Comparative digital study using four methods of measurements of the tibial distal anatomical axes for determining the anatomical-mechanical angle in dogs with cranial cruciate ligament rupture.

OBJECTIVE: This study evaluates the amplitude of the anatomical-mechanical angle (AMA-angle) using 4 measuring methods of the tibial distal anatomical axes (DAA) previously described, comparing the literature results to determine if there are significant differences in patients with cranial cruciate ligament (CrCL) rupture. ANIMALS: This study was comprised of 30 tibiae (29 dogs), including 1 bilateral case. METHODS: A retrospective study was selected for this research. DAA measurements were performed on all surgically confirmed cases of canine CrCL rupture at Hospital Veterinário de Especialidades Bruselas from 2019 to 2022. Four different published methods (identified by surname of the corresponding author of the original publication) were compared. Tibial measurements were made using Veterinary Preoperative Orthopedic Planning Pro software (https://vpop-pro.com/) on mediolateral radiographic projections obtained from a digital database. RESULTS: The mean (range) in the DAA method conducted by Hulse obtained a AMA-angle of 5.4° (3.3 to 8.1°), 3.0° (0 to 5.8°) for Osmond et al, 3.2° (0.9 to 6°) for Miles, and 5.9° (2.4 to 8.8°) for Tudury. Differences among the means of the AMA-angle of the authors methods were found with a statistical difference (P < .05), except between Osmond and Miles. The mean AMA-angle with the Osmond method concurred with previous study results that determined the magnitude using the same measurement method of DAA in patients with CrCL rupture. CLINICAL RELEVANCE: The AMA-angle magnitude has been associated with higher sensitivity and specificity for predicting the development of CrCL rupture compared to other anatomical factors evaluated; therefore, future comparisons with different methods of measurement of the DAA between healthy and affected patients are recommended to determine whether any of them can increase the percentage value as a predictive factor for the occurrence of this condition.

Postoperative efficacy of chondroprotectors and diacerein in dogs with osteoarthritis secondary to cranial cruciate ligament disease.

Background: Cranial cruciate ligament disease is one of the leading causes of pelvic limb claudication in canines and osteoarthritis in the stifle joint. Historically, studies have focused on surgical options to improve the stability of the stifle joint, although none of the techniques described in the literature prevents the development of osteoarthritis. Aim: This study aimed at proving the presence of osteoarthritis at the time of diagnosis of cranial cruciate ligament rupture, as well as evaluating the benefits of administering diacerein (DAR) or chondroprotective coadjuvants to the extracapsular fabelo-tibial technique. Methods: Seventeen dogs aged between 2 and 8, weighing more than 25 kg, with no predilection for breed or sex, were operated on using this technique. These were divided into three groups: DAR, Chondroprotector (CP), and Control. The animals were treated for 90 days and controlled clinically, radiologically, and using multidimensional scales for pain and quality of life. The statistical analysis used was descriptive and through non-parametric tests. Results: All patients had some degree of osteoarthritis at the beginning of the study associated with the presence of pain. The treated groups improved the claudication scores; however, the changes were significant for the DAR group. The pain score improved in all animals, including those in the Control group; however, the differences were significant only in the treated groups. On the other hand, no significant differences were detected in the radiological studies, so it would be convenient to perform this study over more than 90 days. Conclusion: The surgical treatment accompanied by drugs that act on the degradation of articular cartilage has better clinical results.

Morphology of the stifle in agouti (Dasyprocta prymnolopha, Wagler 1831).

The agouti (Dasyprocta prymnolopha, Wagler 1831) is a wild rodent of great zootechnical potential, a fact that enables anatomical and morphological studies to support management actions with this animal. In this perspective, this study aimed to describe the anatomy and histology of the agouti stifle joint. Four adult agoutis were used, two females and two males. The animals were submitted to dissection and identification of the structures of the stifle joint. For light microscopy study, samples of the patellar ligament, cranial and caudal cruciate ligaments, medial and lateral collateral ligaments were used. Agouti has a highly congruent patellofemoral joint; elongated patella; medial and lateral fabellae at the proximal insertion of the gastrocnemius muscle; medial and lateral meniscus with lunula; in addition to the presence of the following ligament structures: patellar ligament, cranial and caudal cruciate ligaments, medial and lateral collateral ligaments, meniscofemoral ligament, caudal meniscal ligament of the medial meniscus, and medial and lateral cranial ligaments. The patellar ligament presents bundles of parallel collagen fibers with a straight path and coated fibroblasts; collateral and cruciate ligaments had loose and dense connective tissue, coated fibroblasts and collagen bundle undulations, the latter most expressive in the caudal cruciate ligament. Thus, except for the shape and angulation of the stifle, which allows specific movements, the agouti stifle has structures analogous to that of other rodents and domestic animals.

Tibial plateau leveling osteotomy in dogs: an ex vivo comparative study of knee's surrounding structures protection methods

