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.

Evaluation of the quadriceps muscle length to femoral length ratio in small breed dogs with medial patellar luxation.

OBJECTIVE: To determine the quadriceps muscle length (QML) to femoral length (FL) ratio (QML/FL) and its associated factors in small breed dogs with medial patellar luxation (MPL) and to compare the differences in the QML/FL between MPL grades. STUDY DESIGN: Retrospective study. SAMPLE POPULATION: Small breed dogs (<10 kg) with MPL: 78 dogs (134 limbs). METHODS: Medical records and computed tomography (CT) images from 2008-2020 were reviewed. Furthermore, age, bodyweight, sex, laterality, MPL grade, femoral inclination angle (FIA), femoral torsion angle (FTA), anatomical lateral distal femoral angle (aLDFA), and patellar ligament length to patellar length ratio were included in the regression analysis to determine the factors associated with QML/FL. Each measurement parameter was compared among the four MPL grade groups. RESULTS: The final model demonstrated that the QML/FL increased with increasing age (p = .004) and decreased with increasing FTA and aLDFA (p = .015 and p < .001, respectively). The MPL grade IV group had a lower QML/FL than the grade I, II, and III groups (p = .002, p < .001, and p < .001, respectively). CONCLUSION: Among small breed dogs, those with MPL grade IV had a shortened QML associated with femoral deformities. CLINICAL SIGNIFICANCE: Noninvasive evaluation of the QML/FL improves our understanding of the length mismatch between the quadriceps muscle and the femur.

Partial tarsal arthrodesis with closing wedge ostectomy for treatment of bilateral twisted leg deformity in a cat.

A 5-month-old male domestic shorthair cat was presented with severe bilateral hind-limb deformities that caused the cat to walk on the dorsal aspect of the metatarsals. Computed tomography (CT) images revealed that the calcaneus was externally rotated, and the distal end of the calcaneus was turned medially to the talus in both hind limbs. The cat was diagnosed with twisted leg deformity, a congenital tarsal hyperextension deformity (clubfoot). Based on CT images, closing wedge ostectomy was done at the level of the tarsometatarsal joint with the wider part facing laterally. Partial transection of the common calcaneal tendon was not performed. Nine weeks after surgery, the cat was able to walk and jump, with its paws correctly placed on the ground, despite the limited range of motion in the tarsal joints. Based on radiographs with maximum tarsal flexion, the angle of the partial tarsal arthrodesis limited the range of motion. This is apparently the first case report describing CT images and closing wedge ostectomy in a cat with twisted leg deformity. Key clinical message: This article reports the findings obtained from CT imaging of a cat with twisted leg deformity. The current case was successfully managed by closing wedge ostectomy without partial transection of the common calcaneal tendon.

Arthrodèse partielle du tarse avec ostectomie de fermeture pour le traitement d'une déformation bilatérale des pattes tordues chez un chat. Un chat domestique à poil court mâle âgé de 5 mois a été présenté avec de graves déformations bilatérales des membres postérieurs qui ont amené le chat à marcher sur la face dorsale des métatarsiens. Les images de tomodensitométrie (CT) ont révélé que le calcanéus était en rotation externe et que l'extrémité distale du calcanéum était tournée médialement vers le talus dans les deux membres postérieurs. Le chat a été diagnostiqué avec une déformation de la jambe tordue, une déformation congénitale du tarse en hyperextension (pied bot). Sur la base d'images par CT, une ostectomie de fermeture a été réalisée au niveau de l'articulation tarsométatarsienne avec la partie la plus large tournée latéralement. Aucune section partielle du tendon calcanéen commun n'a été réalisée. Neuf semaines après l'opération, le chat était capable de marcher et de sauter, les pattes correctement posées au sol, malgré l'amplitude de mouvement limitée des articulations du tarse. Sur la base de radiographies avec une flexion tarsienne maximale, l'angle de l'arthrodèse partielle du tarse limitait l'amplitude de mouvement. Il s'agit apparemment du premier rapport de cas décrivant des images CT et une ostectomie de fermeture chez un chat présentant une déformation de la jambe tordue.Message clinique clé:Cet article rapporte les résultats obtenus à partir de l'imagerie CT d'un chat avec une déformation des pattes tordues. Le cas actuel a été géré avec succès par une ostectomie de fermeture sans section partielle du tendon calcanéen commun.(Traduit par Dr Serge Messier).

Stress Changes in the Canine Radius after Locking Plate Fixation Using Finite Element Analysis.

