Articular cartilage lesions of the patellofemoral joint in dogs with naturally occurring cranial cruciate ligament disease.

OBJECTIVE: To evaluate frequency, severity, and location of patellofemoral (PF) osteoarthritis (OA) in dogs with naturally occurring cranial cruciate ligament (CCL) disease. STUDY DESIGN: Cross-sectional observational study. ANIMALS: Dogs (n = 40; stifles, 44). METHODS: Stifle arthroscopic video recordings and radiographs were performed. Cartilage pathology was scored at 3 locations (proximal, middle, distal) in the trochlear groove and patella. A radiographic osteoarthrosis and synovial pathology score were assigned. A Kruskal-Wallis test was used to determine if lesion severity varied by site, synovitis, and osteoarthrosis, and the Dunn's test was used for pairwise comparisons. The variability of body weight was evaluated using 1 way ANOVA; P < .05 was considered significant. RESULTS: Cartilage pathology and synovitis was identified in all PF joints. The proximal aspect of the trochlear groove had significantly higher cartilage scores than the middle and distal sites and the middle groove site was significantly higher than the distal site. The distal aspect of the patella had significantly greater scores than the middle and proximal patellar locations. Higher synovitis scores were associated with increased cartilage scores. Cartilage scores were significantly greater in stifles with higher radiographic osteophytosis, tibial sclerosis, and patellar enthesiophytosis scores. Higher body weights were significantly associated with greater synovial and radiographic scores. CONCLUSIONS: Dogs with CCL disease have a high incidence of PF cartilage pathology and the severity of cartilage lesions varies depending on location within the joint.

Comparison of the tibial mechanical joint orientation angles in dogs with cranial cruciate ligament rupture.

Use of the tibial mechanical joint orientation angles is now the standard of care for evaluating tibial deformities, although they have not been used to evaluate dogs with cranial cruciate ligament (CrCL) rupture. The objective of this study was to compare the tibial mechanical joint orientation angles and tibial plateau angle (TPA) between dogs with bilateral CrCL rupture (BR) and unilateral CrCL rupture with (UR-SR) and without subsequent contralateral CrCL rupture (UR-w/o-SR) as risk factors for subsequent contralateral CrCL rupture. Twenty dogs (21.7%) were classified as BR, 38 (41.3%) were classified as UR-SR, and 34 (37.0%) were classified as UR-w/o-SR. The tibial mechanical joint orientation angles and TPA, in the range studied (< 35°), were not statistically different for dogs with BR, UR-SR, and UR-w/o-SR, and were not significant risk factors for subsequent contralateral CrCL rupture.

Comparaison des angles tibials mécaniques chez les chiens diagnostiqués avec une rupture du ligament croisé cranial. Bien que l'usage de l'angle tibial mécanique constitue la norme d'évaluation des déformations du tibia, cette méthode n'a pas encore été décrite pour l'évaluation des patients canins atteints de rupture du ligament croisé cranial. L'objectif de cette étude était de comparer les valeurs des angles mécaniques tibials avec l'angle du plateau tibial chez les chiens atteints de rupture bilatérale (BR) du ligament croisé cranial, ou atteints de rupture unilatérale suivie de la rupture du ligament croisé cranial contra-lateral (UR-SR), ou atteints seulement de rupture du ligament croisé unilateral (UR-w/o-SR); additionnellement l'objectif de cette étude était d'identifier les facteurs prédisposant la rupture du ligament croisé cranial contralatéral. Vingt chiens (21,7 %) furent diagnostiqués avec BR, 38 (41,3 %) furent diagnostiqués avec UR-SR et 34 (37,0 %) avec UR-w/o-SR. L'analyse statistique n'a pas révélé de différence statistique entre les angles tibials mécaniques et l'angle du plateau tibial dans le range d'angles etudiés (< 35°) chez les différentes catégories de patients. De plus, aucun facteur de risque predisposant pour la rupture du ligament croisé cranial contralatéral ne fût identifié.(Traduit par les auteurs).