Background: Cranial cruciate ligament failure is one of the leading causes of pelvic limb lameness in dogs and one of the most recommended treatments is tibial plateau leveling osteotomy (TPLO) surgery. However, this procedure may lead to some complications as fractures of the fibula, laceration in varying degrees of the popliteal vasculature and its branches, neuropraxia, neurotmeses, among others. The goals of this study were to compare the effectiveness of 8 methods used during TPLO, to prevent damage to the cranial tibial artery, fibula, tibial and fibular nerve (surgical compresses, specific surgical retractors I and II and an osteotomy technique variation). Materials, Methods & Results: A total of 40 canine cadavers weighing 25.9 ± 3.7 kg were submitted to TPLO. Animals were previously prepared with 1: 4 barium red latex solution, to provide radiopacity of arteries surrounding the knee (n = 80). TPLO was performed using 8 methods to protect the cranial tibial artery, fibula, and tibial and fibular nerves. Each method was used in one of the knees of 5 animals. The contralateral knee was maintained as a control (without protection). The knees were radiographed in orthogonal projections before and after the osteotomies and then anatomically dissected. The evaluated structures were photographed, and the images sent to four blind evaluators (visual macroscopy) to classify the possible injuries. The highest incidence of injuries was identified when protection methods were used. However, this difference was not significant (P > 0.05). No significant differences regarding efficacy were found between all 8 protection methods. Discussion: In this study, the total incidence of injuries following TPLO was 20% was much higher than that presented in the literature which indicates when considering only intraoperative injuries. The dogs cadavers tissue resistance and stiffened latex may have predisposed the osteotomy injury, as soft tissues with greater flexibility are less susceptible to trauma caused by the oscillatory saw. When compared to others cadaveric studies that also evaluated the efficacy of surgical dressings to protect the cranial tibial artery, during TPLO, we also find a higher incidence of damage. Maybe the limb's position was responsible for this difference, once in the after mentioned researches the limb was positioned suspended to simulate a dorsal decubitus position and we choose the limb position with the lateral face resting on the surface of the operating table, and this may have provided extra pressure from the structures towards the osteotomy saw, increasing the occurrence of those damages. Although the present study did not reveal a significant difference for the use of protection methods, we believe that the dimensions of the compresses used herein may have contributed to a higher incidence of injuries. They probably increased the tissue trauma needed for their allocation and led to a lower positioning accuracy for the isolation of these structures. Maybe for the same reason, the specific type II surgical retractor was the only shield that, observationally, did not increase the occurrence of injuries, once less dissection was required to allocate it. The difference in geometric dimensions between the retractors may justify the superiority of the retractor II, since it allows a more careful and apparently less traumatic allocation. Performing TPLO without adopting these protection methods did not lead to a higher risk of injury to the cranial tibial artery, fibula, and tibial and fibular nerves.

Leveling osteotomy of the tibial plateau at an inverted angle in a dog / Osteotomia de nivelamento do platô tibial em ângulo invertido em um cachorro

One dog, Golden Retriever, 5 months old, was seen complaining of lameness and pain in the left pelvic limb. Avulsion of the tibial crest was diagnosed by radiographic means, which was corrected with a tension band. The absence of postoperative radiographic monitoring and the non-removal of the apparatus led to the early closure of the cranial tibial physis with continuous flow growth, resulting in pain, functional loss of the limb after one year and at a 13.2º tibial plateau angle negative. The biomechanical alteration of the limb was corrected using the inverted TPLO technique, converting the angle of the tibial plateau to 5.3 positive, without a rockback evidenced in 30, 60, 90 days up to four months after the operation. The objective of this case report is to describe the surgical correction with the inverted TPLO technique in a case of angle of the negative tibial plateau secondary to not removing the tension band applied in avulsion of the growing tibial crest. After 120 days, the dog was presented fully recovery and weight-bearing without any complication.

Um cão, Golden Retriever, de 5 meses de idade, foi atendido com queixa de claudicação e dor em membro pélvico esquerdo. Diagnosticou-se por meio radiográfico a avulsão da crista da tíbia, a qual foi corrigida com banda de tensão. A ausência de acompanhamento radiográfico pós-operatório e a não retirada do aparato levou ao fechamento precoce da fise tibial cranial com crescimento contínuo da caudal, resultando em dor, perda funcional do membro após um ano e em um ângulo de platô tibial de 13,2º negativos. A alteração biomecânica do membro foi corrigida por meio da técnica de TPLO invertida, convertendo o ângulo do platô tibial em 5,3º positivos, sem rockback evidenciado em 30, 60, 90 dias até quatro meses de pós-operatório. O objetivo desse relato de caso é descrever a correção cirúrgica com a técnica de TPLO invertida em um caso de ângulo do platô tibial negativo secundário a não retirada de banda de tensão aplicada em avulsão da crista da tíbia em crescimento. Após 120 dias, o paciente apresentou recuperação total com adequado suporte do peso no membro, sem qualquer complicação.

Comparação de três métodos de imagem para análise da evolução da osteoartrite induzida pela ruptura do ligamento cranial em coelhos / Comparison of three imaging methods for the evaluation of osteoarthritis induced by cranial cruciate ligament transection in rabbits

Background: Osteoarthritis is a degenerative joint disease that affects specially cartilage, meniscus, and tendons. Ligaments, muscles, subchondral bone and synovium. This pathology is a common condition limiting the quality of life ofpatients. Imaging modalities have also been used for evaluation the progression of the osteoarthritis, or degenerative processes induced by acute injury. In order to use more accessible imaging modalities for experimentation, this study aimedto compare radiographic, computed tomography, and ultrasound findings in the evaluation of osteoarthritis induced by thecranial cruciate ligament transection model in rabbits.Materials, Methods & Results: Twenty-four male Norfolk rabbits aged approximately 5 months old were used. All rabbits were submitted to cranial cruciate ligament transection of the left stifle and evaluated 45 days after the surgery. Theradiographic findings were subchondral bone sclerosis (33.33%); joint space narrowing (66%); presence of osteophytesat medial femoral condyle (4.16%), lateral femoral condyle (4.16%), medial fabela (20.83%), lateral fabela (8.33%) andsesamoid of the popliteal muscle (4.16%). No osteophytes were seen at medial and lateral tibial condyles. The tomographiccomputed findings were joint space narrowing (62.5%); presence of osteophytes at medial femoral condyle (75%), lateralfemoral condyle (54.16%), medial fabela (66.66%), lateral fabela (37.5%), medial tibial condyle (75%), lateral tibialcondyle (20.83%) and sesamoid of the popliteal muscle (37.5%). The ultrasound findings were synovial hypertrophy(95.83%); effusion in the suprapatellar recess (75%), distal tibial recess (16.66%) and cranial joint space (75%); changes(hyperechogenic foci and heterogeneity) of the lateral meniscus (50%) and medial meniscus (25%); increased thickness ofthe medial condyle (54.16%) and lateral condyle (45.83%); irregularity of the medial condyle (66.66%) and lateral condyle...(AU)

