Fluoroscopically-assisted closed reduction and percutaneous fixation of sacroiliac luxations in cats using 2.4 mm headless cannulated compression screws: Description, evaluation and clinical outcome.

OBJECTIVE: To describe fluoroscopically-assisted closed reduction and percutaneous fixation of sacroiliac-luxation (SIL) in cats and report radiographic results and long-term functional outcomes. STUDY DESIGN: Retrospective clinical study. ANIMALS: Eleven cats. METHODS: Percutaneous fixation of 17 SILs in 11 cats was performed with 2.4 mm headless cannulated compression screws under fluoroscopic guidance. Luxation-reduction, screw placement and purchase within the sacral body, pelvic canal diameter ratio (PCDR) and hemipelvic canal width ratio (HCWR) were assessed on pre- and postoperative radiographs. Radiographic follow-up was performed to assess the same parameters when available. Long-term clinical outcome was evaluated with an owner questionnaire. Wilcoxon paired-test was performed for comparison. RESULTS: Mean age and bodyweight of the cats were 3.3 ± 2.6 years and 4.0 ± 0.82 kg, respectively. Nine cats presented with concurrent pelvic injuries. Median luxation-reduction was 94.1% (IQR = 13.9) and median screw-purchase within the sacral body was 73.3% (IQR = 17.0) immediately postoperatively. One screw exited the sacral body caudally. Upon 7-week radiographic follow-up, luxation-reduction (88.3%, IQR = 20.1) and screw-purchase (70.7%, IQR = 12.8) had decreased compared to immediately postoperatively (p = .008 and p = .013 respectively). Screw migration was not observed. PCDR and HCWR measured on postoperative radiographs indicated successful restoration of the pelvic canal width. Owners reported an excellent long-term functional outcome (mean postoperative time: 19 ± 5 months). CONCLUSION: Fluoroscopically-assisted closed reduction and fixation of feline SIL using 2.4 mm headless cannulated compression screws allowed good reduction and optimal screw purchase within the sacral body. An excellent functional outcome was reported. CLINICAL SIGNIFICANCE: Minimally invasive reduction and fixation with headless compression screws should be considered in cats with SIL.

SURGICAL MANAGEMENT OF A TARSAL LUXATION IN A RED KANGAROO (OSPHRANTER RUFUS).

Joint luxations commonly occur in animals secondary to traumatic injury. Because of the unique hind-limb anatomy of macropods, surgical stabilization of orthopedic injuries is considered challenging, and reports of successful management are limited. A 4-yr-old male neutered red kangaroo (Osphranter rufus) presented with a dorsolateral luxation of the left tibiotarsal joint. Surgical reduction and tarsal arthrodesis were performed. Although the full range of motion of the tarsal joint was limited, this kangaroo was still able to ambulate normally at slow speeds following surgery and recovery. The aim of this report was to describe the surgical and postoperative management of a tibiotarsal luxation in a kangaroo. There were significant postoperative complications in this kangaroo, and antibiotic regional limb perfusion was used to treat wound and implant infection.

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.

Poor success rates with double pelvic osteotomy for craniodorsal luxation of total hip prosthesis in 11 dogs.

OBJECTIVE: To report the outcome of double pelvic osteotomy (DPO) for craniodorsal luxation of total hip replacement (THR). STUDY DESIGN: Retrospective case series. ANIMALS: Eleven client-owned animals. METHODS: Dogs with craniodorsal luxation of THR and high angle of lateral opening (ALO) were considered candidates for DPO. The ALO and the version angle (VA) were measured on pre- and post-DPO radiographs. Pre- and post-DPO ALO and VA were compared using a Wilcoxon signed-rank test. Clinical and radiographic outcomes were assessed at 2 and 6 months post-DPO. RESULTS: Eleven DPOs were performed on 11 dogs after THR luxation. The ALO was reduced from a median of 66.2° (range 37.3-73.1°) to 55.9° (range 13.2-60.0°) (p ≤ .001), and VA increased from a median of 25.6° (range 6.8-51.9°) to 35.3° (range 15.1-51.7°) (p ≤ .03). Craniodorsal luxation recurred in five dogs and was managed with closed reduction (one dog), capsulorrhaphy (one dog), or repositioning of the acetabular cup (three dogs). The median clinical follow-up duration was 19.7 months (range 3.4-73.0). In the long term, seven dogs required explantation (five aseptic loosenings, two infections) (median 8.2 months, range 2.6-50.6). CONCLUSION: Reluxation was frequent after DPO, 5/11 dogs requiring additional procedures, including three cup revisions. The long-term outcome was considered to be poor due to frequent explantation. CLINICAL SIGNIFICANCE: Double pelvic osteotomy may be considered to avoid cup replacement when managing craniodorsal THR luxations in dogs but is not recommended due to high complication rates.

