Hypoechoic ultrasonographic findings in the patellar ligaments are common in riding and trotting horses in training (116 cases).

Patellar ligament (PL) injuries are increasingly being reported in horses, but few studies have described the normal PL ultrasonographic appearance in horses. The aims of this prospective observational study were to describe the ultrasonographic appearance of the PLs and infrapatellar fat pad in a population of horses in training and to relate the ultrasonographic findings to objectively measured movement asymmetry. B-mode and color Doppler ultrasonographic examination of the PLs and infrapatellar fat pad in both hind limbs and objective gait analyses were performed on the 116 riding and trotting horses included in the study. The association between ultrasonographic findings, horse age, and movement asymmetry during the trot was then investigated. Distinct or diffuse hypoechoic regions were commonly found in the intermediate PL (24/116; 20.7%), especially in the caudal aspect of the mid-third of the ligament. The infrapatellar fat pad had a hypoechoic striated appearance in all horses except one, in which it was hyperechoic. No association was found between ultrasonographic findings in the PLs and infrapatellar fat pad and lameness. It is important to recognize that there is biological variation in PL appearance, which may or may not be associated with pain in this area, therefore emphasizing the use of local analgesia to determine the location of the lameness.

Combination of closing-wedge distal femoral osteotomy and modified tibial plateau levelling osteotomy for the treatment of medial patellar luxation and concomitant cranial cruciate ligament disease in dogs.

Considering the prevalence of cranial cruciate ligament disease (CCLD) and concurrent medial patellar luxation (MPL) among dogs, and the concomitant bone deviations routinely identified, the aim of this study is to evaluate the efficacy of the combination between distal femoral osteotomy (DFO) and modified tibial plateau levelling osteotomy (mTPLO) for the treatment of MPL with distal femoral varus, tibial torsion, and CCLD. Dogs with concurrent MPL and CCLD that underwent DFO and mTPLO procedures were included. Subjective clinical evaluations of gait and pre-operative and immediate post-operative radiographic examinations were performed. Surgical data were documented. The anatomical lateral distal femoral angle (aLDFA), femoral varus angle, mechanical medial proximal tibial angle, and tibial plateau angle (TPA) were compared between the pre- and post-operative periods. A total of 12 dogs were included in this study. Closing-wedge DFO and mTPLO procedures were performed on 14 limbs. The mean pre-operative and post-operative aLDFA values were 104.8 ± 3.9° and 95.4 ± 2.4°, respectively. TPA values were 26.2 ± 3.7° pre-operatively and 6.3 ± 3.2° post-operatively. Bone healing was observed in 7.1 %, 71.3 %, and 85.5 % of patients at the first, second, and third follow-up, respectively. Lameness was resolved in 28.5 %, 78.5 %, and 100 % at 30, 60, and 90 days, respectively. No major peri- or post-operative complications were reported. The combination of mTPLO and DFO aligns the stifle extensor mechanism, promoting dynamic stabilization. It can be considered for the treatment of concurrent MPL and CCLD in dogs, performed as a single procedure, and is associated with favorable short-term outcomes.

Relationship between Feline Knee Joint Osteoarthritis and Bone Mineral Density Quantified Using Computed Tomography and Computed Digital Absorptiometry.