Comparação de três métodos de imagem para análise da evolução da osteoartrite induzida pela ruptura do ligamento cranial em coelhos / Comparison of three imaging methods for the evaluation of osteoarthritis induced by cranial cruciate ligament transection in rabbits

Background: Osteoarthritis is a degenerative joint disease that affects specially cartilage, meniscus, and tendons. Ligaments, muscles, subchondral bone and synovium. This pathology is a common condition limiting the quality of life ofpatients. Imaging modalities have also been used for evaluation the progression of the osteoarthritis, or degenerative processes induced by acute injury. In order to use more accessible imaging modalities for experimentation, this study aimedto compare radiographic, computed tomography, and ultrasound findings in the evaluation of osteoarthritis induced by thecranial cruciate ligament transection model in rabbits.Materials, Methods & Results: Twenty-four male Norfolk rabbits aged approximately 5 months old were used. All rabbits were submitted to cranial cruciate ligament transection of the left stifle and evaluated 45 days after the surgery. Theradiographic findings were subchondral bone sclerosis (33.33%); joint space narrowing (66%); presence of osteophytesat medial femoral condyle (4.16%), lateral femoral condyle (4.16%), medial fabela (20.83%), lateral fabela (8.33%) andsesamoid of the popliteal muscle (4.16%). No osteophytes were seen at medial and lateral tibial condyles. The tomographiccomputed findings were joint space narrowing (62.5%); presence of osteophytes at medial femoral condyle (75%), lateralfemoral condyle (54.16%), medial fabela (66.66%), lateral fabela (37.5%), medial tibial condyle (75%), lateral tibialcondyle (20.83%) and sesamoid of the popliteal muscle (37.5%). The ultrasound findings were synovial hypertrophy(95.83%); effusion in the suprapatellar recess (75%), distal tibial recess (16.66%) and cranial joint space (75%); changes(hyperechogenic foci and heterogeneity) of the lateral meniscus (50%) and medial meniscus (25%); increased thickness ofthe medial condyle (54.16%) and lateral condyle (45.83%); irregularity of the medial condyle (66.66%) and lateral condyle...

Short-term outcomes and complications of 65 cases of porous TTA with flange: a prospective clinical study in dogs.

BACKGROUND: Cranial cruciate ligament rupture (CrCLR) is the most common orthopaedic cause of lameness in the hind limb in dogs. Many surgical treatments have been described, but tibial tuberosity advancement (TTA) is one of the most commonly used today. Since it was first described, TTA has evolved to reduce major complications and to arrest the progression of osteoarthrosis. The aim of this study was to assess a surgical technique called Porous TTA with flange prospectively. This study was performed in 61 dogs that underwent 65 Porous TTA with flange procedures, to validate it as an alternative CrCLR treatment. Complications and clinical outcomes (pain, lameness, weight bearing, flexion, extension, crepitation and atrophy) were reported over 3 months, i.e. at 3, 6 and 12 weeks postoperatively. RESULTS: The results showed a positive clinical outcome, a minor complication rate of 47.69% at the first review 3 weeks postoperatively, 10.77% at the second one (6 weeks after the surgery) and 4% at the third one (at 12 weeks). Major complications were observed only at the last review, with one case that had an infection requiring implant removal; this represented 1.5% of cases. Variables evaluated for a relationship with complication scores and improvement were body condition score, sex, age, breed, body weight, breed size, side of the affected limb, traumatic anamnesis and time of lameness before surgery. No relationship was detected. CONCLUSIONS: Clinical outcomes and complications show that Porous TTA with flange is an efficient alternative for surgical treatment of CrCLR in dogs.

Pressão articular na osteoartrose femorotibial de cães (Canis lupus familiaris) - uma revisão sistemática / Intra-articular pressure in femorotibial osteoarthrosis in dogs (Canis lupus familiaris) - a systematic review / Presión intraarticular en la osteoartrosis femorotibial de perros (Canis lupus familiaris) - una revisión sistemática

Os principais sinais clínicos da osteoartrose incluem a claudicação e a diminuição da amplitude de movimento articular. A diminuição do espaço articular é uma característica importante e comum em osteoartrose femorotibial, podendo induzir ao aumento da pressão intra-articular dentro do espaço fascial ou osseofascial e desencadear a Síndrome Compartimental Articular, quer pela diminuição do tamanho do espaço intra-articular ou pelo acúmulo de líquido sanguinolento, seroma ou linfa. Essa síndrome pode resultar na inadequada perfusão sanguínea e causar isquemia local, e consequentemente, maior dano articular. Visto que a aferição da pressão intra-articular não é uma prática comum na Medicina Veterinária, o presente estudo teve como objetivo realizar uma revisão da literatura sobre a pressão intra-articular da articulação femorotibial de cães acometidos por osteoartrose.(AU)