Outcomes for 15 cats with bilateral sacroiliac luxation treated with transiliosacral toggle suture repair.

OBJECTIVE: To report a surgical technique and outcomes of transiliosacral toggle suture repair to treat feline bilateral sacroiliac luxation/fracture (SILF). STUDY DESIGN: Retrospective study. ANIMALS: Fifteen client-owned cats. METHODS: The medical records of cats with bilateral SILF treated using a transiliosacral toggle suture repair were reviewed. Short- and medium-term outcomes were assessed through standard postoperative clinical evaluation and radiographs, including measurements of angle of deviation (AoD), percentage of reduction (PoR), and pelvic canal width ratio (PCWR). Long-term functional follow up was obtained from a questionnaire derived from the Feline Musculoskeletal Pain Index (FMPI). RESULTS: Fifteen cats were enrolled retrospectively, among which 13 survived to discharge. One minor wound complication, treated by secondary intention healing, was encountered. No major complication was reported. Immediately postoperatively, the mean absolute PoR values were 88.1 ± 11.2% and 91 ± 11.6% on the right and left side, respectively. The mean absolute AoD was 3.1 ± 2.8°, and the mean PCWR was 1.24 ± 0.08. The medium-term radiographic follow up at a median of 205 (71-682) days postsurgery revealed the good stability of the repair. Excellent functional outcomes were identified upon the analysis of 12 long-term questionnaires at a median of 365 (119-798) days postsurgery. CONCLUSION: Anatomic reduction was satisfactory and comparable with previously described techniques with good implant placement documented. Functional outcomes based on FMPI-derived questionnaires were good to excellent in our population. CLINICAL SIGNIFICANCE: Transiliosacral toggle suture stabilization of bilateral SILF was associated with good outcomes in cats. Further studies are required to compare biomechanical properties and outcomes between this technique and previously described transiliosacral stabilization.

Successful total hip arthroplasty in a miniature horse.

OBJECTIVE: To describe the surgical treatment, postoperative management, and outcome of a miniature horse undergoing total hip arthroplasty (THA). STUDY DESIGN: Case report. ANIMALS: A 4-year-old miniature horse stallion weighing 85 kg. METHODS: The horse presented with left coxofemoral luxation of ~6 weeks duration. Computed tomography confirmed craniodorsal luxation with marked degenerative changes to the femoral head. The horse underwent THA using cementless press fit implants, including an interlocking lateral bolt for the femoral stem. RESULTS: The horse recovered well from anesthesia but suffered a coma-like episode after returning to a stable. Following treatment of presumed hypovolemia, the horse regained normal mentation and was discharged 24 days after surgery. At reassessment 12 weeks postoperatively, the horse was 2/10 left hind limb lameness at trot with good healing of the surgery site. Five months postoperatively mild (1/10) lameness remained at trot but the horse was able to canter normally on both reins. The horse has since been managed normally with no veterinary treatment required for 32 months postoperatively. CONCLUSION: Total hip arthroplasty is possible in miniature horses weighing up to 85 kg and can result in a good long-term outcome.

Outcome and complications following modified prosthetic capsule technique for treatment of craniodorsal hip luxation in dogs.

Objective: The objective of this retrospective study was to report the clinical outcome of dogs with craniodorsal hip luxation (CDHL) treated with a modified prosthetic capsule technique (mPCT). Animals and procedure: Retrospective study of medical records from dogs with CDHL treated with mPCT between 2012 and 2018. Results: Sixty-four dogs were included. All luxations were reduced successfully. No intraoperative complications were observed. The postoperative complication rate was 28% (n = 18), with 14% (n = 9) major and 14% (n = 9) minor complications, and the majority occurring within 1 mo after surgery. Complications included reluxation (9.4%), severe lameness (3%), osteomyelitis (1.6%), and intermittent lameness or stiffness (14%). Of dogs without major complication (33/55 dogs), long-term owner follow-up assessment (> 6 mo) (median: 39 mo, range: 19 to 51 mo) revealed an excellent or good quality of life, although 5 dogs had intermittent lameness or stiffness. Radiographs of 13/33 dogs (median: 27 mo, range: 10 to 46 mo) showed no or mild osteoarthritis progression. Conclusion and clinical relevance: The mPCT is an effective technique for surgical treatment of CDHL in dogs. Further studies are required to objectively evaluate limb use and long-term radiographic changes.

