling, increased tissue flexibility, strengthening, improved proprioception, improved limb and joint biomechanics, and improved weight-bearing. In this article, we introduce a variety of rehabilitation therapy options for postoperative CCL patients including modalities, manual therapy, therapeutic exercise, and the benchmarks for a full return to function.

The canine shoulder: selected disorders and their management with physical therapy.

The shoulder joint is the most mobile of all main limb joints. While its primary motion is in a sagittal plane, the shoulder has a significant amount of abduction and adduction, and internal and external rotation. Its stability is ensured by the joint capsule, by its specialized bands (medial and lateral glenohumeral ligaments), and by large tendons located inside (eg, tendon of origin of the biceps brachii muscle) or immediately outside the joint (eg, supraspinatus, infraspinatus, teres minor, and subscapularis). Sprains or strains of all supporting structures of the canine shoulder have now been reported and the shoulder pathology resembles the pathology of the human shoulder that includes strains and tears of the rotator cuff muscles, adhesive capsulitis, and calcific tendonitis.

Treatment of medial shoulder joint instability in dogs by extracapsular stabilization with a prosthetic ligament: 39 cases (2008-2013).

OBJECTIVE To investigate clinical outcomes for dogs surgically treated for medial shoulder joint instability (MSI) by extracapsular stabilization with a prosthetic ligament. DESIGN Retrospective multicenter case series. ANIMALS 39 client-owned dogs. PROCEDURES Medical records of 3 veterinary medical centers were searched to identify dogs with MSI diagnosed by clinical examination and arthroscopic assessment and treated by extracapsular stabilization with a prosthetic ligament. A minimum 6-month follow-up period was required for study inclusion. Signalment, function or use of the dog, duration of clinical signs, clinical and diagnostic imaging data, MSI grade (1 [mild] to 4 [complete luxation]), follow-up duration, complications, and outcome data were recorded. RESULTS All grades of MSI were represented. Implants were placed successfully in all dogs. Complications (4 major and 2 minor) were recorded for 6 of 39 (15%) dogs; all were treated successfully. Function at the time of last follow-up (6 to 68 months) was deemed full in 30 of 39 (77%) dogs and acceptable in 9 (23%). CONCLUSIONS AND CLINICAL RELEVANCE Surgical treatment of MSI in dogs by extracapsular stabilization with a prosthetic ligament was associated with a complication rate considered acceptable for orthopedic procedures. All patient outcomes were considered successful.

Partial Cranial Cruciate Ligament Tears Treated with Stem Cell and Platelet-Rich Plasma Combination Therapy in 36 Dogs: A Retrospective Study.

OBJECTIVE: To evaluate outcomes in 36 dogs with a partial cranial cruciate ligament (CCL) tear treated with autologous bone marrow aspirate concentrate (BMAC) or adipose-derived progenitor cells (ADPC) with platelet-rich plasma (PRP) combination. MATERIALS AND METHODS: Medical records of client-owned dogs diagnosed with an early partial (≤50%) tear of the craniomedial band of the CCL that was treated with BMAC-PRP or ADPC-PRP were reviewed from 2010 to 2015. Signalment, medical history, physical and orthopedic examination, objective temporospatial gait analyses, radiographs, day 0 and day 90 diagnostic arthroscopy findings, treatment, and outcome were among the data collected. A functional owner questionnaire, including the validated Helsinki chronic pain index (HCPI), was sent to owners whose dog was known to not have had a tibial plateau leveling osteotomy (TPLO). Statistical analysis was performed on data, where significance was established at p < 0.05. RESULTS: Stifle arthroscopy findings at 90 days posttreatment were available on 13 of the 36 dogs. In nine dogs, a fully intact CCL with marked neovascularization and a normal fiber pattern was found with all previous regions of disruption healed. One dog revealed significant improvement and received an additional injection. The remaining three dogs had a >50% CCL tear, and a TPLO was performed. Four additional dogs were known to have had a TPLO performed elsewhere. Baseline and day 90 posttreatment objective gait analyses were available on 11 of the 36 dogs. A significant difference was found between the treated limb total pressure index percent (TPI%) at day 0 and day 90 (p = 0.0124), and between the treated limb and contralateral limb TPI% at day 0 (p = 0.0003). No significant difference was found between the treated limb and contralateral limb TPI% at day 90 (p = 0.7466). Twelve questionnaires were returned, of which eight were performance/sporting dogs. Seven of the eight had returned to sport; the remaining dog had just begun a return to sport conditioning program 6 months posttreatment. All 12 respondents believed that their dog had an excellent or very good quality of life and rated their dog's procedural outcome as excellent or good. CONCLUSION: The use of BMAC-PRP and ADPC-PRP shows promise for the treatment of early partial CCL tears in dogs. Further studies are needed and should be randomized, blinded, and controlled.

Traumatic fracture of the medial coronoid process in 24 dogs.

OBJECTIVE: To describe traumatic fracture of the medial coronoid process in dogs as a clinically distinct disease unrelated to congenital elbow dysplasia. METHODS: Clinical records of dogs with acute, traumatic, unilateral lameness attributable to medial coronoid process disease were reviewed retrospectively. Clinical interpretation included findings on physical examination, orthopaedic examination, and subjective gait analysis. Radiographs of the affected and contralateral elbows were obtained and reviewed for pathology. Arthroscopy of the elbow joints was performed by one of three surgeons and findings were compared to preoperative diagnostics. Postoperative follow-up was continued for 16 weeks. RESULTS: Twenty-four dogs were included in this study. All dogs in this study were free of radiographic evidence of medial coronoid pathology. All dogs were diagnosed with a single, large, displaced or non-displaced fracture of the medial coronoid process, with no other joint pathology. Dogs generally had an excellent short-term outcome following arthroscopic treatment of the fractured medial coronoid process. CLINICAL SIGNIFICANCE: Traumatic fracture of the medial coronoid process should be considered a clinical disease distinct from dysplasia-related fragmentation and should be considered as a differential diagnosis in dogs that are presented with the complaint of acute unilateral elbow discomfort or lameness, especially after concussive activities involving the forelimb. .