The main clinical signs of osteoarthrosis includes lameness and decreased range of joint motion. The decreased joint space its an important and common feature in femorotibial osteoarthrosis of the and may induce an increased intra-articular pressure within the fascial or osteofascial space, triggering the Joint Compartment Syndrome, either by decreasing the size of the joint space or through the accumulation of bloody fluid, seroma or lymph. This Syndrome can result on inadequate blood flow and create an hypoxic joint, leading to greater joint damage. Since intra-articular pressure measurement is not a common practice in Veterinary Medicine, the present study aimed to review the literature on intra-articular femorotibial pressure in dogs with osteoarthrosis.(AU)

Las principales manifestaciones clínicas de osteoartrosis incluyen cojera y disminución de la amplitud del movimiento articular. El estrechamiento del espacio articular es una importante y común característica en la osteoartrosis femorotibial, y puede inducir una elevación de la presión dentro del espacio fascial u osofascial, con la consiguiente síndrome compartimental articular, ya sea decreciendo el tamaño del espacio intra articular o mediante acumulación de líquido sanguinolento, seroma o linfa. Esta síndrome puede provocar una perfusión sanguínea inadecuada y causar una isquemia articular, resultando en, un mayor daño articular. Dado que la medición de la presión sobre las articulaciones no es una práctica común en medicina veterinária, el presente estudio tuvo como objetivo revisar la literatura acerca de la presión de la articulación femorotibial de perros con osteoartrosis.(AU)

Exercise on a vibratory platform increases blood perfusion on the stifle joint and rectal temperature in healthy dogs / Exercício em plataforma vibratória aumenta a perfusão sanguínea da articulação do joelho e a temperatura retal de cães saudáveis

The effects of two vibration platform (VP) exercise protocols on stifle and rectal temperatures were evaluated. Eleven animals participated in two exercise protocols, different in duration in each exercise. Exercise protocol 1 (EP1) took 30 seconds and EP2, 60 seconds, with different vibratory levels in both cases (L1 = acceleration ≅ 1g, L4 = acceleration ≅ 2.5g, and L7 = acceleration ≅ 5g). The animals were evaluated before and 1 minute after the exercise, using infrared thermography to obtain stifle temperatures. The rectal temperature (RT) was also checked at each moment. The dogs had higher stifle temperatures in EP1 at all vibratory levels compared to the time before the exercise; EP2 resulted in higher temperature only at maximum vibration intensity (L7). Increase in TR was observed only in EP2. The results suggested that the short duration protocol (EP1) increased the muscular and peripheral vascular activities of the joint, regardless of the vibration intensity. The long duration protocol (EP2) with maximum vibration intensity increased the RT, demonstrating activity beyond the stifle muscle group. It is concluded that exercises on the VP can be used as complementary therapy for low-impact muscle activity in dogs and may be adequate for efficient energy consumption.(AU)

Foram avaliados os efeitos de dois protocolos de exercício em plataforma vibratória (PV) sobre as temperaturas dos joelhos e retais. Onze animais participaram de dois protocolos de exercício, diferentes na duração de cada exercício. O protocolo de exercício 1 (PE1) foi de 30 segundos e o PE2 foi de 60 segundos, com diferentes níveis vibratórios em ambos (L1 = aceleração ≅ 1g; L4 = aceleração ≅ 2,5g; e L7 = aceleração ≅ 5g). Os animais foram avaliados antes e um minuto após os exercícios, por meio de termografia infravermelha para a obtenção das temperaturas dos joelhos. A temperatura retal (TR) foi aferida em cada momento. Os cães apresentaram temperaturas dos joelhos mais elevadas em PE1, em todos os níveis vibratórios, em comparação a antes do exercício; o PE2 resultou em temperatura mais alta apenas na intensidade máxima de vibração (L7). Aumento na TR foi observado apenas no PE2. Os resultados sugerem que o protocolo de curta duração (PE1) aumentou as atividades muscular e vascular periférica da articulação, independentemente da intensidade da vibração; o protocolo de longa duração (PE2) com intensidade máxima de vibração aumentou a TR demonstrando atividade além do grupo muscular do joelho. Conclui-se que os exercícios na PV podem ser utilizados como terapia complementar para atividade muscular de baixo impacto em cães e pode ser adequada para o consumo eficiente de energia.(AU)

Exercise on a vibratory platform increases blood perfusion on the stifle joint and rectal temperature in healthy dogs / Exercício em plataforma vibratória aumenta a perfusão sanguínea da articulação do joelho e a temperatura retal de cães saudáveis

The effects of two vibration platform (VP) exercise protocols on stifle and rectal temperatures were evaluated. Eleven animals participated in two exercise protocols, different in duration in each exercise. Exercise protocol 1 (EP1) took 30 seconds and EP2, 60 seconds, with different vibratory levels in both cases (L1 = acceleration ≅ 1g, L4 = acceleration ≅ 2.5g, and L7 = acceleration ≅ 5g). The animals were evaluated before and 1 minute after the exercise, using infrared thermography to obtain stifle temperatures. The rectal temperature (RT) was also checked at each moment. The dogs had higher stifle temperatures in EP1 at all vibratory levels compared to the time before the exercise; EP2 resulted in higher temperature only at maximum vibration intensity (L7). Increase in TR was observed only in EP2. The results suggested that the short duration protocol (EP1) increased the muscular and peripheral vascular activities of the joint, regardless of the vibration intensity. The long duration protocol (EP2) with maximum vibration intensity increased the RT, demonstrating activity beyond the stifle muscle group. It is concluded that exercises on the VP can be used as complementary therapy for low-impact muscle activity in dogs and may be adequate for efficient energy consumption.(AU)