Résultat et complications après une technique de capsule prosthétique modifiée pour le traitement de la luxation cranio-dorsale de la hanche chez le chien. Objectif: L'objectif de cette étude rétrospective était de rapporter les résultats cliniques des chiens atteints de luxation craniodorsale de la hanche (CDHL) traités avec une technique de capsule prosthétique modifiée (mPCT). Animaux et procédure: Étude rétrospective des dossiers médicaux de chiens atteints de CDHL traités par mPCT entre 2012 et 2018. Résultats: Soixante-quatre chiens ont été inclus. Toutes les luxations ont été réduites avec succès. Aucune complication peropératoire n'a été observée. Le taux de complications postopératoires était de 28 % (n = 18), avec 14 % (n = 9) de complications majeures et 14 % (n = 9) de complications mineures, la majorité survenant dans le mois suivant la chirurgie. Les complications comprenaient la reluxation (9,4 %), la boiterie sévère (3 %), l'ostéomyélite (1,6 %) et la boiterie ou la raideur intermittente (14 %). Parmi les chiens sans complication majeure (33/55 chiens), l'évaluation de suivi à long terme du propriétaire (> 6 mois) (médiane : 39 mois, intervalle : 19 à 51 mois) a révélé une excellente ou bonne qualité de vie, bien que 5 chiens avaient une boiterie ou une raideur intermittente. Les radiographies de 13/33 chiens (médiane : 27 mois, intervalle de 10 à 46 mois) n'ont montré aucune progression ou une légère progression de l'arthrose. Conclusion et pertinence clinique: Le mPCT est une technique efficace pour le traitement chirurgical du CDHL chez le chien. D'autres études sont nécessaires pour évaluer objectivement l'utilisation des membres et les modifications radiographiques à long terme.(Traduit par Dr Serge Messier).

Bilateral non-traumatic elbow luxation in a Yorkshire terrier puppy.

A 10-week-old Yorkshire terrier had lameness of the right forelimb with complete lateral radioulnar luxation at the humerus, consistent with Type III congenital elbow luxation; this is rarely treated in the presence of multiple skeletal deformities. Lateral subluxation of the radial head at the left elbow was diagnosed as Type I congenital elbow luxation. Procurvatum, distal valgus, and external torsion were present in both antebrachiae. Surgical stabilization of the right elbow was performed with temporary transarticular pins in the humeroulnar and radioulnar joints. A custom-made orthosis was applied to support the surgical reduction for 20 wk. Recurrent luxation was not observed. After complete right-sided function was established, the left forelimb showed noticeable instability in the antebrachium, and the puppy frequently fell while running. The lateral collateral ligament of the left elbow was augmented using screws and synthetic ligaments 22 wk after the right-side surgery. Congruity of the left elbow joint improved, and the puppy could bear full weight on the left forelimb, although slight deficits in movement and falling were observed. We demonstrate the effectiveness of combining a temporary transarticular pin and custom-made orthosis while treating Type III congenital elbow luxation and the inadequacy of collateral ligament augmentation alone for treating Type I congenital elbow luxation with antebrachium deformities. Key clinical message: Herein, we observed that a combination of a temporary transarticular pin and a custom-made orthosis was effective for the treatment of Type III congenital elbow luxations.

Luxation bilatérale non traumatique du coude chez un chiot Yorkshire terrier. Un Yorkshire terrier de 10 semaines présentait une boiterie du membre antérieur droit avec une luxation radio-ulnaire latérale complète au niveau de l'humérus, compatible avec une luxation congénitale du coude de type III; ceci est rarement traité en présence de multiples déformations squelettiques. La subluxation latérale de la tête radiale au niveau du coude gauche a été diagnostiquée comme une luxation congénitale du coude de type I. Procurvatum, valgus distal et torsion externe étaient présents dans les deux sections antébrachiales. La stabilisation chirurgicale du coude droit a été réalisée avec des broches trans-articulaires temporaires dans les articulations huméro-ulnaire et radio-ulnaire. Une orthèse sur mesure a été appliquée pour soutenir la réduction chirurgicale pendant 20 semaines. Aucune luxation récurrente n'a été observée. Une fois la fonction complète du côté droit établie, le membre antérieur gauche a montré une instabilité notable de la section antébrachiale et le chiot tombait fréquemment en courant. Le ligament collatéral latéral du coude gauche a été augmenté à l'aide de vis et de ligaments synthétiques 22 semaines après la chirurgie du côté droit. La congruence de l'articulation du coude gauche s'est améliorée et le chiot pouvait supporter tout son poids sur le membre antérieur gauche, bien que de légers déficits de mouvement et des chutes aient été observés. Nous démontrons l'efficacité de la combinaison d'une broche trans-articulaire temporaire et d'une orthèse sur mesure dans le traitement de la luxation congénitale du coude de type III et l'insuffisance de l'augmentation du ligament collatéral seule pour traiter la luxation congénitale du coude de type I avec des déformations de la section antébrachiale.Message clinique clé:Ici, nous avons observé qu'une combinaison d'une broche trans-articulaire temporaire et d'une orthèse sur mesure était efficace pour le traitement des luxations congénitales du coude de type III.(Traduit par Dr Serge Messier).

