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Treatment

OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis

Summary:

To update and expand upon prior Osteoarthritis Research Society International (OARSI) guidelines by developing patient-focused treatment recommendations for individuals with Knee, Hip, and Polyarticular osteoarthritis (OA) that are derived from expert consensus and based on an objective review of high-quality meta-analytic data.

Conclusion:

These guidelines offer comprehensive and patient-centered treatment profiles for individuals with Knee, Hip, and Polyarticular OA. The treatment algorithm will facilitate individualized treatment decisions regarding the management of OA.

Author & Journal:, R R Bannuru, M C Osani, E E Vaysbrot, N K Arden, K Bennell, S M A Bierma-Zeinstra, V B Kraus, L S Lohmander, J H Abbott, M Bhandari, F J Blanco, R Espinosa, I K Haugen, J Lin, L A Mandl, E Moilanen, N Nakamura, L Snyder-Mackler, T Trojian, M Underwood, T E McAlindon, Osteoarthritis and Cartilage, 2019
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Double pelvic osteotomy for the treatment of hip dysplasia in young dogs.

Summary:

The aim of this study was to evaluate the feasibility of the double pelvic osteotomy (DPO) (osteotomy of the ilium and pubis) to treat clinical cases of hip dyplasia in young dogs instead of performing a triple pelvic osteotomy (TPO) (osteotomy of the ilium, pubis, and ischium).

Conclusion:

Restoration of normal joint congruity (PC from 50 to 72%) and maintenance of the pelvic geometry without pelvic narrowing were the most intriguing features of DPO. The complications observed were greatly reduced when using dedicated DPO plates. Based on our experience, the morbidity after unilateral and bilateral DPO was lower than after TPO because elimination of the ischiatic osteotomy allowed for increased stability of the pelvis. The surgical technique of DPO was a little more demanding than TPO because of the difficulty in handling and rotating the acetabular iliac segment, but this difficulty was offset by elimination of ischial osteotomy.

Author & Journal:Vezzoni A, et al, VCOT 2010
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Tibial tuberosity advancement in 65 canine stifles.

Summary:

The tibial tuberosity advancement (TTA) procedure was developed to treat dogs with cranial cruciate ligament deficient stifles. A retrospective, descriptive study was performed on 57 dogs that underwent unilateral or bilateral TTA.

Conclusion:

TTA subjectively appears to be a useful alternative in the management of cranial cruciate ligament disease. Few severe complications were encountered. Good clinical outcome and owner satisfaction was reported with the procedure in this set of cases.

Author & Journal:2. Hoffmann DE, et al, Vet Comp Orthop Traumatol 19:219–227, 2006
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Effects of early intensive postoperative physiotherapy on limb function after tibial plateau leveling osteotomy in dogs with deficiency of the cranial cruciate ligament.

Summary:

To determine effects of early intensive postoperative physiotherapy on limb function in dogs after tibial plateau levelingosteotomy (TPLO) for deficiency of the cranial cruciate ligament (CCL).

Conclusion:

After TPLO in CCL-deficient dogs, early physiotherapy intervention should be considered as part of the postoperative management to prevent muscle atrophy, build muscle mass and strength, and increase stifle joint flexion and extension ROMs.

Author & Journal:Monk, ML, et al, Am J Vet Res 67:529-536, 2006
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Total joint replacement in the dog.

Summary:

Total joint replacement has evolved over the past 50 years from a concept that was first attempted in people suffering from osteoarthritis to a commonly applied practice in veterinary medicine. Although many questions have been answered, several controversies still exist, with many implant and technical options being explored.

Conclusion:

Currently, total hip and elbow replacement are commercially available options viable for use in dogs. These options are detailed in this article. Joint replacement for other canine joints (ie, knee, hock, shoulder) that develop osteoarthritis likely will be developed in the near future.

Author & Journal:Conzemius MG, et al, Vet Clin North Am Small Anim 2005
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Tibial osteotomies for cranial cruciate ligament insufficiency in dogs.

Summary:

To review the biomechanical considerations, experimental investigations, and clinical data pertaining to tibial osteotomyprocedures for treatment of cranial cruciate ligament (CrCL) insufficiency in dogs.

Conclusion:

Currently available data does not allow accurate comparisons between different tibial osteotomy procedures, or with traditional methods of stabilizing the CrCL-deficient stifle. Carefully designed long-term clinical studies and further biomechanical analyses are required to determine the optimal osteotomy technique, and whether these procedures are superior to other stabilization methods.

Author & Journal:Kim SE, et al, Vet Surg 37:111–125, 2008
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Safety and functional outcomes associated with short-term rehabilitation therapy in the post-operative management of tibial plateau leveling osteotomy.

Summary:

This retrospective cohort study using electronic questionnaires compared the perioperative complication rates of tibial plateau levelling osteotomy (TPLO) surgery and the 8-week, 6-month, and 1-year functional outcomes, between rehabilitation and traditional post-operative management.

Conclusion:

This study suggests that rehabilitationperformed by a certified practitioner is safe and may improve short-term outcomes when used in the initial postoperative managementfor dogs treated with TPLO.

Author & Journal:Romano LS, et al, Can Vet J 56:942-946, 2015
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Long-term follow-up of avascular necrosis of the femoral head in the dog.

Summary:

In a clinical study of 35 dogs with avascular necrosis of the femoral head, 60 per cent were Yorkshire terriers; the mean age of 33 of the dogs at onset of clinical signs was seven months. The dogs had the following signs: muscle atrophy (n = 25), shortening of the affected leg (n = 14), pain on passive movement of the hip joint (n = 28), and crepitation of the hip joint (n = 8). Radiographic findings were irregular density and flattening of the femoral head in combination with degenerative joint disease. Conservative treatment consisted of exercise therapy, and surgical treatment of a standard femoral head and neck excision.

Conclusion:

In 17 of the dogs the results of therapy were evaluated with the help of a questionnaire. It is concluded that femoral head and neck excision is indicated when conservative treatment fails to lead to clinical improvement within four weeks. Femoral head and neck excision has a good long term prognosis; however, slight intermittent lameness may remain.

Author & Journal:Piek CJ, et al, J Small Anim Pract 1996 37(1):12-18
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