Osteoarthritis (OA), including knee joint OA, is a common chronic condition in cats. In both cats and humans, knee joint OA is characterized radiographically by the presence of osteophytes, enthesiophytes, subchondral sclerosis, and joint space narrowing. However, only in humans have these radiographic signs been reported to increase bone mineral density (BMD). Therefore, this study aims to quantify the volumetric (vBMD) and relative (rBMD) BMD measures of the feline knee joint and compare BMD measures between various severities of OA to test the hypothesized OA-BMD relationship in the knee joint in cats. The 46 feline knee joints were imaged using computed tomography (CT) and conventional radiography supported by the computed digital absorptiometry (CDA) method to obtain vBMD and rBMD, respectively. Both BMD measures were assessed in three regions of interest (ROIs): the distal femur (ROI 1), patella (ROI 2), and proximal tibia (ROI 3). In all locations, vBMD and rBMD showed moderate (ROI 2: r = 0.67, p < 0.0001) to strong (ROI 1: ρ = 0.96, p < 0.0001; ROI 3: r = 0.89, p < 0.0001) positive correlations. Due to differences (p < 0.0001) in the width of the distal femur (17.9 ± 1.21 mm), patella (8.2 ± 0.82 mm), and proximal tibia (19.3 ± 1.16 mm), the rBMD was corrected (corr rBMD) using the thickness coefficient of 0.46 ± 0.04 for ROI 2 and 1.08 ± 0.03 for ROI 3. Regardless of the quantification method used, BMD measures increased linearly from a normal knee joint to severe OA, with differences in BMD between normal and mild to severe knee joint OA. The OA-BMD relationship in the feline knee joint can be preliminarily confirmed.

Male porcine stifle joint: Insights into osteology and meniscus anatomy for orthopaedic research.

INTRODUCTION: Utilizing large animal model like male pig for biomechanical studies offers a cost-effective approach to understanding human joint and tissue mechanics. Our study explores the osteology and meniscus anatomy of the male porcine stifle joint and compares it to human knee joint parameters, aiming to provide a valuable reference for orthopaedic research and surgical training. METHODS: We examined 60 male porcine stifle joints and analyzed their menisci and bones. Dissections were meticulously performed, with measurements taken using digital Vernier calipers and ImageJ software. These dimensions included bone morphology and meniscal width, height, and volume, followed by statistical analysis using unpaired Student's t-tests. RESULTS: The various measurements of bones and menisci indicated a high degree of anatomical similarity to human knees. The anterior width of the medial meniscus was 12.545 ± 1.763 mm, while the lateral meniscus was 14.99 ± 1.720 mm. The middle width of the medial meniscus was 12.065 ± 1.691 mm, compared to the lateral meniscus at 14.375 ± 1.732 mm. The posterior width was 15.25 ± 1.741 mm for the medial meniscus and 16.39 ± 1.662 mm for the lateral meniscus. The femoral intercondylar notch dimensions widened and became shallower with age, resembling the maturation patterns seen in human knee development. The average volume of the medial meniscus was 4.30 ± 0.13 ml, while the lateral meniscus was 5.9 ± 0.29 ml. The aspect ratio of the femoral condyles was 1.04 ± 0.04 (0.95-1.11), while the aspect ratio of the tibial condyles was 0.65 ± 0.02 (0.61-0.70), measured via digital Vernier calipers. These findings were statistically significant, showcasing the male porcine model's relevance in replicating human knee mechanics (p < 0.05). CONCLUSION: Male porcine stifle joints present a valid and accessible model for knee anatomy research. Our study underscores the value of the male porcine model in understanding human knee joint biomechanics and supports its continued use in orthopaedic research and training. These findings have significant implications for advancing orthopaedic research methodologies and enhancing surgical training practices by providing a reliable and anatomically comparable model.

Double-Needle Meniscal Suture Technique: Technical Description and Clinical Application in Dogs.

Current treatments for medial meniscus lesions in association with CCL ruptures have shown disappointing long-term outcomes. Meniscal suturing may improve the outcome, but their clinical application remains limited. This study aims to assess the practicability of a minimally invasive DNT to facilitate meniscal suturing in dogs. Ten stifles of eight client-owned dogs with arthroscopically confirmed CCL disease and medial meniscal tears in the abaxial third of the meniscus were included. The described suture technique was applied under joint distraction using the Titan joint distractor. Surgical stabilization of all stifles was then accomplished via an X-Porous TTA procedure. The DNT allowed for the precise placement of meniscal sutures. Minor intraoperative complications included reduced arthroscopic visibility (n = 2) and suture breakage during its passage through the meniscus (n = 3). No complications related to the meniscal sutures were noted throughout the six-month follow-up period. The described DNT proved to be a viable and effective method for suturing lesions of the caudal horn of the medial meniscus, provided there is adequate visualization during the procedure. Appropriate stifle stabilization postoperatively is mandatory for protecting the suture and avoiding concomitant meniscal lesions due to joint instability.

