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Clinical comparison of a novel extracapsular stabilization procedure and tibial plateau leveling osteotomy for treatment of cranial cruciate ligament deficiency in dogs

Summary:

To develop and test a novel extracapsular technique, TightRope CCL technique (TR), and compare its 6-month clinicaloutcomes to tibial plateau leveling osteotomy (TPLO) in dogs with cranial cruciate ligament (CCL) deficiency.

Conclusion:

TR resulted in 6-month outcomes that were not different than TPLO in terms of radiographic progression of OA and client-evaluated level of function. TR was associated with shorter anesthesia and surgery times as well as a lower complication rate.

Author & Journal:11. Cook J, et al, Vet Surg 2010;39(3):315-23
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Canine hip dysplasia treated by juvenile pubic symphysiodesis. Part II: two year clinical results.

Summary:

To determine the clinical effects of juvenile pubic symphysiodesis (JPS) treatment in hip dysplasia-prone puppies with comparison to similar untreated control puppies.

Conclusion:

In JPS dogs with preoperative mild to moderate hip laxity (DI = 0.40-0.69), insignificant osteoarthritis occurred at two years. Juvenile pubic symphysiodesis surgery also improved other clinical criteria (Ortolani, HRA, hip pain, N-DIS). Osteoarthritis was generally not prevented by JPS in dogs with initial severely lax hips (DI≥0.70). Juvenile pubic symphysiodesissurgery at 12 to 24 weeks of age was an effective and safe pre-emptive bilateral treatment for mild to moderate hip dysplasia.

Author & Journal:Dueland RT, et al, VCOT 2010
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The cruciate ligaments of the canine stifle: an anatomical and functional analysis.

Summary:

Fifty canine stifles were used to study the anatomy and function of the cruciate ligaments.

Conclusion:

It was found that both cruciate ligaments were composed of 2 component parts and that the geometry of their femoral attachments was responsible for a reciprocal loosening and tightening of these components through a range of motion. It was also found that transection of one or both cruciate ligaments resulted in marked joint instability.

Author & Journal:Arnoczky SP, et al, Am J Vet Res. 1977 Nov;38(11):1807-14
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Short-term and long-term outcomes for overweight dogs with cranial cruciate ligament rupture treated surgically or nonsurgically.

Summary:

To determine short- and long-term rates of successful outcomes of surgical and nonsurgical treatments for overweight dogswith cranial cruciate ligament rupture (CCLR).

Conclusion:

Overweight dogs with CCLR treated via surgical and nonsurgical methods had better outcomes than dogs treated via nonsurgical methods alone. However, almost two-thirds of the dogs in the nonsurgical treatment group had a successful outcome at the 52-week evaluation time.

Author & Journal:Wucherer KL, et al, J Am Vet Med Assoc 2013;242:1364-1372
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Canine elbow dysplasia: anatomy and pathogenesis.

Summary:

Canine elbow dysplasia is a complex of diseases that includes ununited anconeal process, fragmented medial coronoid process, osteochondrosis of the medial humeral condyle, and elbow incongruity. Three causes of elbow dysplasia have been proposed: osteochondrosis, trochlear notch dysplasia, and asynchronous growth of the radius and ulna.

Author & Journal:Trostel CT, et al, Compend Contin Educ Pract Vet 2003 25 (10):754-761
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Prevalence of and risk factors for hip dysplasia and cranial cruciate ligament deficiency in dogs

Summary:

To evaluate prevalence of and risk factors for hip dysplasia (HD) and cranial cruciate ligament deficiency (CCLD) in dogs and determine change in prevalence over time.

Conclusion:

Results suggested that sex, age, and breed were risk factors for HD, CCLD, or both in dogs and that prevalences of HD and CCLD have increased over time.

Author & Journal:Witsberger TH, et al JAVMA 232:1818-1824, 2008
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Tibial tuberosity transposition-advancement for treatment of medial patellar luxation and concomitant cranial cruciate ligament disease in the dog. Surgical technique, radiographic and clinical outcomes.

Summary:

To report surgical technique, morphometric effects and clinical outcomes for tibial tuberosity transposition-advancement(TTTA), sulcoplasty and para-patellar fascial imbrication for management of concomitant medial patellar luxation (MPL) and cranialcruciate ligament (CCL) disease in 32 dogs.

Conclusion:

Thirty-nine stifles were treated by surgery. Medial patellar luxation grade ranged from II to IV/IV. The CCL rupture was complete in 17/39 stifles, and incomplete in 22/39. Complications occurred in 11/39 stifles including MPL recurrence (n=4). Resolution of subjectively-assessed lameness occurred in 29/39 stifles at the six to eight week assessment. Resolution of lameness was eventually documented in 35/39 stifles (4/39 lost to follow-up), and was maintained at the six to 20 month reassessment where available. The TTTA induced relative patella baja in 31/39 stifles. Magnitude of actual tibial tuberosity advancement was lower than that predicted by cage size.

Author & Journal:Yeadon R, et al, V Comp Orthop Traumatol 2011 24:18-26
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Canine Hip Dysplasia: Reviewing the Evidence for Nonsurgical Management

Summary:

This systematic review of available evidence for nonsurgical management of hip dysplasia considered 14 articles and scored nonsurgical management including: activity restrictions, weight management, acupuncture, modulation of joint disease by polysulfated glycosaminoglycans, mesenchymal stem cell therapy, and extra corporeal shock wave therapy.

Conclusion:

“Weight management is an effective and important component of managing dogs with HD and associated osteoarthritis. Techniques that modulate the progression of joint disease may also be beneficial for treating dogs with HD. Further studies are needed to investigate other methods of managing HD such as hydrotherapy and physical rehabilitation.”

Author & Journal:Shaw, Kristin Kirkby et al, Veterinary Surgery, 2012
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Comparison of three methods for the management of fragmented medial coronoid process in the dog: A systematic review and meta-analysis.

Summary:

The objective of this review and analysis was to compare arthroscopy, medial arthrotomy and medical management for treating fragmented coronoid process in the dog.

Conclusion:

The data come from manuscripts published in peer-reviewed veterinary journals, and the study design is a systematic review followed by meta-analysis. The meta-analysis combines data from a set of studies so that surgical techniques and medial management can be compared in a single analysis. Several literature databases and veterinary texts were thoroughly searched to provide a list of over 400 candidate manuscripts. Inclusion criteria were used to filter the candidate manuscripts to a final set of four manuscripts that directly pertained to the clinical question. They were scored for their evidentiary value using a semi-objective measure.

The results were that arthroscopy was superior to medial arthrotomy and medical management, but medial arthrotomy was not superior to medical management. Only one manuscript was a randomized controlled trial, hence the results must be tempered by the evidentiary value of the data.

Author & Journal:Evans RB, et al, Vet Comp Orthop Traumatol 2008 21:106-109
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Miller’s Anatomy of the Dog 3rd ed.

Author & Journal:Evans HE., 1993
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