OBJECTIVE: The aim of this study was to evaluate the stress changes in the radii beneath the locking plates (LP) of dogs implanted with LP using finite element analysis (FEA). STUDY DESIGN: The study included radii harvested from eight dogs. After computed tomography (CT) scans of the forelimb, the articular surface of the radius was fixed using resin. Material tests were conducted to identify the yield and fracture points and for verification with FEA. The CT data of the radius were imported into FEA software. The radii were classified into three groups based on the placement of the LP (nonplate placement, intact group; 1 mm above the radial surface, LP + 1 mm group; 3 mm above the radial surface, LP + 3 mm group). Equivalent, maximum, and minimum principal stresses and minimum principal strain were measured after FEA at the radial diaphysis beneath the plate. RESULTS: In shell elements, the LP + 1 mm and LP + 3 mm groups showed a significantly lower maximum principal stress compared with the intact group. In solid elements, the LP + 1 mm and LP + 3 mm groups showed a significantly higher equivalent stress and a significantly lower maximum principal stress compared with the intact group. CONCLUSION: When an axial load is applied to the radius, LP placement reduces the tension stress on the cortical bone of the radius beneath the plate, possibly related to implant-induced osteoporosis and bone formation in the cortical bone beneath the plate.

Examination of Proximodistal Patellar Position in Dogs with the Stifle at Full Extension.

OBJECTIVE: The aim of this study was to determine the factors related to functional patella alta, with which the proximodistal patellar position exceeds the reference range of healthy small dogs proximally when the stifle is at full extension. STUDY DESIGN: Mediolateral-view radiographs of dogs weighing less than 15 kg were obtained and classified into the medial patellar luxation (MPL) and control groups. The reference range of the proximodistal patellar position was determined from the control group. In both groups, a patellar position exceeding this reference range proximally was considered functional patella alta. Multiple logistic regression analysis was performed to examine the factors related to functional patella alta. A receiver operating characteristic (ROC) curve was made for each factor. RESULTS: Overall, radiographs of 127 stifles of 75 dogs were obtained. Eleven stifles in the MPL group and one stifle in the control group were determined to be functional patella alta. The factors associated with functional patella alta included a greater full extension angle of the stifle joint, longer patellar ligament, and shorter femoral trochlear length. The full extension angle of the stifle joint had the biggest area under the ROC curve. CONCLUSION: Mediolateral radiographs of the stifle joint in full extension are clinically important in dogs with MPL because some dogs might have a proximally positioned patella that is recognizable only when the stifles are extended.

Comparison of patellar position and moment arm between tibial plateau leveling osteotomy and cranial closing wedge ostectomy: An ex vivo study.

Background: Tibial plateau leveling osteotomy (TPLO) and cranial closing wedge ostectomy (CCWO) are common treatments for cranial cruciate ligament disease. These two techniques mainly differ in whether the proximal tibial fragment contains the attachment site of the patellar ligament. Currently, no reports compare how these techniques affect the patellofemoral joint. Aim: This ex vivo study aimed to compare the effects of TPLO and CCWO on the patellar position and moment arm in healthy Beagles. Methods: TPLO and CCWO were performed on each stifle in six cadavers of Beagles. Pre- and postoperative mediolateral radiographs with the stifle angle at approximately 90° were obtained. The modified Blumensaat index (MBI), patellar ligament length to patella length ratio (PLL:PL), and patellar moment arm (PMA) were measured in each radiograph. Mixed-model multiple regression analyses for the MBI, PLL:PL, and PMA, with the surgical procedure as the independent variable, were then performed. The joint angle was included as an independent variable for MBI and PMA. Results: The PLL:PL was decreased after TPLO. Additionally, the PLL:PL after TPLO was significantly lower than that after CCWO. The MBI decreased with flexion. Postoperative MBI values were reduced for both procedures, with lower values after CCWO than after TPLO. The PMA values decreased with flexion. Postoperative values for both methods were reduced in the PMA, with the values being lower after CCWO than after TPLO. Conclusion: Both TPLO and CCWO affect the patellofemoral joint. Compared with TPLO, CCWO produced more excellent downward traction on the patella. Therefore, CCWO may be used to correct the patellar alta and treat cranial cruciate ligament disease.

Medial patellar luxation grade IV according to the Singleton system can be classified into skeletally immature and skeletally matured types.