Foram avaliados os efeitos de dois protocolos de exercício em plataforma vibratória (PV) sobre as temperaturas dos joelhos e retais. Onze animais participaram de dois protocolos de exercício, diferentes na duração de cada exercício. O protocolo de exercício 1 (PE1) foi de 30 segundos e o PE2 foi de 60 segundos, com diferentes níveis vibratórios em ambos (L1 = aceleração ≅ 1g; L4 = aceleração ≅ 2,5g; e L7 = aceleração ≅ 5g). Os animais foram avaliados antes e um minuto após os exercícios, por meio de termografia infravermelha para a obtenção das temperaturas dos joelhos. A temperatura retal (TR) foi aferida em cada momento. Os cães apresentaram temperaturas dos joelhos mais elevadas em PE1, em todos os níveis vibratórios, em comparação a antes do exercício; o PE2 resultou em temperatura mais alta apenas na intensidade máxima de vibração (L7). Aumento na TR foi observado apenas no PE2. Os resultados sugerem que o protocolo de curta duração (PE1) aumentou as atividades muscular e vascular periférica da articulação, independentemente da intensidade da vibração; o protocolo de longa duração (PE2) com intensidade máxima de vibração aumentou a TR demonstrando atividade além do grupo muscular do joelho. Conclui-se que os exercícios na PV podem ser utilizados como terapia complementar para atividade muscular de baixo impacto em cães e pode ser adequada para o consumo eficiente de energia.(AU)

Pressão articular na osteoartrose femorotibial de cães (Canis lupus familiaris) - uma revisão sistemática / Intra-articular pressure in femorotibial osteoarthrosis in dogs (Canis lupus familiaris) - a systematic review / Presión intraarticular en la osteoartrosis femorotibial de perros (Canis lupus familiaris) - una revisión sistemática

Os principais sinais clínicos da osteoartrose incluem a claudicação e a diminuição da amplitude de movimento articular. A diminuição do espaço articular é uma característica importante e comum em osteoartrose femorotibial, podendo induzir ao aumento da pressão intra-articular dentro do espaço fascial ou osseofascial e desencadear a Síndrome Compartimental Articular, quer pela diminuição do tamanho do espaço intra-articular ou pelo acúmulo de líquido sanguinolento, seroma ou linfa. Essa síndrome pode resultar na inadequada perfusão sanguínea e causar isquemia local, e consequentemente, maior dano articular. Visto que a aferição da pressão intra-articular não é uma prática comum na Medicina Veterinária, o presente estudo teve como objetivo realizar uma revisão da literatura sobre a pressão intra-articular da articulação femorotibial de cães acometidos por osteoartrose.

The main clinical signs of osteoarthrosis includes lameness and decreased range of joint motion. The decreased joint space it’s an important and common feature in femorotibial osteoarthrosis of the and may induce an increased intra-articular pressure within the fascial or osteofascial space, triggering the Joint Compartment Syndrome, either by decreasing the size of the joint space or through the accumulation of bloody fluid, seroma or lymph. This Syndrome can result on inadequate blood flow and create an hypoxic joint, leading to greater joint damage. Since intra-articular pressure measurement is not a common practice in Veterinary Medicine, the present study aimed to review the literature on intra-articular femorotibial pressure in dogs with osteoarthrosis.

Las principales manifestaciones clínicas de osteoartrosis incluyen cojera y disminución de la amplitud del movimiento articular. El estrechamiento del espacio articular es una importante y común característica en la osteoartrosis femorotibial, y puede inducir una elevación de la presión dentro del espacio fascial u osofascial, con la consiguiente síndrome compartimental articular, ya sea decreciendo el tamaño del espacio intra articular o mediante acumulación de líquido sanguinolento, seroma o linfa. Esta síndrome puede provocar una perfusión sanguínea inadecuada y causar una isquemia articular, resultando en, un mayor daño articular. Dado que la medición de la presión sobre las articulaciones no es una práctica común en medicina veterinária, el presente estudio tuvo como objetivo revisar la literatura acerca de la presión de la articulación femorotibial de perros con osteoartrosis.

Avaliação ultrassonográfica de cães com ruptura do ligamento cruzado cranial submetidos a artrotomia / Ultrasonographic evaluation of dogs with cranial cruciate ligament rupture undergoing to arthrotomy

Background: The cranial cruciate ligament rupture (CrCLR) is the most common disease of the stifle joint in dogs. Oneof the major concerns in the assessment of these animals is diagnosing the presence of a medial meniscus tears, which isa frequent consequence due to the instability of the joint. Ultrasonography is indicated in the evaluation of the meniscifrom human and canine patients, and the results are similar to magnetic resonance imaging. The aim of this study was tocompare the ultrasonography and the arthrotomy in the evaluation of the cranial cruciate ligament and medial meniscusof dogs with CrCLR undergoing surgery for stifle stabilization.Materials, Methods & Results: Ultrasonographic examination was performed prior to arthrotomy in 23 dogs with diagnosis of complete CrCLR and five with suspected partial CrCLR undergoing for stifle joint stabilization surgery. Theultrasonography identified the complete rupture in 82.6% and the arthrotomy in 100% of the joints with this diagnosis. Inthe joints with suspected CrCLR during the clinical exam, arthrotomy and ultrasonography identified respectively threeand four joints with partial CrCLR, and two and one with healthy ligaments. There was no difference between the twotechniques in the assessment of the cranial cruciate ligament (P = 0.20). The ultrasonography identified medial meniscaltears in 39.3%, while arthrotomy was found in 21.4% (P = 0.0006) of the joints. The most frequent meniscal tear type observed in the arthrotomy was folded caudal horn. The ultrasonography was able only in differentiate presence and absenceof meniscal injury. Besides the real tear that affects the meniscus morphology, the ultrasound also identified echogenicityand echotexture changes in the medial (5/28) and lateral (8/28) menisci. Other changes observed in all joints evaluated byultrasound were the presence of effusion and synovial membrane thickening...(AU)