Subaxial cervical articular process subluxation and dislocation: Cervical locked facet injuries in dogs.

OBJECTIVE: To describe neurologic signs, diagnostic imaging findings, potential treatments, and outcomes in dogs with subaxial cervical articular process subluxation and dislocation, or a "locked facet." STUDY DESIGN: Retrospective case series. ANIMALS: Ten client-owned dogs. METHODS: Dogs with a diagnosis of cervical locked facets were identified through medical records and imaging reports searches. Data on presenting signs, diagnostic findings, treatment, and outcome were recorded. RESULTS: All cases were small or toy-breed dogs with preceding trauma. Four dogs were tetraplegic with intact pain perception, five were nonambulatory tetraparetic, and one was ambulatory tetraparetic, with half of the tetraparetic dogs having worse motor function in the thoracic limbs. The only sites affected were C5/6 (n = 6) and C6/7 (n = 4). All dogs had unilateral dorsal displacement of the cranial articular process of the caudal vertebra relative to the caudal articular process of the cranial vertebra at the luxation site. Five dogs were treated surgically, three by external coaptation, one by restriction, and one was euthanized the day after diagnosis. All dogs with outcome data (n = 8) became ambulatory. Nonambulatory dogs returned to ambulation in a median of 4 weeks (IQR 1-12; range 1-28). CONCLUSION: In these dogs, locked facet injuries affected the caudal cervical vertebrae in small breeds and could be identified on imaging through the presence of dorsal displacement of a cranial articular process. Our small cohort had a functional recovery regardless of treatment. CLINICAL SIGNIICANCE: Locked facet injuries should be a differential for small or toy-breed dogs with a cervical myelopathy secondary to trauma.

Accuracy of a drilling with a custom 3D printed guide or free-hand technique in canine experimental sacroiliac luxations.

OBJECTIVE: To improve the accuracy of drilling during the repair of sacroiliac luxations (SILs) with a 3D-printed patient-specific drill guide (3D-GDT) compared to free-hand drilling technique (FHDT). STUDY DESIGN: Blinded, randomized, prospective ex vivo study. SAMPLE POPULATION: Sixteen canine cadavers (20-25 kg). METHODS: Dorsal, bilateral SILs were created. Pelvic CT was performed pre- and post-drilling. The FHDT was drilled followed by 3D-GDT. CT and 3D measurements of craniocaudal and dorsoventral angles were compared between FHDT and 3D-GDT, as well as deviations of entry and exit points relative to optimal trajectory. RESULTS: Mean craniocaudal and dorsoventral angles for both CT- and 3D-measured 3D-GDT (CT 4.2 ± 3.9° and 3.9 ± 3.2°, respectively; 3D 5.1 ± 5.1° and 2.8 ± 2.3°, respectively p = .0006) were lower compared to FHDT (CT 11.8 ± 4.0°, p < .0001 and 8.9 ± 6.1°, p = .01; 3D 12.4 ± 5.9°, p = .0006 and 5.3 ± 5.24°, p = .05). Entry dorsoventral and end craniocaudal, dorsoventral, and 3D linear deviations were reduced with 3D-GDT. Sacral corridor disruption was present in 20% (3/15) for FHDT compared with 0% for 3D-GDT. CT and 3D analyses were in strong agreement (r = 0.77). CONCLUSION: Deviations of drill trajectories were minimized relative to optimal trajectories with 3D-GDT compared to FHDT in the dorsoventral and craniocaudal planes. CLINICAL SIGNIFICANCE: The use of 3D-GDT improves accuracy of sacral drilling compared with FHDT in canine cadavers. These results justify further evaluation in a clinical, prospective study.

