Intra-articular Fibrolipoma of the Stifle in a Dog.

A 12 yr old male castrated miniature Australian shepherd dog presented for surgical consultation of historical bilateral medial patellar luxations with a 3 mo history of an acute onset of a left pelvic limb lameness. Physical examination confirmed medial patellar luxations and a mass effect of the left stifle medially. Radiographs showed medial distension of the joint capsule by a soft tissue opacity. Fine-needle aspirate of the left stifle revealed a mesenchymal cell population. Left medial parapatellar stifle arthrotomy found a fatty mass, which was excised at its base. A benign fibrolipoma was diagnosed on histopathology, and the excision was expected to be curative. The owners reported immediate improvement of perceived comfort postoperatively. At 2 and 24 wk, the dog returned to a normal level of function. Lipomas of the stifle, although rare, should be considered as a differential for intra-articular masses causing lameness.

Ventral femoral head and neck ostectomy: Standard versus novel K-wire guided technique using a premeasured ostectomy angle in canine cadavers.

OBJECTIVE: To assess the accuracy and efficiency of performing ventral FHO (vFHO) after measuring the ideal femoral head and neck ostectomy angle (iFHOA), with and without guidance of a K-wire. To compare the iFHOA to the previously accepted 45° angle to guide vFHOs. STUDY DESIGN: Randomized, controlled, ex vivo study. ANIMALS: Ten mixed-breed canine cadavers. METHODS: A routine un-guided and guided vFHO was performed on each cadaver. A single unmodified ostectomy was performed on all hips. The pre- and postoperative iFHOA and postoperative residual femoral neck were radiographically assessed. Subjective intraoperative palpation and postoperative radiographic ostectomy completeness (OC) scores were assigned. RESULTS: Subjective OC scores (p > .63) did not differ between techniques, and guided vFHOs were as good or better for 7/10 dogs assessed via intraoperative palpation, and 9/10 dogs assessed radiographically. Residual femoral neck measurements were similar in both groups (p > .75). The average iFHOA in this study was 38.5°, with no significant difference between limbs of the same cadaver (p = .34). Guided vFHO took longer (294.5 s, p = .002) than unguided vFHO (166.7 s). CONCLUSION: The mean iFHOA of 38.5° was less than the previously published 45° angulation for vFHOs. Subjectively, use of a K-wire guide improved soft tissue retraction, neck visualization, and confidence in cut angulation. CLINICAL SIGNIFICANCE: Preoperative iFHOA measurement may minimize the risk of inappropriate vFHO angles.

Psoas compartment and sacral plexus block via electrostimulation for pelvic limb amputation in dogs.

OBJECTIVE: To assess the efficacy of psoas compartment and sacral plexus block for pelvic limb amputation in dogs. STUDY DESIGN: Prospective clinical study. ANIMALS: A total of 16 dogs aged 8±3 years and weighing 35±14 kg (mean±standard deviation). METHODS: Dogs were administered morphine (0.5 mg kg-1) and atropine (0.02 mg kg-1); anesthesia was induced with propofol and maintained with isoflurane. Regional blocks were performed before surgery in eight dogs with bupivacaine (2.2 mg kg-1) and eight dogs were administered an equivalent volume of saline. The lumbar plexus within the psoas compartment was identified using electrolocation lateral to the lumbar vertebrae at the fourth-fifth, fifth-sixth and sixth-seventh vertebral interspaces. The sacral plexus, ventrolateral to the sacrum, was identified using electrolocation. Anesthesia was monitored using heart rate (HR), invasive blood pressure, electrocardiography, expired gases, respiratory frequency and esophageal temperature by an investigator unaware of the group allocation. Pelvic limb amputation by coxofemoral disarticulation was performed. Dogs that responded to surgical stimulation (>10% increase in HR or arterial pressure) were administered fentanyl (2 µg kg-1) intravenously for rescue analgesia. Postoperative pain was assessed at extubation; 30, 60 and 120 minutes; and the morning after surgery using a visual analog scale (VAS). RESULTS: The number of intraoperative fentanyl doses was fewer in the bupivacaine group (2.7±1.1 versus 6.0±2.2; p<0.01). Differences in physiologic variables were not clinically significant. VAS scores were lower in bupivacaine dogs at extubation (0.8±1.9 versus 3.8±2.5) and at 30 minutes (1.0±1.4 versus 4.3±2.1; p<0.05). CONCLUSIONS AND CLINICAL RELEVANCE: Psoas compartment (lumbar plexus) and sacral plexus block provided analgesia during pelvic limb amputation in dogs.

Comparison of owner satisfaction between stifle joint orthoses and tibial plateau leveling osteotomy for the management of cranial cruciate ligament disease in dogs.