Shoulder arthrodesis in 14 dogs.

OBJECTIVES: To report surgical technique and clinical outcome of shoulder arthrodesis in dogs. STUDY DESIGN: Multicenter clinical case series. ANIMALS: Dogs (n = 14). METHODS: Shoulder arthrodesis featured craniolateral plate and screw application, with application of a 2nd plate and screws craniolaterally or caudolaterally in 5 shoulders. Implants included the locking string of pearls (SOP)™ plate in 7 shoulders. Subjective preoperative, 5-8 weeks postoperative, and 11-16 weeks postoperative clinical and radiographic findings were documented. Owner questionnaire evaluation of outcome was performed 6-20 months postoperatively. RESULTS: Mean angle of arthrodesis was 114° (range 102°-122°). Progression of arthrodesis was noted in 13/14 cases at both the 5-8 and 11-16 weeks postoperative radiographic assessments. Nine complications occurred in 7/14 dogs, graded as catastrophic in 2/9, major in 2/9, and minor in 5/9. Where morbidity was successfully managed, 11-16-week and 6-10-month postoperative limb function was positive on both veterinary and owner evaluations in almost all cases, and in several, functional lameness was considered sufficiently mild as to be imperceptible on subjective veterinary evaluation. Where present, limb circumduction was noted as the major feature of persistent lameness. CONCLUSIONS: Shoulder arthrodesis in dogs results in acceptable limb function and should be considered for the management of debilitating shoulder pathology despite a high incidence of complications. Application of the SOP plate to aid shoulder arthrodesis warrants further study.

Accuracy of Femoral Head and Neck Excision via a Craniolateral Approach or a Ventral Approach.

OBJECTIVES: This study aimed to compare the completeness of femoral head and neck removal via a craniolateral approach or a ventral approach when femoral head and neck excision (FHNE) is performed by a novice veterinarian. METHODS: FHNE was performed on both femurs of 10 canine cadavers with each femur randomized by a coin toss to FHNE via the craniolateral or ventral approach. Computed tomography (CT) of the femurs was performed prior to and following FHNE. The volume of bone that should have been removed with an ideal FHNE, the percentage of this volume that remained following FHNE, time to complete the procedure and the number of technical errors were compared between the two groups. RESULTS: No significant difference (p = 0.88) was found in the volume of bone that should have been removed with an ideal ostectomy when using the two approaches (craniolateral 3,814.7 ± 409.4 mm3; ventral 3,806.2 ± 479.4 mm3), mean excess residual femoral neck (craniolateral 6.0 ± 9.6%; ventral 4.8 ± 6.8%), mean duration of the procedure (craniolateral 19.3 ± 5.4 minutes; ventral 23.7 ± 5.6 minutes) or number of technical errors (craniolateral 0/10; ventral 1/10) between the craniolateral and ventral approach groups. CLINICAL RELEVANCE: The completeness of bone removal was not significantly different when FHNE was performed by a novice veterinarian via a craniolateral or ventral approach.

Comparison of arthroscopic and radiographic abnormalities in the hip joints of juvenile dogs with hip dysplasia.