Estudo da técnica intracapsular assistida por artroscopia para o tratamento da ruptura do ligamento cruzado cranial em cadáveres de cães / Study in dog's cadavers of the assisted by arthroscopy intracapsular technique for the treatment of the cranial cruciate ligament rupture in the dog

O objetivo foi estudar e aprimorar a técnica intracapsular de reparação do ligamento cruzado cranial assistida por artroscopia em cadáveres de cães com a confecção dos túneis tibial e femoral e utilização de autoenxerto osso-tendão patelar-osso. Foram utilizados 10 membros pélvicos de cães > 20kg. Os túneis ósseos foram confeccionados de forma independente e na posição anatômica original dos locais de inserção do ligamento cruzado cranial. Foram realizados estudo radiográfico e tomográfico para avaliar a articulação. A coleta das porções ósseas do enxerto foi feita com osteótomo e martelo. Ocorreram fratura em três patelas e em três tuberosidades tibiais. Os enxertos apresentaram comprimento médio 7,56cm. Os túneis tibiais e os túneis femorais foram confeccionados no local de inserção do ligamento cruzado cranial em 80% e 90% das articulações, respectivamente. Os túneis tibiais apresentaram ângulo médio de 62,95º mensurado por tomografia computadorizada. Os túneis femorais foram confeccionados em posição 13hs para o joelho esquerdo (100%) e 11hs para o direito (100%). Ao final do procedimento, obteve-se gaveta negativo em 100% das articulações. Pode-se concluir que a técnica proposta é viável de ser realizada no cão, porém faz-se necessário instrumental específico devido ao pequeno tamanho da articulação canina para obter melhor acurácia.(AU)

The aim was study and improve the intra-articular technique assisted by arthroscopy of the cranial cruciate ligament repair in dog's cadavers. The bone-patelar tendon-bone was used as a graft and were made the femoral and tibial tunnels. The hindlimb of 10 dogs cadavers weighing > 20kg were harvested. The femoral and tibial tunnels were made independent of each other, in the footprint of the original cranial cruciate ligament. Radiographic and tomographic studies were performed to evaluate the joint. The osseous portions of the graft were were harversted with osteotome and hammer. Fractures occurred in 3 patellas and 3 tibial tuberosities. The medium lenght of the grafts was 7,56cm. Tibial and femoral tunnels were in the footprint of the cranial cruciate ligament in 80% and 90% of the joints, respectively. The tibial tunnel had an average angle of 62,95º measured by computer tomography. The femoral tunnel was at 13h in the left knee and at 11h in the right knee in all joints (100%). At the end of the procedure the drawer test was negative in all joints (100%). It can be concluded that the proposed technique is feasible to be performed in the dog. But because to the small size of the canine joint it is necessary specific instruments in order to obtain better acuracy.(AU)

Estudo da técnica intracapsular assistida por artroscopia para o tratamento da ruptura do ligamento cruzado cranial em cadáveres de cães / Study in dog's cadavers of the assisted by arthroscopy intracapsular technique for the treatment of the cranial cruciate ligament rupture in the dog

O objetivo foi estudar e aprimorar a técnica intracapsular de reparação do ligamento cruzado cranial assistida por artroscopia em cadáveres de cães com a confecção dos túneis tibial e femoral e utilização de autoenxerto osso-tendão patelar-osso. Foram utilizados 10 membros pélvicos de cães > 20kg. Os túneis ósseos foram confeccionados de forma independente e na posição anatômica original dos locais de inserção do ligamento cruzado cranial. Foram realizados estudo radiográfico e tomográfico para avaliar a articulação. A coleta das porções ósseas do enxerto foi feita com osteótomo e martelo. Ocorreram fratura em três patelas e em três tuberosidades tibiais. Os enxertos apresentaram comprimento médio 7,56cm. Os túneis tibiais e os túneis femorais foram confeccionados no local de inserção do ligamento cruzado cranial em 80% e 90% das articulações, respectivamente. Os túneis tibiais apresentaram ângulo médio de 62,95º mensurado por tomografia computadorizada. Os túneis femorais foram confeccionados em posição 13hs para o joelho esquerdo (100%) e 11hs para o direito (100%). Ao final do procedimento, obteve-se gaveta negativo em 100% das articulações. Pode-se concluir que a técnica proposta é viável de ser realizada no cão, porém faz-se necessário instrumental específico devido ao pequeno tamanho da articulação canina para obter melhor acurácia.

The aim was study and improve the intra-articular technique assisted by arthroscopy of the cranial cruciate ligament repair in dog's cadavers. The bone-patelar tendon-bone was used as a graft and were made the femoral and tibial tunnels. The hindlimb of 10 dogs cadavers weighing > 20kg were harvested. The femoral and tibial tunnels were made independent of each other, in the footprint of the original cranial cruciate ligament. Radiographic and tomographic studies were performed to evaluate the joint. The osseous portions of the graft were were harversted with osteotome and hammer. Fractures occurred in 3 patellas and 3 tibial tuberosities. The medium lenght of the grafts was 7,56cm. Tibial and femoral tunnels were in the footprint of the cranial cruciate ligament in 80% and 90% of the joints, respectively. The tibial tunnel had an average angle of 62,95º measured by computer tomography. The femoral tunnel was at 13h in the left knee and at 11h in the right knee in all joints (100%). At the end of the procedure the drawer test was negative in all joints (100%). It can be concluded that the proposed technique is feasible to be performed in the dog. But because to the small size of the canine joint it is necessary specific instruments in order to obtain better acuracy.