Selection of X-ray Tube Settings for Relative Bone Density Quantification in the Knee Joint of Cats Using Computed Digital Absorptiometry.

Bone mineral density (BMD) varies with aging and both systemic and local diseases; however, such evidence is lacking in feline medicine. This may be due to the need for general anesthesia in cats for direct BMD measurements using dual-energy X-ray absorptiometry (DXA) or quantitative computed tomography (QCT). In this study, computed digital absorptiometry (CDA), an indirect relative BMD-measuring method, was optimized to select an X-ray tube setting for the quantitative assessment of the feline knee joint. The knee joints of nine cats were radiographically imaged and processed using the CDA method with an aluminum density standard and five X-ray tube settings (from 50 to 80 kV; between 1.2 and 12 mAs). The reference attenuation of the X-ray beam for ten steps (S1-S10) of the density standard was recorded in Hounsfield units (HU), compared between X-ray tube settings, and used to determine the ranges of relative density applied for radiograph decomposition. The relative density decreased (p < 0.0001) with an increase in kV and dispersed with an increase in mAs. Then, the percentage of color pixels (%color pixels), representing ranges of relative density, was compared among S1-S10 and used for the recognition of background artifacts. The %color pixels was the highest for low steps and the lowest for high steps (p < 0.0001), regardless of X-ray tube settings. The X-ray tube setting was considered the most beneficial when it effectively covered the lowest possible HU ranges without inducing background artifacts. In conclusion, for further clinical application of the CDA method for quantitative research on knee joint OA in cats, 60 kV and 1.2 mAs settings are recommended.

Ex vivo evaluation of the soft tissue components of the equine stifle using 3 Tesla magnetic resonance imaging under flexion, extension, and loading.

High-field MRI of the equine stifle provides high-resolution information about soft tissues that is useful in the diagnosis of stifle lameness. The aim of this prospective anatomic study was to describe the appearance, position, size, and shape of the equine femorotibial ligaments, meniscal ligaments, and menisci using 3 Tesla MRI under extended, extended-loaded, and flexed conditions. Additionally, histologic examination of the collateral and cruciate ligaments (CLs) of a single stifle was performed to compare with MRI images. In extension, mild variations in MRI signal intensity were apparent in the CLs, and the cranial had two distinct longitudinal regions indicating two ligament bundles. Flexion had minor effects on CL signal intensity and altered the tibial angles of attachment. Histology indicated that both CLs were comprised of two fiber bundles. The collateral ligaments were the same low-signal intensity. The medial collateral ligament had a smaller cross-sectional area than the lateral, and flexion increased the length of the medial collateral ligament and the cross-sectional area of the lateral. Low loads in extension did not affect the MRI appearance of stifle soft tissues. Flexion of the stifle impacted cruciate ligament insertion angles and the size and shape of collateral ligaments. This study provides support for the use of MRI to understand the anatomy and function of stifle ligaments.

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.

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.

Micro-computed tomography reveals high-density mineralised protrusions and microstructural lesions in equine stifle joint articular cartilage.