OBJECTIVE: To compare radiographic and arthroscopic abnormalities in juvenile dogs with clinically apparent hip dysplasia. DESIGN: Case series. ANIMALS: 52 dogs (70 hip joints) with clinical signs of hip dysplasia scheduled to undergo triple pelvic osteotomy. PROCEDURE: A ventrodorsal radiographic projection of the pelvis was evaluated by a radiologist unaware of clinical and arthroscopic findings, and radiographic osteoarthritic abnormalities were judged and scored as absent (0), mild (1), moderate (2), or severe (3). Arthroscopy was performed by a surgeon unaware of clinical and radiographic findings, and arthroscopic abnormalities were graded from 0 (normal) to 5 (exposed, eburnated subchondral bone). RESULTS: In 30 of the 70 (43%) hip joints, no radiographic osteoarthritic abnormalities were seen. Severe, full-thickness articular cartilage lesions (grade 4) of the femoral head or acetabulum were seen arthroscopically in 14 (20%) joints. Lesions > or = grade 2 were seen in 60 (86%) joints. Partial tearing of the ligament of the femoral head was present in 57 (81%) joints, and complete rupture was seen in 5 (7%). Radiographic abnormalities were seen in 13 of the 14 (93%; 95% confidence interval, 66% to 99.8%) joints with grade 4 arthroscopic abnormalities but in only 23 of the 46 (50%; 95% confidence interval, 35% to 65%) joints with grade 2 or 3 arthroscopic abnormalities. CONCLUSIONS AND CLINICAL RELEVANCE: Results suggest that radiography is not a sensitive method for identifying moderate cartilage lesions in juvenile dogs with hip dysplasia. If moderate cartilage lesions are an important prognostic indicator for the success of triple pelvic osteotomy, then methods other than radiography should be used to detect these lesions.

Use of a jugular vein autograft for reconstruction of the cranial vena cava in a dog with invasive thymoma and cranial vena cava syndrome.

A spayed female dog was evaluated because of edema of the ventral cervical region, lethargy, cough, and reduced exercise tolerance. Invasive thymoma and cranial vena cava syndrome were diagnosed by use of ultrasound-guided fine-needle biopsy and contrast-enhanced helical computed tomography. Resection of the cranial vena cava and an autogenous jugular vein graft were used for restoration of normal venous return to the right atrium and alleviation of the cranial vena cava syndrome.

Evaluation of the radiographic infrapatellar fat pad sign of the contralateral stifle joint as a risk factor for subsequent contralateral cranial cruciate ligament rupture in dogs with unilateral rupture: 96 cases (2006-2007).

OBJECTIVE: To determine prevalence of the contralateral radiographic infrapatellar fat pad sign and contralateral radiographic degenerative sign (degenerative changes) and evaluate both signs as risk factors for subsequent contralateral cranial cruciate ligament (CrCL) rupture in dogs with unilateral CrCL rupture. DESIGN: Retrospective cohort study. ANIMALS: 96 dogs with unilateral CrCL rupture and 22 dogs with bilateral CrCL rupture. PROCEDURES: Dogs with unilateral CrCL rupture were classified as having normal (n = 84) or abnormal (12) contralateral stifle joints on the basis of joint palpation. Associations between potential predictive variables and rates of subsequent contralateral CrCL rupture were evaluated. RESULTS: Of the 84 dogs with unilateral CrCL rupture in which the contralateral stifle joint was palpably normal, 29 (34.5%) had a contralateral fat pad sign and 31 (36.9%) had a degenerative sign. All dogs with unilateral CrCL rupture in which the contralateral stifle joint was palpably abnormal had a contralateral fat pad sign and degenerative sign. The contralateral fat pad sign was the most important risk factor for subsequent rupture of the contralateral CrCL. For dogs with unilateral CrCL rupture and palpably normal contralateral stifle joint with and without a contralateral fat pad sign, median time to subsequent rupture was 421 and 1,688 days, respectively, and the 3-year probability of subsequent rupture was 85.3% and 24.9%, respectively. CONCLUSIONS AND CLINICAL RELEVANCE: Bilateral stifle joint radiography should be performed for all dogs with CrCL rupture. Bilateral stifle joint arthroscopy should be considered for dogs with a contralateral fat pad sign.

Computed tomographic evaluation of canine radioulnar incongruence in vivo.