Técnica de avanço e transposição da tuberosidade tibial (TTTA) com uso de espaçador único de TTA-Maquet em cão / Technique of tibial tuberosity transposition and advancement (TTTA) with use of TTA-Maquet cage-only in dog

Background: The most common conditions that compromise the stifle joint in dogs are medial patellar luxation (MPL) and cranial cruciate ligament (CCL) rupture. Surgical procedures are usually indicated for the treatment of these diseases. One ordinarytechnique for the treatment of MPL is the tibial tuberosity transposition, and one prominent technique for CCL rupture is the tibialtuberosity advancement. These techniques can be associated in one surgical procedure called tibial tuberosity transposition andadvancement (TTTA) for the simultaneous treatment of both stifle diseases. The aim of this study is to report the surgical treatmentof a dog with MPL and CCL rupture affecting the same joint by the TTTA technique with the use of a TTA-Maquet cage-only.Case: A 3-year-old Pitbull dog weighing 39 kg was attended at Veterinary Hospital with a history of marked lameness in theleft pelvic limb. The orthopedic examination showed positive results for cranial drawer motion and tibial compression tests,and a complete CCL rupture was diagnosed. The presence of patellar luxation was evaluated by manual pressure on the patella, and grade 3 of MPL was diagnosed. Both conditions were affecting the same stifle joint. In addition, survey radiographsof the affected joint were performed. Surgical treatment was indicated by the TTTA technique. Radiographic measurementswere taken to calculate the cranial tibial tuberosity advancement by the tibial plateau and the common tangent methods, and atitanium TTA-Maquet cage-only of 10.5 x 20.0 mm was selected. Linear osteotomy was performed on the tibial tuberosity withthe aid of an oscillating saw, based on the Maquet hole technique. The tibial tuberosity was carefully displaced cranially and thecage was inserted at the site of osteotomy. The cage ears were molded on the tibial surface and fixed with 2.4 mm self-tappingcortical screws...(AU)

Avaliação ultrassonográfica de cães com ruptura do ligamento cruzado cranial submetidos a artrotomia / Ultrasonographic evaluation of dogs with cranial cruciate ligament rupture undergoing to arthrotomy

Background: The cranial cruciate ligament rupture (CrCLR) is the most common disease of the stifle joint in dogs. Oneof the major concerns in the assessment of these animals is diagnosing the presence of a medial meniscus tears, which isa frequent consequence due to the instability of the joint. Ultrasonography is indicated in the evaluation of the meniscifrom human and canine patients, and the results are similar to magnetic resonance imaging. The aim of this study was tocompare the ultrasonography and the arthrotomy in the evaluation of the cranial cruciate ligament and medial meniscusof dogs with CrCLR undergoing surgery for stifle stabilization.Materials, Methods & Results: Ultrasonographic examination was performed prior to arthrotomy in 23 dogs with diagnosis of complete CrCLR and five with suspected partial CrCLR undergoing for stifle joint stabilization surgery. Theultrasonography identified the complete rupture in 82.6% and the arthrotomy in 100% of the joints with this diagnosis. Inthe joints with suspected CrCLR during the clinical exam, arthrotomy and ultrasonography identified respectively threeand four joints with partial CrCLR, and two and one with healthy ligaments. There was no difference between the twotechniques in the assessment of the cranial cruciate ligament (P = 0.20). The ultrasonography identified medial meniscaltears in 39.3%, while arthrotomy was found in 21.4% (P = 0.0006) of the joints. The most frequent meniscal tear type observed in the arthrotomy was folded caudal horn. The ultrasonography was able only in differentiate presence and absenceof meniscal injury. Besides the real tear that affects the meniscus morphology, the ultrasound also identified echogenicityand echotexture changes in the medial (5/28) and lateral (8/28) menisci. Other changes observed in all joints evaluated byultrasound were the presence of effusion and synovial membrane thickening...

Técnica de avanço e transposição da tuberosidade tibial (TTTA) com uso de espaçador único de TTA-Maquet em cão / Technique of tibial tuberosity transposition and advancement (TTTA) with use of TTA-Maquet cage-only in dog

Background: The most common conditions that compromise the stifle joint in dogs are medial patellar luxation (MPL) and cranial cruciate ligament (CCL) rupture. Surgical procedures are usually indicated for the treatment of these diseases. One ordinarytechnique for the treatment of MPL is the tibial tuberosity transposition, and one prominent technique for CCL rupture is the tibialtuberosity advancement. These techniques can be associated in one surgical procedure called tibial tuberosity transposition andadvancement (TTTA) for the simultaneous treatment of both stifle diseases. The aim of this study is to report the surgical treatmentof a dog with MPL and CCL rupture affecting the same joint by the TTTA technique with the use of a TTA-Maquet cage-only.Case: A 3-year-old Pitbull dog weighing 39 kg was attended at Veterinary Hospital with a history of marked lameness in theleft pelvic limb. The orthopedic examination showed positive results for cranial drawer motion and tibial compression tests,and a complete CCL rupture was diagnosed. The presence of patellar luxation was evaluated by manual pressure on the patella, and grade 3 of MPL was diagnosed. Both conditions were affecting the same stifle joint. In addition, survey radiographsof the affected joint were performed. Surgical treatment was indicated by the TTTA technique. Radiographic measurementswere taken to calculate the cranial tibial tuberosity advancement by the tibial plateau and the common tangent methods, and atitanium TTA-Maquet cage-only of 10.5 x 20.0 mm was selected. Linear osteotomy was performed on the tibial tuberosity withthe aid of an oscillating saw, based on the Maquet hole technique. The tibial tuberosity was carefully displaced cranially and thecage was inserted at the site of osteotomy. The cage ears were molded on the tibial surface and fixed with 2.4 mm self-tappingcortical screws...