OBJECTIVE: To determine the signalment and musculoskeletal morphology of small-breed dogs affected by medial patellar luxation (MPL) grade IV based on the age of the CT scan. ANIMALS: 40 small-breed dogs (54 limbs) with MPL grade IV. PROCEDURES: Dogs that had undergone corrective surgery for MPL grade IV and had performed CT of the hind limb before surgery were included. Signalment (age, body weight, sex, laterality, and breed) and concomitant cranial cruciate ligament rupture (CrCLR) were recorded. Femoral inclination angle, anatomical lateral distal femoral angle (aLDFA), femoral torsion angle, quadriceps muscle length to femoral length ratio (QML/FL), and patellar ligament length to patellar length were obtained by CT images. The dogs were categorized into 2 groups based on their age at the time of the CT scan, the skeletally immature group and the skeletally matured group. Signalment and group were included in the multiple regression analysis to determine the factors associated with each measurement parameter. A logistic regression analysis was conducted to determine the risk of CrCL concomitant with age. RESULTS: The multiple regression model demonstrated that the group was associated with the value of aLDFA and QML/FL. aLDFA was higher, and QML/FL was lower in group SI than in group SM. CrCLR was present in 5/54 limbs (9.2%), with a mean age of 70.8 months and it was associated with increasing age. CLINICAL RELEVANCE: In Singleton's classification, dogs classified as grade IV can be categorized into 2 groups based on musculoskeletal morphology and pathophysiology: the skeletally immature and skeletally matured types.

Effects of long-term and high-dose administration of glucocorticoids on the cranial cruciate ligament in healthy beagle dogs.

This study aimed to determine the effects of long-term and high-dose administration of glucocorticoids (GCs) on the histological and mechanical properties of the cranial cruciate ligament (CrCL) in healthy beagle dogs. A synthetic corticosteroid at 2 mg/kg every 12 h was administered for 84 days in nine dogs (18 CrCLs) (GC group). Twenty CrCLs from 12 healthy male beagles were used as the normal control (control group). CrCLs were histologically examined (n = 12 in the GC group and n = 14 in the control group) using hematoxylin-eosin, Alcian-Blue, Elastica-Eosin stains, and immunohistological staining of type 1 collagen and elastin. An additional 12 CrCLs were mechanically tested (n = 6 in the GC and n = 6 in the control groups) to determine failure pattern, maximum tensile strength, maximum stress, elastic modulus, and stress and strain at the transition point. The histological examination revealed a significant increase in interfascicular area and fibrillar disorientation at the tibial attachment in both groups. The ratios of mucopolysaccharide-positive area and positive areas of elastic fibers were significantly higher in the control group than in the GC group. The biomechanical examination demonstrated significantly lower stress at the transition point in the GC group than in the control group. The present study results indicate that high-dose corticosteroids may affect metabolism, such as mucopolysaccharides and elastic fibers production, although the effect on type 1 collagen production is small. These changes of the extracellular matrix had a small effect on the strength of the ligament. This study suggested that the ligamentous changes associated with GC are different from the degeneration observed in spontaneous canine CrCL disease.

Examination of the proximodistal patellar position in small dogs in relation to anatomical features of the distal femur and medial patellar luxation.

OBJECTIVE: To determine the influence of anatomical features of the distal femur on the proximodistal patellar position and compare the proximodistal patellar position between dogs with and without medial patellar luxation (MPL). STUDY DESIGN: Retrospective case series (n = 71). METHODS: Mediolateral-view radiographs of clinical cases of dogs weighing less than 15 kg were obtained. The stifle joint angle, patellar ligament length, patellar length, size of the femoral condyle, trochlear length, and trochlear angle were measured and included in multiple linear regression analyses to ascertain their effects on the proximodistal patellar position. Radiographs were divided into MPL and control groups. The effects of MPL on the proximodistal patellar position and morphological factors were also examined. RESULTS: The final model for the proximodistal patellar position revealed that the patella became distal as the ratio of the patellar ligament length to patellar length decreased, the trochlear angle relative to the femur increased, the trochlear length relative to the patellar length increased, or the trochlear length relative to the femoral condyle width decreased. The proximodistal patellar position in the MPL group was not significantly different from that in the control group despite the trend towards a distally positioned patella (p = 0.073). The MPL group showed a significantly shorter trochlea (p<0.001) and greater trochlear angle relative to the femur (p = 0.029) than the control group. CONCLUSION: The proximodistal patellar position depends on multiple factors, and its determination based on PLL/PL alone may not be appropriate. Dogs with MPL did not have a proximally positioned patella compared with dogs without MPL. Although hindlimbs with MPL had a shorter trochlea than those without patellar luxation, this difference did not appear to be sufficient to displace the patellar position proximally in small dogs, possibly compensated by increased trochlear angle relative to the femur.

Alterations in the ground reaction force of dogs during trot after immobilization of the stifle joint: An experimental study.

This study aimed to evaluate changes in the vertical and fore-aft force generation of the hindlimbs in dogs with stifle orthoses. Custom-made orthoses were used on the right stifle joint. Force plate and marker data from four beagle dogs in trials without orthoses, with fixed orthoses, and with unfixed orthoses were collected. The vertical ground reaction force of the right side was increased with fixed orthoses and decreased with unfixed orthoses compared to that of gait without orthoses. When compared to that of gait without orthoses, the fore-aft ground reaction force changed with fixed orthoses but not with unfixed orthoses. It is suggested that the level of constraint of the orthosis affected the ground reaction force pattern.

