Influence of orthopedic examination on lameness scores and interobserver and intraobserver agreement in dogs with naturally occurring elbow osteoarthritis.

OBJECTIVE: To determine the influence of orthopedic examination on numerical rating score (NRS) and visual analog score (VAS) when scoring lameness in dogs with elbow osteoarthritis (OA) and to evaluate interobserver and intraobserver agreement in NRS and VAS on the basis of video-graphic gait analysis. DESIGN: Prospective blinded study. ANIMALS: Eighteen client-owned dogs with radiographically confirmed elbow OA. METHODS: Videos were obtained for all dogs at a walk and at a trot both prior to and immediately after orthopedic examination. All videos were randomly sequenced. Six observers, unaware of the timing of the video, independently assigned both NRS and VAS twice, with at least a 2-week interval. Scores were evaluated with mixed analysis of variance, and the agreement among observers was accessed by intraclass correlation coefficient (ICC). RESULTS: No difference was detected between NRS and VAS at walk or at trot before and after orthopedic examination. Numeric rating score and VAS at walk were lower than those at trot before an orthopedic examination by scores of 0.17 (P = .0018) and 3.54 (P = .0019), respectively. The ICC for both scores for all observers was >0.9. CONCLUSION: An orthopedic examination did not exacerbate the NRS and the VAS for dogs with elbow OA. Interobserver and intraobserver agreement was high for both lameness scores. CLINICAL SIGNIFICANCE: Lameness may be scored after gait evaluation in dogs with elbow OA irrespective of the timing of a comprehensive orthopedic examination.

The impact of body mass index on metatarsalgia surgical outcomes.

INTRODUCTION: Several studies have suggested that an increased body mass index (BMI) is a negative factor for forefoot plantar pain but its influence in the surgical correction of metatarsalgia is unknown. The purpose of the present study is to evaluate the influence of the BMI on the surgical outcomes of metatarsalgia. It has been hypothesized that the higher the BMI, the worse the functional outcomes after metatarsalgia surgical treatment at one year follow-up. MATERIAL AND METHODS: A prospective cohort study that included all patients operated on for third rocker metatarsalgia was conducted. Weil's osteotomy was performed on all the patients operated on. The patients' pre-operative height, weight, and BMI were recorded. The patients were subsequently divided into three groups based on their BMI. There was group 1 or the normal group (18.5 > BMI ≤ 25 kg/m2), group 2 or the overweight group (25 > BMI ≤ 30 kg/m2), and group 3 or the obese group (BMI > 30 kg/m2). Pre-operative, post-operative, and differential AOFAS were used to evaluate and compare the groups. The post-operative VAS was also measured to assess pain. The correlation between the BMI and those variables was also analyzed. RESULTS: After the exclusion criteria were applied, 107 patients were finally assessed. There were 22 patients (20.6%) in group 1, 52 patients (48.6%) in group 2, and 33 patients (30.8%) in group 3. No correlation was observed between the BMI and AOFAS (p > 0.05). Neither were any differences found when the three groups were compared (p > 0.05). Moreover, no correlation between the BMI and the VAS score was observed (p = 0.690). CONCLUSION: Obesity does not negatively influence functional outcomes after surgery for metatarsalgia in short to medium term. Regardless of their BMI, patients with propulsive metatarsalgia improve in functionality after surgical treatment.

Assessment of radiolucent lines in cemented shoulder hemi-arthroplasties: study of concordance and reproducibility.

We report on the concordance and reproducibility of the evaluation of radiolucent lines in the humeral component of shoulder arthroplasty. Thirty-two shoulder prostheses were assessed independently, on two occasions, by five observers. The level of inter- and intra-observer agreement was calculated using the kappa statistic. Intra-observer agreement: the overall kappa values ranged from 0 to 0.6, meaning poor, fair and moderate agreement levels. Inter-observer agreement: when the anteroposterior (AP) views were analysed, the values obtained for the bone-cement interface ranged from 0.290 to 0.539, meaning a poor-to-moderate agreement. For the cement-implant interface, the values ranged from 0.064 to 0.684, meaning a poor-to-good agreement. When radiolucent lines of the humeral component were analysed, inter-observer agreement proved to be as low as that obtained when total hip or knee components were analysed. Intra-observer agreement showed better results.

Fractures above and below a modular nail for knee arthrodesis. A case report.

Several techniques have been advocated for knee arthrodesis, and there has been an increasing interest in modular intramedullary nails in the recent last years. We report a case of femoral and tibial fractures at each end of a modular nail in a solidly fused knee 8 months after an arthrodesis.