Management

Comparison of short- and long-term function and radiographic osteoarthrosis in dogs after postoperative physical rehabilitation and tibial plateau leveling osteotomy or lateral fabellar suture stabilization.

Summary:

To compare short- and long-term functional and radiographic outcome of cranial cruciate ligament (CrCL) injury in dogstreated with postoperative physical rehabilitation and either tibial plateau leveling osteotomy (TPLO) or lateral fabellar suture stabilization(LFS).

Conclusion:

No significant difference in outcome as determined by ground reaction forces or radiographic OA scores were found between dogs with CrCL injury treated with LFS or TPLO.

Author & Journal:Au, KK, et al, Vet Surg 39:173-180, 2010

Pelvic osteotomy for axial rotation of the acetabular segment in dogs with hip dysplasia

Summary:

Pelvic osteotomy has provided normal function and activity to dogs with hip dysplasia.

Conclusion:

Physical and radiographic examination and palpation under anesthesia permit evaluation of the degenerative process and provide the specific amount of axial rotation of the pelvis necessary for each dog. The technique consists of an osteotomy of the pubis, ischium, and ilium to reestablish acetabular support of the femoral head.

Author & Journal:Slocum B, et al, Vet Clin North Am Small Anim Pract 1992

Short-term and eight to 12 months results of a tibial tuberosity advancement as treatment of canine cranial cruciate ligament damage.

Summary:

To describe the perioperative complications and the six weeks and eight to 12 months outcome of cases of canine cranialcruciate ligament damage treated with a tibial tuberosity advancement.

Conclusion:

The complication rate was comparable with previous reports of cranial cruciate ligament rupture treated with a tibial tuberosityadvancement or a tibial plateau leveling osteotomy (TPLO). The most frequent complication was a symptomatic late secondary meniscal damage in six cases (8.5 per cent). These cases were successfully treated with a partial meniscectomy during a minimal invasive procedure. The six-week re-evaluation showed advanced healing of the tibial crest osteotomies in 94 per cent of the cases and a significant reduction of the lameness in all dogs. Eighty-three per cent of the owners reported that their dogs are never lame or only after heavy exercise eight to 12 months after the tibial tuberosity advancement procedure. Sixty-five per cent of the owners stated the overall treatment to be excellent, 28 per cent good.

Author & Journal:Stein S, et al, J Small Anim Pract. 2008 Aug;49(8):398-404

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

Techniques of application and initial clinical experience with sliding humeral osteotomy for treatment of medial compartment disease of the canine elbow.

Summary:

To determine medium-term clinical efficacy of sliding humeral osteotomy (SHO) for treatment of lameness and elbow pain associated with clinically diagnosed elbow disease featuring cartilage eburnation of the medial elbow compartment (medial compartmentdisease–MCD).

Conclusion:

Of 59 limbs that had SHO, 39 had preoperative focal treatment of the diseased medial aspect of the coronoid process. Mean +/- SD dog age was 45.5 +/- 37.48 months and body weight ranged from 13.6 to 46.7 kg. Mean preoperative duration of lameness was 14.7 +/- 18.50 months. Lameness improved for all limbs by 26 weeks, and resolved in 21/32 limbs. Significant improvements in postoperative elbow pain scores and most owner assessments of function were observed. Incidence of major complications requiring surgical intervention was 17.2%, 22.2%, and 4.8% for each of the 3 technique variants described. Histologic examination of 2 elbows at >12 months revealed fibrocartilage cover of medial aspect of humeral condyle.

Author & Journal:Fitzpatrick N, et al, Vet Surg 2009 38:261-278

Effects of intramuscular administration of glycosaminoglycan polysulfates on signs of incipient hip dysplasia in growing pups.

Summary:

We tested the hypothesis that treatment of growing, susceptible (to hip dysplasia) pups by IM administration of glycosaminoglycanpolysulfates would mitigate the signs of incipient hip dysplasia.

Conclusion:

Of 8 treated pups, none had subluxation radiographically, whereas 4 of 8 control dogs had femoral head subluxation. Mean Norberg angle on the radiographs was 109.7 degrees +/- 1.6 degrees for the treated group and was 101.5 degrees +/- 1.6 degrees for controls, representing a mean improvement in coxofemoral congruity of 8.2 degrees in the treated pups.

Author & Journal:Lust G, et al, Am J Vet Res 1992; 53:1836-1843

Long-term functional outcome of tibial plateau leveling osteotomy versus extracapsular repair in a heterogeneous population of dogs.

Summary:

To compare the long-term outcome of tibial plateau leveling osteotomy (TPLO) and extracapsular repair (ECR) for treatment of a ruptured cranial cruciate ligament (RCCL).

Conclusion:

Dogs achieved normal limb loading faster after TPLO than ECR. TPLO resulted in operated limb function that was indistinguishable from the control population by 1 year postoperatively.

Author & Journal:Nelson SA, et al, Vet Surg 42:38-50, 2013

Triple pelvic osteotomy: effect on limb function and progression of degenerative joint disease

Summary:

The objective of this study was to evaluate prospectively the outcome of 21 clinical patients treated with triple pelvic osteotomies during the year following surgery.

Conclusion:

Twelve dogs were treated unilaterally and nine dogs were treated bilaterally with triple pelvic osteotomies. There were no differences in mean anteversion angles, angles of inclination, or preoperative DJD between treated hips and untreated hips. Degenerative joint diseaseprogressed significantly in all hips regardless of treatment. Two cases developed hyperextension of their hocks after the triple pelvicosteotomies. However, no radiographic evidence of DJD was observed for any of the stifles or hocks at any observation time. A significant increase in vertical peak force (VPF) scores was noted for treated legs by two-to-three months after surgery, which continued over time. Untreated legs did not show a significant change in VPF scores over time. No differences were found in progression to higher scores when unilaterally treated legs, first-side treated legs, and second-side treated legs were compared.

Author & Journal:Johnson AL, et al, J Am Anim Hosp Assoc. 1998 May-Jun;34(3):260-4

Effects of postoperative rehabilitation on limb function after cranial cruciate ligament repair in dogs.

Summary:

To determine the effects of early postoperative rehabilitation on limb function in dogs after surgery for ruptured cranialcruciate ligament (RCCL).

Conclusion:

Dogs that have surgery for RCCL and a torn medial meniscus benefit from postoperativerehabilitation; rehabilitation should be considered part of the postoperative management of these patients.

Author & Journal:Marsolais, GS, et al, J Am Vet Med Assoc 220:1325-1330, 2002

Use of client-specific outcome measures to assess treatment effects in geriatric, arthritic dogs: controlled clinical evaluation of a nutraceutical.

Summary:

“A questionnaire method was designed for dog owners to monitor the orthopedic disabilities of their pets for evaluation of a nutraceutical with joint health claims. Fifty large-breed dogs, 7 to 12 years of age, presenting with signs of osteoarthritis, were randomly allocated to placebo and active treatment groups. Degree of disability was assessed by physical examination, a standard questionnaire on daily activities, and a case-specific questionnaire that monitored specific impairments of each dog. The test product was a special milk protein concentrate (SMPC) from hyperimmunized cows, previously shown to express anti inflammatory and antiarthritic activity in humans”

Conclusion:

“Overall improvement was noted in 68% and 35% of the SMPC and placebo groups, respectively.”

Author & Journal:Gingerich D.A., et al, Veterinary Therapeutics, 2003