OBJECTIVE To compare owner satisfaction between custom-made stifle joint orthoses and tibial plateau leveling osteotomy (TPLO) for the management of medium- and large-breed dogs with cranial cruciate ligament disease (CCLD). DESIGN Owner survey. SAMPLE 819 and 203 owners of dogs with CCLD that were managed with a custom-made stifle joint orthosis or TPLO, respectively. PROCEDURES Client databases of an orthosis provider and veterinary teaching hospital were reviewed to identify potential survey respondents. An online survey was developed to evaluate owner-reported outcomes, complications, and satisfaction associated with the nonsurgical (orthosis group) and surgical (TPLO group) interventions. Survey responses were compared between groups. RESULTS The response rate was 25% (203/819) and 37% (76/203) for the orthosis and TPLO groups, respectively. The proportion of owners who reported that their dogs had mild or no lameness and rated the intervention as excellent, very good, or good was significantly greater for the TPLO group than for the orthosis group. However, ≥ 85% of respondents in both groups reported that they would choose the selected treatment again. Of 151 respondents from the orthosis group, 70 (46%) reported skin lesions associated with the device, 16 (11%) reported that the dog subsequently underwent surgery, and 10 (7%) reported that the dog never tolerated the device. CONCLUSIONS AND CLINICAL RELEVANCE Results indicated high owner satisfaction rates for both interventions. Owners considering nonsurgical management with an orthosis should be advised about potential complications such as persistent lameness, skin lesions, patient intolerance of the device, and the need for subsequent surgery.

Arthroscopic biceps ulnar release procedure (BURP): technique description and in vitro assessment of the association of visual control and surgeon experience to regional damage and tenotomy completeness.

OBJECTIVES: (1) Describe arthroscopic BURP surgical technique, (2) assess association of visual control and surgeon experience to tenotomy completeness and regional iatrogenic tissue damage. STUDY DESIGN: Cadaveric study. SAMPLE POPULATION: Canine cadavers weighing >20 kg (n = 16; 32 elbows). METHODS: Phase 1 = dissection/anatomic description/procedural refinement (n = 6). Phase 2 = technique description (n = 6). Phase 3 = association of surgeon experience and procedural visual control to tenotomy completion and regional iatrogenic damage (n = 20). Elbows were randomly assigned via coin toss to an experienced- or inexperienced-arthroscopist. Using conventional medial portals, surgeons sought to identify the medial collateral ligament (MCL) and ulnar insertion of the biceps tendon (uBT) before attempting complete tenotomy. Upon procedural completion, surgeons assigned a standardized "visual control score" (VCS) describing viewing that governed procedure and predicted % uBT release, MCL, and median nerve damage. Post-procedural dissection determined actual tenotomy completion and iatrogenic tissue damage. RESULTS: Complete BURP was achieved in 16 of 19 elbows. VCS was associated with tenotomy completeness (P < .01). "Blind" BURP was incomplete in both elbows in which it was attempted. Perception of complete BURP was associated with complete release (P < .01). MCL damage occurred in 10% of elbows. Surgeon experience did not influence VCS, regional damage, or BURP completeness. CONCLUSION: In canine cadavers, arthroscopic BURP can be consistently performed using conventional arthroscopic instruments and portals by both experienced and inexperienced arthroscopists when visual control guides the tenotomy into the distal aspect of the tendon.

Comparison of the mechanical behaviors of semicontoured, locking plate-rod fixation and anatomically contoured, conventional plate-rod fixation applied to experimentally induced gap fractures in canine femora.

OBJECTIVE: To compare the mechanical behaviors of a semicontoured, locking compression plate-rod (LCP-rod) construct and an anatomically contoured, limited-contact dynamic compression plate-rod (LC-DCP-rod) construct applied to experimentally induced gap fractures in canine femora. SAMPLE POPULATION: 16 femora from 8 cadaveric dogs. PROCEDURES: 8 limbs from 8 dogs were assigned to the LCP-rod construct group or the LC-DCP-rod construct group. In each femur, a 39-mm mid-diaphyseal ostectomy was performed at the same plate location and the assigned construct was applied. Construct stiffness and ostectomy gap subsidence were determined before and after cyclic axial loading (6,000 cycles at 20%, 40%, and 60% of live body weight [total, 18,000 cycles]). Three constructs from each group further underwent 45,000 cycles at 60% of body weight (total, 63,000 cycles). Following cyclic loading, mode of failure during loading to failure at 5 mm/min was recorded for all constructs. RESULTS: After 18,000 or 63,000 cycles, construct stiffness did not differ significantly between construct groups. No implant failure occurred in any construct that underwent 63,000 cycles. In both construct groups, ostectomy gap subsidence similarly increased as axial load increased but did not change after 18,000 cycles. Mean +/- SEM loads at failure in the LCP-rod (1,493.83 +/- 200.12 N) and LC-DCP-rod (1,276.05 +/- 156.11 N) construct groups were not significantly different. The primary failure event in all constructs occurred at the screw hole immediately distal to the ostectomy. CONCLUSIONS AND CLINICAL RELEVANCE: Biomechanically, the semicontoured LCP-rod construct is similar to the anatomically contoured LC-DCP-rod system.