Mechanical evaluation of canine sacroiliac joint stabilization using two short screws.

OBJECTIVE: To assess the feasibility and mechanical stability of sacroiliac (SI) joint stabilization using 2 short 3.5 mm cortical screws, each spanning an average of 23% of the width of the sacral body. STUDY DESIGN: Cadaveric experimental study. SAMPLE POPULATION: Twenty-four canine pelvis specimens. METHODS: Pelvis specimens were prepared by disarticulation of the left SI joint and osteotomy of the left pubis and left ischium, and stabilized using a single long lag screw (LLS), 2 short lag screws (SLS) or 2 short positional screws (SPS). Computed tomography (CT) imaging was used to determine standardized screw lengths for each group and was repeated following implant insertion. Specimens were secured within a servohydraulic test frame and loaded through the acetabulum to simulate weight bearing under displacement control at 4 mm/min for 20 mm total displacement. Group mechanical testing data were compared. RESULTS: Peak load, yield load, and stiffness were more than 2 times greater in both the SLS and SPS groups when compared with the LLS group. No mechanical difference was identified between the short-screw groups. CONCLUSION: Sacroiliac luxation fixation using 2 short screws created a stronger, stiffer construct when compared with fixation using a single lag screw spanning 60% of the width of the sacral body. No mechanical advantage was observed between short screws inserted in positional vs. lag fashion. CLINICAL SIGNIFICANCE: Sacroiliac luxation fixation using 2 short screws creates a mechanically superior construct with a larger region of acceptable implant positioning and potentially reduced risk of iatrogenic injury compared with conventional fixation.

Repeatability and accuracy of a novel, quantitative radiographic method for differentiating normal canine sacroiliac joints from joints with subluxation or luxation: Pilot study.

Canine sacroiliac (SI) joint subluxation or luxation is most commonly diagnosed based on qualitative radiographic assessments. Aims of this two-part, retrospective, diagnostic accuracy, pilot study were to develop and evaluate a novel quantitative method based on measuring the angle between a line connecting the iliac wings and parallel lines across three anatomical landmarks (cranial endplate of L7, caudal endplate of L6, cranial endplate of L6) on a single ventrodorsal radiograph. For the first part of the study, angle measurements from a single observer were compared for 20 normal canine pelvic radiographs and 20 pelvic radiographs with SI luxation or subluxation. Mean values significantly differed between datasets (P < 0.001). The angles for the normal pelves ranged from 0.6° to 1.5°, while abnormal angles ranged from 3.8° to 7.1°. For the second part of the study, a dataset of 25 normal and 25 abnormal canine pelvic radiographs was evaluated using the novel technique by three blinded readers with varying levels of expertise at two different time points. There was excellent reliability among the three readers with an intraclass correlation (ICC) value of 0.90 and an excellent agreement between day 0 and day 30 readings with an ICC value of 0.91. It was also determined that a cut-off angle of 2.0°, using the line parallel to the cranial endplate of L6, provided overall the best accuracy, sensitivity, and specificity to differentiate normal versus abnormal pelves. These findings may be helpful for clinical cases with equivocal diagnoses and for future development of automated diagnostic tools.

Superficial digital flexor tendon luxation repaired with abrasion calcaneoplasty and primary retinaculum repair in dogs.

Surgical treatment of a superficial digital flexor tendon luxation is the treatment of choice, since nonsurgical treatment has been shown to be unsuccessful in dogs in which it has been attempted. The objectives of this study were to report complications and short- to long-term outcomes in dogs with superficial digital flexor tendon luxation treated with abrasion calcaneoplasty, an adjunctive surgical technique, in addition to traditional repair. In total, 12 client-owned dogs with superficial digital flexor tendon luxations were examined in this retrospective case series (from 2010 to 2020) of a novel surgical technique using abrasion calcaneoplasty, in addition to retinaculum imbrication. Records were reviewed for signalment, chronicity of clinical signs, preoperative diagnostics tests, surgical techniques, postoperative complications, and outcomes. Abrasion calcaneoplasty, in addition to traditional primary retinaculum repair, was successfully performed in 12 dogs, with ultimate resolution of clinical lameness in all patients, despite short-term reluxation in 1 patient. Based on the findings of this case series, we inferred that abrasion calcaneoplasty can be considered in addition to traditional repair as an option to treat luxation of the superficial digital flexor, with a 58% short-term complication rate, and no evidence of long-term complications.

