Comparison of complications and outcome following unilateral, staged bilateral, and single-stage bilateral ventral bulla osteotomy in cats.

OBJECTIVE: To compare complications and outcome following unilateral, staged bilateral, and single-stage bilateral ventral bulla osteotomy (VBO) in cats. ANIMALS: 282 client-owned cats treated by VBO at 25 veterinary referral and academic hospitals from 2005 through 2016. PROCEDURES: Medical records of cats were reviewed to collect information on signalment, clinical signs, diagnostic test results, surgical and postoperative management details, complications (anesthetic, surgical, and postoperative), and outcome. Associations were evaluated among selected variables. RESULTS: Unilateral, staged bilateral, and single-stage bilateral VBO was performed in 211, 7, and 64 cats, respectively, representing 289 separate procedures. Eighteen (9%), 2 (29%), and 30 (47%) of these cats, respectively, had postoperative respiratory complications. Cats treated with single-stage bilateral VBO were significantly more likely to have severe respiratory complications and surgery-related death than cats treated with other VBO procedures. Overall, 68.2% (n = 197) of the 289 procedures were associated with Horner syndrome (19.4% permanently), 30.1% (87) with head tilt (22.1% permanently), 13.5% (39) with facial nerve paralysis (8.0% permanently), and 6.2% (18) with local disease recurrence. Cats with (vs without) Horner syndrome, head tilt, and facial nerve paralysis before VBO had 2.6, 3.3, and 5.6 times the odds, respectively, of having these conditions permanently. CONCLUSIONS AND CLINICAL RELEVANCE: Findings suggested that staged bilateral VBO should be recommended over single-stage bilateral VBO for cats with bilateral middle ear disease. Cats with Horner syndrome, head tilt, and facial nerve paralysis before surgery were more likely to have these conditions permanently following surgery than were cats without these conditions.

Tibial plateau levelling osteotomy in eleven cats with cranial cruciate ligament rupture.

OBJECTIVE: To report the surgical procedure, intra- and postoperative complications, and short-term follow-up of tibial plateau levelling osteotomy (TPLO) in feline patients with cranial cruciate ligament (CrCL) rupture using a 2.0 or 2.4 mm Synthes® TPLO plate. STUDY DESIGN: Prospective study. MATERIAL AND METHODS: Eleven cats with a CrCL rupture were included in the study. Inspection of intra-articular structures was carried out via arthroscopy or arthrotomy. Each patient was re-examined one and 10 days after surgery. Orthopaedic examination and follow-up radiographs were obtained four to 12 weeks postoperatively. RESULTS: Two meniscopathies and one partial CrCL rupture were detected. Minor intra-operative complications occurred in five cats (suboptimal positioning of the plate [n = 3], proximal fibular fracture [n = 1], a visible osteotomy gap [n = 1]). Postoperatively, minor complications were detected in three cats (mild patellar desmitis [n = 2], superficial wound infection [n = 1]). No additional surgical reintervention, graded as major complication, was necessary. Four to eight weeks postoperatively, all cats showed no to mild intermittent lameness. Complete bone union was apparent within four to 12 weeks. Owners reported a high level of comfort and mobility during the last follow-up. CONCLUSION: The preliminary results of this study support the use of TPLO in cats, but larger case numbers are needed to evaluate its practicability, as well as long-term outcome (>1 year), especially evaluating the development and the clinical relevance of osteoarthritis.

Cementless total hip replacement in 20 juveniles using BFX™ arthroplasty.

OBJECTIVE: To describe outcome after a minimum of 1 year for total hip replacement (THR) using BioMedtrix BFX™ biologic fixation implants in skeletally immature dogs (6-10 months of age). STUDY DESIGN: Case series. ANIMALS: Dogs (n = 20). METHODS: Medical records (November 2007-June 2010) of 20 dogs, 6-10 months old that had cementless THR were reviewed. Preoperative, immediate, 6-week and >1-year postoperative radiographs were compared. Clinical examination was performed at 6 weeks and >1 year postoperatively. Owner questionnaire was obtained at final follow-up. RESULTS: Cementless THR using BFX™ implants was performed because of debilitating coxofemoral pain, resulting from canine hip dysplasia, after unsatisfactory outcome with medical management. Radiographs taken immediately, 6 weeks and at a mean of 29.8 months (range, 12-48 months) postoperatively revealed satisfactory implant positioning and stability. Significant change in measured cranial-caudal femoral stem fill and level (P < .001 and P = .006, respectively) were recorded at 6 weeks postoperatively without clinical significance. No further change in stem positioning occurred. Acetabular cup orientation remained unchanged throughout follow-up. Complications requiring further surgical intervention were not encountered. One minor superficial infection was recorded and treated. Lameness and pain on manipulation of the affected hip had greatly improved in all dogs by 6 weeks postoperatively. CONCLUSION: Cementless THR can safely be performed in skeletally immature dogs, providing satisfactory return to normal joint function and implant survivability for at least a mean of 29.8 months.

Total hip replacement with dorsal acetabular rim augmentation using the SOP(TM) implant and polymethylmethacrylate cement in seven dogs with dorsal acetabular rim deficiency.

OBJECTIVE: To describe a surgical technique for reinforced augmentation of the dorsal acetabular rim (DAR) using a string-of-pearls (SOP™) locking plate and polymethylmethacrylate (PMMA) bone cement, and to report clinical outcome in 7 dogs. STUDY DESIGN: Case series. ANIMALS: Dogs (n=7). METHODS: Medical records (November 2009-April 2010) of 7 dogs with large DAR deficits, that had total hip replacement (THR) with reinforced augmentation of the DAR using a SOP™ plate and PMMA were evaluated retrospectively. Reinforced augmentation of the DAR involved anchorage of a precontoured 2.0 or 2.7 mm SOP™ plate dorsal to the acetabulum followed by application of PMMA cement to cover the reamed acetabulum and plate. Cemented acetabular components were used. Implant associated complications were recorded and ≥6-month follow-up obtained. RESULTS: In all dogs, lameness improved at medium-term reassessment (median, 8 months; range, 6-11 months). Complications included transient sciatic neurapraxia in 2 dogs, which resolved by 3 months. CONCLUSIONS: Reinforced augmentation of the DAR using a SOP™ plate and PMMA cement may facilitate placement of acetabular THR component implantation in dogs with severe DAR insufficiency.