OBJECTIVE: To compare radioulnar incongruence (RUI) of normal canine elbows and elbows with arthroscopically confirmed medial compartment disease in vivo using systematic computed tomography (CT) measurements. STUDY DESIGN: Prospective comparison of RUI measurements in normal and dysplastic canine elbows. SAMPLE POPULATION: Right elbows of 25 medium-large breed, adult dogs with medial compartment disease and 9 medium-large breed, adult dogs with no elbow disease. METHODS: Transverse CT images of proximal radioulnar articulation were reformatted to dorsal and sagittal planes. RUI in 3 locations of the forelimb's medial coronoid was measured. Arthroscopy confirmed diagnosis of medial compartment disease in the diseased group. RUI measurements of the diseased and normal elbows were compared. RESULTS: Cumulative statistical analysis of RUI in all planes revealed no significant difference between the normal and abnormal elbows (P = .61). The abnormal elbows had negative mean RUI at the mid (P = .56) and cranial (P = .24) coronoid regions that were not significantly different from normal elbows and mean positive RUI at the base coronoid that was significantly greater than in normal elbows (P = .00082). CONCLUSION: Canine elbows with established medial compartment disease do not have significant RUI at the medial coronoid region at the time of diagnosis when compared with normal elbows. CLINICAL RELEVANCE: If RUI is a significant factor in the pathophysiology of medial compartment elbow disease in the dog, it does not appear to be present at the time of diagnosis of disease. Ulnar or radial osteotomies do not appear to be indicated for restoration of normal radioulnar articular surface alignment.

Accuracy of computerized tomographic evaluation of canine radio-ulnar incongruence in vitro.

OBJECTIVE: To evaluate the accuracy of linear measurements obtained from computer tomography (CT) images of staged radio-ulnar incongruence in a canine cadaver forelimb model. STUDY DESIGN: CT evaluation of induced progressive radio-ulnar incongruence in canine cadaveric forelimbs. SAMPLE POPULATION: Eight cadaveric canine left forelimbs. PROCEDURE: A type 2 external skeletal fixator (ESF) with linear motors was attached to the radius in 8 cadaveric left canine forelimbs. Contiguous incremental and helical CT images of the proximal radio-ulnar articulation were acquired in the transverse, sagittal and dorsal planes. The radius was shortened by 1, 2, and 4 mm increments and scanning protocols were repeated at each increment. Digital caliper and CT image analysis measured the progressive change in distance between 2 marking spheres and the epiphyseal bone surfaces of the radio-ulnar articulation. Statistical analysis of measurements from incremental and helical CT acquisitions, and direct and reformatted images were compared with inter-sphere distance using Pearson product moment correlation coefficients. RESULTS: The reformatted incremental acquisition series at the mid-coronoid in the oblique plane had the highest correlation coefficient (r-value) at 0.908. The mid-coronoid in the dorsal plane had the second highest r-value (0.856). The coronoid incisure in the sagittal plane had an r-value of 0.826. The reformatted incremental acquisition series at the coronoid incisure in the oblique plane had the lowest r-value, 0.592. CONCLUSION: Measurement of radioulnar incongruence may be best performed using reformatted incremental acquisition CT in the mid-coronoid region in an oblique plane. CLINICAL RELEVANCE: Use of the technique reported in this study may enable determination of the association, if any, between radioulnar incongruence and developmental diseases of the canine elbow.

Self-retaining braces for canine arthroscopy.

OBJECTIVE: To describe self-retaining braces for canine shoulder, elbow, hip, and stifle arthroscopy. STUDY DESIGN: Clinical design and application. SAMPLE POPULATION: Clinical patients admitted for elective arthroscopy. METHODS: Self-retaining braces were designed and constructed from commercially available products, steel tubing, and upholstery. The design efficacy was determined by clinical use. RESULTS: A shoulder/hip retraction device was constructed from a heavy-duty Mayo stand and a steel T frame. An elbow brace and a stifle brace were constructed from a commercially available positioning arm and steel tubing. These devices were used successfully in clinical canine arthroscopy and provided consistent stability for arthroscopic surgery without the need of a surgical assistant. CONCLUSIONS: Arthroscopic self-retaining braces can be constructed from commercially available products and other simple materials to provide reliable patient positioning without the need for a surgical assistant. CLINICAL RELEVANCE: Self-retaining braces may provide improved patient stabilization and eliminate the need for a surgical assistant in most cases of canine arthroscopy.