Influence of radiographic examination findings on recommendations made during routine clinical re-evaluation of dogs with uncomplicated tibial plateau leveling osteotomy.

OBJECTIVE: To determine the influence of follow-up radiographic examination on recommendations made during routine clinical re-evaluation of dogs that had undergone uncomplicated tibial plateau leveling osteotomy (TPLO). STUDY DESIGN: Retrospective multi-institutional case series. ANIMALS: Client-owned dogs (N = 1010) that underwent uncomplicated TPLO. METHODS: Records from 11 institutions were searched for dogs that had been treated with unilateral TPLO and had no history of postoperative complications before their routine follow-up examination. The frequency of change in further clinical recommendations resulting from client- or clinician-voiced concerns or radiographic abnormalities was investigated. RESULTS: Follow-up evaluation was performed at a median of 6 (range, 4-15) weeks after TPLO. Radiographic examination findings contributed to a change in recommendations in 4.15% (38/915) of dogs presented without client concerns and without abnormalities at orthopedic examination. Abnormal radiographic findings alone influenced the management of 3.76% (38/1010) of dogs. An association was detected between clinical features and radiological findings leading to a change in recommendations (P < .0001). Administration of analgesia at the time of follow-up was associated with radiographic abnormalities (P = .017) and change in postoperative plans (P = .0007). CONCLUSION: Radiographic examination findings at follow-up did not influence the management of most dogs with uncomplicated TPLO. CLINICAL SIGNIFICANCE: Radiographic examination findings are unlikely to influence the treatment of dogs that seem to be recovering uneventfully from an uncomplicated TPLO without concerns from clients, analgesia, or abnormal findings on thorough orthopedic examination by a surgical specialist, at the time of the planned clinical re-evaluation.

Hybrid cemented/cementless total hip replacement in dogs: seventy-eight consecutive joint replacements.

OBJECTIVE: To evaluate the use of hybrid total hip replacement (THR), using a cementless acetabular component and a cemented femoral component. STUDY DESIGN: Prospective case series. SAMPLE POPULATION: Client-owned dogs (n = 71). MATERIALS AND METHODS: Consecutive clinical cases that had hybrid THR were studied. Radiographic features, pain scores, and lameness scores were recorded pre- and postoperatively. Longer term outcome was assessed by owner questionnaire. RESULTS: Hybrid THRs (n = 78) were performed in 71 dogs. Four cases (5%) had major postoperative complications; 3 were resolved after revision surgery, and 1 owner requested an explantation. No other major complications were identified on follow-up radiographs (67 THR) at 12 weeks. On clinical follow up (77 THR) at 4 weeks, lameness had improved in 68, was unchanged in 8, and was worse in 1. Pain had decreased in 72, was unchanged in 4, and was worse in 1. At 12 weeks (69 THR) compared with preoperative status, lameness had improved in 67 and was unchanged in 2. Pain had improved in 68 and was unchanged in 1. Longer term follow-up (mean, 16 months) was available for all hips. No further complications were reported. Owner satisfaction was good for 76 THRs and reasonable for 2. CONCLUSIONS: Hybrid THR can be performed successfully with a low complication rate and represents an alternative to either entirely cemented or cementless implantation.