BACKGROUND: Stifle osteoarthritis (OA) lesions are most common in the medial femorotibial (MFT) compartment. Their characterisation and mapping will inform equine veterinarians towards an accurate diagnosis of OA. OBJECTIVES: Investigate and map micro-CT (µCT) changes in the hyaline articular cartilage (HAC) in the medial femoral condyle (MFC) and medial tibial plateau (MTP). STUDY DESIGN: Ex vivo cadaveric. METHODS: Stifles (n = 7 OA and 17 control [CO]) were retrieved from a tissue bank. The MFC and MFT were imaged with µCT. Regions of interest (ROIs) were cranial (MFCcr; MTPcr) and caudal (MFCca; MTPca) sites. In each ROI, µCT images were scored for HAC fibrillation, surface mineralisation and for the presence of high-density mineralised protrusions (HDMP). The lesions were mapped, and site-matched histology was performed. RESULTS: The microstructure of healthy and abnormal HAC was discernible on µCT images and confirmed with histology. HAC fibrillation was more prevalent (p = 0.019) in the MFCcr of the OA group (n = 7/7, 100%) when compared with the CO group (n = 7/17, 41%). Score 1 HAC surface mineralisation was more prevalent (p = 0.038) in the OA MFCca (n = 4/7, 57%) when compared with the CO group (n = 2/17, 12%). HDMP were heterogenous and hyperdense mineralised material protruding into the HAC and were more frequent (p = 0.033) in MFCs (n = 12/24, 50%) compared with MTPs (n = 5/24, 20%). Score 3 HDMPs were also more prevalent (p = 0.003) in the MFCcr (n = 7/24, 29%) compared with MFCca (n = 0/24, 0%) and in MFCs (n = 7/24, 29%) compared with MTPs (n = 3/24, 12.5%) (p = 0.046). MAIN LIMITATIONS: Clinical history was not available for all specimens. CONCLUSIONS: Equine HDMP and HAC surface mineralisation are imaged for the first time in the MFT joint. HAC fibrillation and erosion and HDMP are more frequent in the cranial aspect of the MFC. µCT images of OA in equine stifle joints provide a novel perspective of lesions and improve understanding of OA.

Combination of TPLO, medial and lateral augmentation techniques for the treatment of traumatic stifle luxation in a cat.

Case summary: An 11-year-old female neutered domestic shorthair cat was referred for surgical management of a traumatic right stifle luxation. Orthopaedic examination of the affected stifle under general anaesthesia revealed joint effusion and craniocaudal and rotational instability. Cranial displacement of the tibia with respect to the femur and infrapatellar pad sign were identified on radiography. Intraoperatively, complete rupture of both cruciate ligaments and marked disruption of the mid and caudal poles of the medial and lateral menisci were observed. Both collateral ligaments appeared intact. The remnants of the injured cruciate ligaments were removed, and medial and lateral caudal hemimeniscectomies were performed. A tibial plateau levelling osteotomy (TPLO) was performed to address the craniocaudal stifle instability. Intraoperative assessment of the stifle revealed persistent instability with cranial tibial translation, internal and external rotation, and a positive caudal draw test. A lateral augmentation suture was employed to address the persistent cranial tibial translation and internal rotation. To successfully neutralise caudocranial and external rotational instability secondary to the caudal cruciate ligament deficiency, a medial augmentation suture was placed with the aid of three interference screws. Stifle stability was achieved. A modified Robert-Jones bandage was kept on for 24 h postoperatively. An excellent outcome was achieved, with successful limb function restoration. Relevance and novel information: This case report represents the first documented instance of feline traumatic stifle luxation repair by combining a corrective tibial osteotomy and extra-articular augmentation. Notably, it introduces the novel technique of implementing a TPLO with medial and lateral augmentation sutures to address multidirectional stifle instability.

Comparative digital study using four methods of measurements of the tibial distal anatomical axes for determining the anatomical-mechanical angle in dogs with cranial cruciate ligament rupture.