Osteotomia de nivelamento do platô tibial na ruptura de ligamento cruzado cranial em cães: revisão / Tibial plateau leveling osteotomy in the rupture of the cranial cruciate ligament in dogs: review / Ostectomía de nivelación de la meseta tibial en la ruptura del ligamiento cruzado craneal en perros: revisión

A ruptura do ligamento cruzado cranial é uma das afecções mais comuns que ocorrem no joelho dos cães. O tratamento ainda é bastante controverso na medicina veterinária, e muitos profissionais encontram obstáculos em relação ao diagnóstico e ao procedimento cirúrgico a ser adotado. No Brasil, é crescente a abordagem terapêutica por meio das osteotomias corretivas, sendo a osteotomia de nivelamento do platô tibial (TPLO) uma das técnicas indicadas atualmente. Este trabalho tem por objetivo realizar uma revisão dos principais tópicos relacionados à ruptura do ligamento cruzado e descrever os fundamentos técnicos do planejamento e da execução da TPLO, já que esses fatores estão diretamente relacionados ao sucesso ou insucesso desse procedimento, tendo em vista a importância das possíveis complicações pós-operatórias.

Cranial cruciate ligament rupture is one of the most common conditions encounter in the stifle of dogs. It still has a controversial etiology and treatment in veterinary medicine. Many professionals find difficulties in to diagnose and chose the surgical procedure to be adopted. In Brazil, the treatment approach using corrective osteotomies is increasing, and Tibial Plateau Leveling Osteotomy (TPLO) is one ofthe techniques most widely used by professionals. The objective of this study was to review the most important issues associated to the rupture of the cranial cruciate ligament, and to describe the technical principies behind the use of correcting tibial plateau angle, and surgical technique of TPLO. The surgical procedure is directly associated to the success ar failure of treatment, and the importance of the postoperative complications must be taken into consideration.

La ruptura del ligamento cruzado craneal es una de Ias afecciones más frecuentes de la articulación femoro tibio patelar de los perros. El tratamiento sigue syendo bastante discutido en medicina veterinaria. Muchos veterinarios tienen dificultades en el diagnóstico y en cuanto a la conducta terapéutica a ser tomada. Las técnicas correctivas mediante osteotomías correctivas están siendo cada vez más utilizadas, siendo la técnica de nivelación de la meseta tibial (TPLO) una de las más indicadas actualmente. Este trabajo tiene como objetivo realizar una revisión de los principales tópicos relacionados con la ruptura del ligamento cruzado, y describir los fundamentos técnicos en cuanto a planificación y ejecución de la TPLO, ya que estas están directamente relacionados con el éxito o fracaso del procedimiento quirúrgico,teniendo en consideración la importancia de las eventuales complicaciones postoperatorias.

Osteotomia de nivelamento do platô tibial na ruptura de ligamento cruzado cranial em cães: revisão / Tibial plateau leveling osteotomy in the rupture of the cranial cruciate ligament in dogs: review / Ostectomía de nivelación de la meseta tibial en la ruptura del ligamiento cruzado craneal en perros: revisión

A ruptura do ligamento cruzado cranial é uma das afecções mais comuns que ocorrem no joelho dos cães. O tratamento ainda é bastante controverso na medicina veterinária, e muitos profissionais encontram obstáculos em relação ao diagnóstico e ao procedimento cirúrgico a ser adotado. No Brasil, é crescente a abordagem terapêutica por meio das osteotomias corretivas, sendo a osteotomia de nivelamento do platô tibial (TPLO) uma das técnicas indicadas atualmente. Este trabalho tem por objetivo realizar uma revisão dos principais tópicos relacionados à ruptura do ligamento cruzado e descrever os fundamentos técnicos do planejamento e da execução da TPLO, já que esses fatores estão diretamente relacionados ao sucesso ou insucesso desse procedimento, tendo em vista a importância das possíveis complicações pós-operatórias.(AU)

Cranial cruciate ligament rupture is one of the most common conditions encounter in the stifle of dogs. It still has a controversial etiology and treatment in veterinary medicine. Many professionals find difficulties in to diagnose and chose the surgical procedure to be adopted. In Brazil, the treatment approach using corrective osteotomies is increasing, and Tibial Plateau Leveling Osteotomy (TPLO) is one ofthe techniques most widely used by professionals. The objective of this study was to review the most important issues associated to the rupture of the cranial cruciate ligament, and to describe the technical principies behind the use of correcting tibial plateau angle, and surgical technique of TPLO. The surgical procedure is directly associated to the success ar failure of treatment, and the importance of the postoperative complications must be taken into consideration.(AU)

La ruptura del ligamento cruzado craneal es una de Ias afecciones más frecuentes de la articulación femoro tibio patelar de los perros. El tratamiento sigue syendo bastante discutido en medicina veterinaria. Muchos veterinarios tienen dificultades en el diagnóstico y en cuanto a la conducta terapéutica a ser tomada. Las técnicas correctivas mediante osteotomías correctivas están siendo cada vez más utilizadas, siendo la técnica de nivelación de la meseta tibial (TPLO) una de las más indicadas actualmente. Este trabajo tiene como objetivo realizar una revisión de los principales tópicos relacionados con la ruptura del ligamento cruzado, y describir los fundamentos técnicos en cuanto a planificación y ejecución de la TPLO, ya que estas están directamente relacionados con el éxito o fracaso del procedimiento quirúrgico,teniendo en consideración la importancia de las eventuales complicaciones postoperatorias.(AU)