A Retrospective Study of Postoperative Development of Implant-Induced Osteoporosis in Radial-Ulnar Fractures in Toy Breed Dogs Treated with Plate Fixation.

OBJECTIVE: This study aimed to evaluate implant-induced osteoporosis (IIO) development in toy breed dogs treated using internal fixation with digital radiographs as the index of pixel values. STUDY DESIGN: There were 226 cases (236 limbs) of toy breed dogs with radial-ulnar fractures. Pixel values were measured on radiographs immediately, 2 weeks and 1 to 12 months after surgery. The ratio of pixel values (PVR) represented the bone mineral areal density based on the humeral condyle in the same image. The dogs were grouped based on the fixation methods, age and status of destabilization. RESULTS: There was a significant decrease in the PVR at 1 to 12 months postoperatively for all cases. There were not any significant differences in PVR of antebrachial fractures between those repaired with plates using locking head screws, cortex screws or a combination of locking and cortex screws. Implant-induced osteoporosis persisted at 1 to 12 months postoperatively in dogs aged ≧6 months, while the PVR increased after 3 months in dogs aged <6 months. Based on the destabilization method, there was a significant increase in the PVR at 3 months in the plate removal group. CONCLUSION: This study suggests that IIO occurs in small dogs treated with plates and screws. Moreover, patients aged < 6 months showed an early postoperative recovery of bone mineral areal density. Further, screw and plate removal could contribute to the recovery of bone mineral areal density.

Segmental Femoral Ostectomy for the Reconstruction of Femoropatellar Joint in Dogs with Grade IV Medial Patellar Luxation.

OBJECTIVE: The aim of this study was to describe a new surgical method of segmental femoral ostectomy for the reconstruction of the femoropatellar joint (FPJ) in dogs with medial patellar luxation (MPL) grade IV. STUDY DESIGN: The medical records of six dogs that underwent segmental femoral ostectomy to reconstruct the FPJ for MPL grade IV were retrospectively reviewed. The data included breed, age, body weight, comorbidities, history of orthopaedic abnormalities, pre- and postoperative radiographic findings, morphological indicators measured on three-dimensional computed tomographic multiplanar reconstruction images, surgical methods and postoperative complications. OUTCOMES: Eleven hindlimbs with MPL grade IV in six dogs underwent segmental femoral ostectomy to reconstruct the FPJ with the four basic surgical procedures. Six stifle joints with femoral varus deformity were treated by closing wedge ostectomy and segmental ostectomy, while five stifle joints were treated by segmental ostectomy alone. The mean resected femoral length was 11.7 mm. The mean resected femoral length relative to the preoperative femoral length was 14.3%. The stability and congruity of the FPJ was markedly improved, with an increased range of motion in all dogs compared with their preoperative status. CONCLUSION: Segmental femoral ostectomy was a useful treatment method for MPL grade IV with shortened quadriceps muscle length relative to the femoral length. Reconstruction of the FPJ is important for recovery of limb function.

Effect of Limb Position on Measurements of the Quadriceps Muscle Length/Femoral Length Ratio in Normal Beagle Dogs.

OBJECTIVES: Dogs with patella alta reportedly have a shorter extensor mechanism than normal dogs. The present study aimed to measure the length of the extensor mechanism and to assess the effect of limb position on the quadriceps muscle length (QML)/femoral bone length (FL) ratio. STUDY DESIGN: Three-dimensional computed tomography images were taken of 12 Beagle dogs. Each dog underwent computed tomographic imaging 24 times with different limb positions. The QML/FL was measured on each image, along with the hip flexion-extension, hip abduction-adduction and stifle flexion-extension angles. Multiple regression analysis was used to determine the effect of these angles on the QML/FL. RESULTS: The QML/FL was increased with the hip extended (standardized partial regression coefficient 0.855 with linear plotting, 0.829 with log plotting) and with the stifle flexed (standardized partial regression coefficient 0.814 with linear plotting, 0.800 with log plotting). The partial regression coefficient of the hip abduction-adduction angle was small, indicating a small impact on the QML/FL. The 95% confidence range of the QML/FL with the hip extended and stifle flexed was 0.87 to 1.00 (mean ± standard deviation: 0.93 ± 0.03). CONCLUSION: The QML/FL was more influenced by joint angles when the hip was flexed or the stifle was extended. Hence, these positions should be avoided when evaluating the QML/FL so that the QML is less altered by slight positioning disparities.