OBJECTIVE: This study evaluates the amplitude of the anatomical-mechanical angle (AMA-angle) using 4 measuring methods of the tibial distal anatomical axes (DAA) previously described, comparing the literature results to determine if there are significant differences in patients with cranial cruciate ligament (CrCL) rupture. ANIMALS: This study was comprised of 30 tibiae (29 dogs), including 1 bilateral case. METHODS: A retrospective study was selected for this research. DAA measurements were performed on all surgically confirmed cases of canine CrCL rupture at Hospital Veterinário de Especialidades Bruselas from 2019 to 2022. Four different published methods (identified by surname of the corresponding author of the original publication) were compared. Tibial measurements were made using Veterinary Preoperative Orthopedic Planning Pro software (https://vpop-pro.com/) on mediolateral radiographic projections obtained from a digital database. RESULTS: The mean (range) in the DAA method conducted by Hulse obtained a AMA-angle of 5.4° (3.3 to 8.1°), 3.0° (0 to 5.8°) for Osmond et al, 3.2° (0.9 to 6°) for Miles, and 5.9° (2.4 to 8.8°) for Tudury. Differences among the means of the AMA-angle of the authors methods were found with a statistical difference (P < .05), except between Osmond and Miles. The mean AMA-angle with the Osmond method concurred with previous study results that determined the magnitude using the same measurement method of DAA in patients with CrCL rupture. CLINICAL RELEVANCE: The AMA-angle magnitude has been associated with higher sensitivity and specificity for predicting the development of CrCL rupture compared to other anatomical factors evaluated; therefore, future comparisons with different methods of measurement of the DAA between healthy and affected patients are recommended to determine whether any of them can increase the percentage value as a predictive factor for the occurrence of this condition.

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.

Ultrasound and Elastosonographic Features of the Patellar Ligament in Dogs Affected by Cranial Cruciate Ligament Disease.

This study aims to evaluate the morpho-functional change in the patellar ligament in dogs with cranial cruciate ligament disease. We hypothesized that it may show increased thickening and stiffness with increasing days from onset to diagnosis instead of trauma. Understanding this aspect has implications for the choice of timing for treating patients suffering from cranial cruciate ligament disease, as well as the contextualization of patellar ligament desmitis pictures after surgical treatment with tibial plateau leveling osteotomy or tibial tuberosity advancement. Thirty-three dogs affected by unilateral cranial cruciate disease were examined and divided into three groups based on the time elapsed from the onset of lameness to diagnosis: Group 1 (1-15 days), Group 2 (16-60 days), and Group 3 (over 60 days). Conventional B-mode ultrasonographic and elastosonographic examinations of the patellar ligament were performed without sedation for each dog. Upon ultrasonographic examination, all dogs showed modification in the echostructure of the patellar ligament. In addition, the patellar ligament tended to become harder with increasing days after disease, although there were no significant differences between groups. Our results show that as the time increases between the onset of cranial cruciate ligament disease and diagnosis and treatment, the patellar ligament progressively thickens and loses its elasticity.

Use of a Custom-Made Patellar Groove Replacement in an American Staffordshire Terrier Puppy with a Severe Bone Defect in the Femoral Trochlea Caused by Hematogenous Osteomyelitis.

An 8-month-old male American Staffordshire terrier was referred for a no-weightbearing lameness of the right pelvic limb, hyperthermia, lethargy and inappetence. Two months before, endocarditis was diagnosed and treated in another veterinary hospital. Orthopedic, radiographic and tomographic examinations revealed a bone sequestrum of 4 × 1.4 cm and active periosteal reaction of the caudo-lateral cortical in the metaphysis and the distal third of the right femoral diaphysis, medullary osteolysis and interruption of the cranio-medial cortical profile, with involvement of the femoral trochlea leading to a secondary medial patella luxation. Hematogenous osteomyelitis was the suspected diagnosis. Once skeletally mature, after 4 months from surgical debridement and aggressive antibiotic therapy against Klebsiella oxytoca revealed by a bacteriological exam, the patient underwent prosthetic surgery for the application of a custom-made patellar groove replacement (PGR) to fill the bone defect and restore the femoral trochlea surface. Despite the serious injury that afflicted the right pelvic limb, the surgery had satisfactory outcomes until the last 18-month postoperative follow up.

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.

Risk factors for the development of stifle injuries in canine agility athletes.