Luxation du tendon fléchisseur superficiel réparée par calcanéoplastie par abrasion et réparation primaire du rétinaculum chez le chien. Le traitement chirurgical d'une luxation du tendon fléchisseur superficiel est le traitement de choix, car le traitement non chirurgical s'est avéré infructueux chez les chiens chez lesquels il a été tenté. Les objectifs de cette étude étaient de rapporter les complications et les résultats à court et à long terme chez les chiens présentant une luxation du tendon fléchisseur superficiel traitée par calcanéoplastie par abrasion, une technique chirurgicale complémentaire, en plus de la réparation traditionnelle. Au total, 12 chiens de propriétaires présentant des luxations des tendons fléchisseurs superficiels ont été examinés dans cette série de cas rétrospective (de 2010 à 2020) d'une nouvelle technique chirurgicale utilisant la calcanéoplastie par abrasion, en plus de l'imbrication du rétinaculum. Les dossiers ont été examinés pour le signalement, la chronicité des signes cliniques, les tests de diagnostic préopératoires, les techniques chirurgicales, les complications postopératoires et les résultats. La calcanéoplastie par abrasion, en plus de la réparation primaire traditionnelle du rétinaculum, a été réalisée avec succès chez 12 chiens, avec une résolution ultime de la boiterie clinique chez tous les patients, malgré une reluxation à court terme chez un patient. Sur la base des résultats de cette série de cas, nous avons conclu que la calcanéoplastie par abrasion peut être considérée en plus de la réparation traditionnelle comme une option pour traiter la luxation du fléchisseur superficiel, avec un taux de complications à court terme de 58 % et aucune preuve de complications à long terme.(Traduit par Dr Serge Messier).

Outcomes of nine cats with urinary retention after sacrocaudal luxation managed with long-term urinary diversion.

OBJECTIVE: To document the outcomes of cats with urinary retention (UR) after sacrocaudal luxation (SCL) and managed with a long-term cystostomy (LTC). STUDY DESIGN: Short case series. ANIMALS: Nine client-owned cats with SCL and subsequent UR. METHODS: Nine cats suffering from non-relievable UR secondary to SCL, between March 2013 and December 2020, had a LTC placed 4.5 days post-SCL (mean, range 3.5-6.0), until clinical evidence of normal urination recovery. The bladder was emptied at least twice daily. No antimicrobial was given during LTC. Indication for tube removal was voluntary micturition with complete emptying for a minimum of three consecutive days. Recheck examinations were scheduled for post-SCL days 7 and 14, as well as for LTC tube removal. Minor and major complications and length of LTC use were recorded. RESULTS: The LTC was removed 11-42 days (mean 26 days) after placement. All cats recovered normal micturition spontaneously within 17-47 days post-SCL (mean 30.7 days): 1 cat between the 2nd and 3rd weeks, 5 cats between the 3rd and 4th weeks, and 3 cats >30 days after the trauma. Major complications, such tube dislodgement, occurred in two cats, whereas complications resolving after tube removal were recorded in 6 cats. CONCLUSION: LTC was effective at managing UR post-SCL in 9 cats. All cats recovered normal urinary function within 7 weeks. CLINICAL SIGNIFICANCE: LTC can be an alternative to manual expression or bladder catheterization in cats with temporary UR after SCL.

Custom-built constrained uniaxial and rotating hinge total knee replacement in cats: Clinical application, design principles, surgical technique, and clinical outcome.

OBJECTIVE: To describe the design principles and evolution, surgical technique, and outcome for custom constrained (uniaxial and rotating hinge) total knee replacement (TKR) in cats. STUDY DESIGN: Retrospective case series. ANIMALS: Nine cats with traumatic stifle luxation (n = 8) or severe distal femoral deformity (n = 1) were considered suitable candidates. METHODS: Cats that met eligibility criteria and received a custom TKR between 2009 and 2018 by a single surgeon were included in this case series. Three generations of implant were used. Implant positioning was assessed by postoperative orthogonal radiography. Functional outcome was determined by clinical assessment, owner interview, and a feline musculoskeletal pain index questionnaire. RESULTS: Median clinical follow-up time was 12 months (range, 4-41); follow-up time was increased to 29 months (range, 22-47) when results of functional questionnaires with owner were included. Median radiographic follow-up was 12 months (range, 4-25). One cat had a catastrophic outcome. Three cats had good outcomes, and five cats had excellent outcomes. CONCLUSION: Most cats treated with custom-built TKR achieved good to excellent outcomes. CLINICAL SIGNIFICANCE: Custom TKR is a viable option for the treatment of severe pathologies of the feline stifle. Additional research is required to fully evaluate implant suitability.