Objectives: Our aim was to determine risk factors for developing stifle injuries in canine agility athletes. We hypothesized that increased weight, increased frequency of competing, and greater number of runs/day would increase risk. Study design: Internet based survey, n = 4,197. Methods: Individuals with at least one dog who had competed in agility in the past 3 years were eligible. Injury history was defined as an injury to the stifle that kept the dog from participating in agility for >1 week. Logistic regression models were used to estimate associations between variables of interest and injury history. Results: Handlers of 216 dogs reported a history of injury. The majority were cranial cruciate ligament (CCL) injury (101/216), and patella luxation (40/216). In the final model, five variables were independently associated with odds of stifle injury (in addition to age). Heavier dogs (adjusted for height), Border Collies, male dogs neutered <10 months, female dogs spayed before their first heat cycle, handlers aged 18-24, and teeter contact behavior were associated with increased risk. Conclusion: Heavier dogs were more likely to report injury, but there was no association with injury and increased number of competition days, or runs/day. The Border Collie breed was at the highest risk of injury. There was substantial risk for stifle injury with early spay/neuter. Additionally, a significant increase in risk of injury was reported for younger (18-24) vs. older handlers (65+). Athlete fitness level, conformation, and genetic predisposition to injury may play the most significant role in the development of injury.

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.

No correlation found between palpation and ultrasound for evaluation of effusion in the medial femorotibial and femoropatellar joint compartments of horses.

OBJECTIVE: To compare palpation and ultrasound scores of effusion of the medial femorotibial and femoropatellar joints of horses. ANIMALS: 40 horses (80 stifles) were evaluated over a 12-week period. METHODS: Horses > 1 year of age without history of stifle disease were enrolled from September to December 2022. Palpation of right and left medial femorotibial and femoropatellar joint compartments was performed. Amount of effusion was scored by a board-certified large animal surgeon, a third-year large animal surgery resident, and an equine sports medicine intern. Effusion of right and left medial femorotibial and femoropatellar joints was quantified with ultrasound by a board-certified equine sports medicine and rehabilitation clinician. Amount of effusion on palpation and ultrasound was graded as none-mild (1), moderate (2), or severe (3). A 2-way intraclass correlation coefficient evaluated interrater reliability of palpation scores. The Spearman rank correlation determined association between palpation and ultrasound scores. RESULTS: Interrater reliability for palpation of effusion was poor between all observers for all joint compartments. No significant correlation was identified between palpation and ultrasound scores for any joint compartment for any observer. CLINICAL RELEVANCE: Clinicians often rely on palpation of joint effusion as an indication of stifle pathology. We found interrater reliability to be poor for palpation scores, indicating low agreement for palpation of joint effusion between clinicians within our group. No correlation was found between palpation and ultrasound scores for joint effusion, indicating that clinicians should not rely on palpation alone to quantify joint effusion of the medial femorotibial and femoropatellar joints.

Novel crescentic, medial-closing, medially translating, centre-of-rotation-of-angulation-based, levelling osteotomy for lateral compartment stifle disease with partial cranial cruciate ligament tear in two dogs.

CASE HISTORY: Two mature, large breed dogs presented with chronic lameness and discomfort localised to the stifle. CLINICAL FINDINGS: No hindlimb deformities were present on physical examination or radiographic evaluation. No stifle instability was present. Arthroscopy revealed severe (grade 5/5 modified Outerbridge score) cartilage erosion in the lateral compartment (femorotibial), marked degeneration of the lateral meniscus and early cranial cruciate ligament disease in both patients. TREATMENT AND OUTCOME: Medial-closing, medially translating, centre-of-rotation-of-angulation-based, levelling osteotomy (mcmtCBLO) was performed in both patients. The procedure aims to shift the pelvic limb's mechanical axis medially to reduce pressure in the lateral compartment while also reducing craniocaudal shear forces by lowering the tibial plateau angle.Eight weeks after surgery one patient's lameness had resolved while the other had improved significantly. Second-look arthroscopy performed at this time revealed fibrocartilage formation in the lateral compartment without progression of cruciate disease in both cases. At long-term follow-up (approximately 3 and 5 years), favourable outcomes (no or minimal lameness, mild or moderate osteoarthritis) were identified on the long-term owner survey, lameness examination and radiographs. CLINICAL RELEVANCE: mcmtCBLO reduced or eliminated short- and long-term lameness in these two cases afflicted by concurrent lateral compartment and early cranial cruciate ligament disease.