Radiation exposure associated with percutaneous fluoroscopically guided lag screw fixation for sacroiliac luxation in dogs.

OBJECTIVE: To determine radiation exposure to surgical personnel and to evaluate the accuracy of a modified percutaneous lag screw fixation technique for sacroiliac luxation (SIL) under fluoroscopic guidance in dogs. STUDY DESIGN: Cadaveric experimental study. SAMPLE POPULATION: Seventeen beagle cadavers with iatrogenic SIL. METHODS: Seventeen beagles with iatrogenic SIL underwent reduction and stabilization with 3.5-mm screws. Hypodermic needles (14 gauge) and fluoroscopy were used to orient two Kirschner wires for temporary stabilization and to guide drilling of glide and pilot holes using cannulated drill bits. Duration of surgery and radiation exposure were recorded. Postoperative computed tomographic evaluation of screw position and angulation was performed. RESULTS: Average time for fixation was 15.85 minutes (range, 6.37-33.5). Cumulative radiation doses of 0.4 mrem for the dominant arm of the assistant and 0 mrem for the primary surgeon were recorded. The mean dorsoventral and craniocaudal screw angles were 0.68° ± 3.4° (range - 5.4° to 9.5°) and 1.9° ± 3.2° (range - 4.3° to 9.1°), respectively. Sixteen of the 17 dogs had 100% sacral screw purchase, with the remaining case achieving 93.4% purchase. CONCLUSION: Fluoroscopy-assisted percutaneous placement of 3.5-mm cortical screws in lag fashion performed with 14-gauge needles in conjunction with Kirschner wires and cannulated drill bits yielded repeatable accurate screw placement with low levels of ionizing radiation exposure to the surgical team. CLINICAL SIGNIFICANCE: The described technique may be a viable method for minimally invasive osteosynthesis fixation of SIL with low levels of radiation exposure to the surgical team. These results provide evidence to support further evaluation of radiation exposure in clinical cases and can aid in study design and sample size determination.

Conservative management of sacroiliac luxation in 17 dogs: Radiographic changes and long-term owner follow-up.

The long-term outcome of dogs with sacroiliac (SI) luxation treated conservatively was evaluated in this study. The cranial displacement of the ilial wing relative to sacral length was measured. Long-term follow-up was conducted via owner telephone interview. Short-term radiographic changes were analyzed. Seventeen dogs with a mean radiographic follow-up time of 8 weeks ± 1.9 weeks and mean survey follow-up time of 63 months ± 51 months were included. Mean ilial cranial displacement at the time of injury was 42.1% ± 21.4% (range: 9% to 86%). At recheck examination, 7/9 had no worsening of displacement. Thirteen of 17 dogs were bearing weight within 2 weeks. Fourteen dogs (82%) had complete resolution of lameness within 3 months. Fifteen owners (88%) reported an excellent recovery, indicating no current lameness. No dogs were reported to have a poor outcome. Dogs with SI luxation can have excellent long-term outcomes when managed conservatively.

Gestion conservatrice de luxation sacro-iliaque chez 17 chiens : changements radiographiques et suivi à long terme auprès des propriétaires. Le devenir à long terme de chiens avec une luxation sacro-iliaque (SI) traités de manière conservatrice fut évalué dans cette étude. Le déplacement crânial de l'aile iliaque relativement à la longueur sacrale fut mesuré. Le suivi à long terme fut mené auprès des propriétaires via une entrevue téléphonique. Les changements radiographiques à court terme furent analysés. Dix-sept chiens avec un temps moyen de suivi radiographique de 8 semaines ± 1,9 semaine et un temps moyen de suivi de 63 mois ± 51 mois furent inclus. Le déplacement crânial moyen de l'aile iliaque au moment de la blessure était de 42,1 % ± 21,4 % (écart : 9 % à 86 %). Au moment de la réévaluation, le déplacement n'avait pas empiré chez 7/9 chiens. Treize des 17 chiens mettaient du poids sur la jambe affectée en dedans d'une période de 2 semaines. Une résolution complète de la boiterie fut notée chez quatorze chiens (82 %) à l'intérieur d'une période de 3 mois. Quinze propriétaires (88 %) ont rapporté une excellente guérison, en indiquant qu'aucune boiterie n'était observée au moment de l'entrevue. Aucun des chiens ne présenta un résultat médiocre. Un excellent résultat peut être obtenu chez les chiens avec une luxation SI lorsqu'ils sont gérés de manière conservatrice.(Traduit par Dr Serge Messier).

Successful Treatment of Acute Craniodorsal Coxofemoral Luxation in a Scarlet Ibis (Eudocimus ruber) Using Closed Reduction and a Modified Ehmer Sling.

Whereas craniodorsal displacement of the coxofemoral joint is the most common luxation reported in small and large mammals, it occurs less often in avian species. Closed reduction and external coaptation with a modified Ehmer sling is the initial treatment, in most cases, for small animals (eg, dogs, cats) that present with a coxofemoral luxation. However, the Ehmer sling is reported to have a low success rate in treating coxofemoral luxations in these animals. Intractable coxofemoral luxations require an open surgical reduction. A few successful closed reductions of coxofemoral luxations have been reported in avian patients, as well as open reduction surgical techniques to repair avian coxofemoral luxations. The successful treatment of an acute craniodorsal coxofemoral luxation in a scarlet ibis (Eudocimus ruber) with a closed reduction and a modified Ehmer sling is described in this clinical report. The specific characteristics of both the patient and the injury are thought to have contributed to the success in this case.

Biomechanical comparison of ex vivo lumbar vertebral fracture luxations stabilized with tension band or polymethylmethacrylate in cats.

OBJECTIVE: To evaluate spinal stabilization with tension band stabilization (TS) in cats compared to screw and polymethylmethacrylate fixation (SP). STUDY DESIGN: Ex vivo study. SAMPLE POPULATION: Sixteen feline thoracolumbar spinal specimens. METHODS: The intact specimens were mounted in a six-degree-of-freedom biaxial testing machine for nondestructive testing to obtain the neutral zones (NZ) and range of motion (ROM) in flexion and extension. Thereafter, nondestructive testing was consecutively performed after destabilization by disc fenestration and partial L1 corpectomy and after treatment with either TS or SP. Load to failure was compared after surgical treatment in flexion. Significance was assessed by Student's t test or Wilcoxon signed-rank test. RESULTS: Range of motion was 26.4° ± 2.2° in TS constructs and 13.4° ± 2.1° in SP constructs (P = .0005). When flexion and extension were analyzed separately, no difference was found for ROM in flexion (SP, 7.0° ± 3.7°; TS, 8.3° ± 2.1°; P = .38). In extension, the mean displacement was 6.4° ± 2.7° and 18.1° ± 5.1° in SP and TS constructs, respectively (P = .0001). Neutral zone was 2.9° ± 0.6° and 7.5° ± 0.8° for the SP and TS groups, respectively (P = .0003). Screw and polymethylmethacrylate fixation constructs were two times stiffer (P = .045). CONCLUSION: Tension band stabilization provided stability comparable to SP in flexion. In extension, ROM of SP constructs was half that of TS constructs. The mode of failure of TS was related to the limited dorsal bone stock of feline lumbar vertebrae. CLINICAL SIGNIFICANCE: Surgeons should be aware of the limited stability in extension provided by TS when it is used to stabilize thoracolumbar spinal injuries. Our results provide evidence to justify additional studies to clarify the type of fractures amenable to TS.

Traumatic medial luxation of the triceps brachii tendon with medial subluxation of the elbow joint in a dog.

OBJECTIVE: To describe the surgical reduction of luxation of the triceps brachii tendon in a dog. ANIMAL: One 2.5-year-old 2.58 kg castrated male toy poodle. STUDY DESIGN: Clinical case report. METHODS: The dog displayed intermittent, non-weight bearing lameness of the right forelimb for approximately 18 months before presenting at the veterinary medical center. Medial subluxation of the right elbow joint was detected by palpation. The Campbell test was consistent with an increased range of motion during supination. At ultrasonographic examination, medial luxation of the triceps brachii tendon was noted, whereas collateral ligaments appeared normal. No skeletal deformities were found on radiographs of the right forelimb. The luxation of the triceps brachii tendon was surgically corrected with antirotational suture, a stopper pin, medial retinaculum release, and imbrication of the lateral retinaculum. RESULTS: The right triceps brachii tendon and elbow joint were successfully reduced. Gait returned to normal by 55 days postoperatively. No implant failure or recurrence were observed 3.5 years after surgery. CONCLUSION: Surgical reduction of a luxation of the triceps brachii tendon in a dog resolved lameness and restored the range of motion of the affected elbow, leading to good long-term outcome.