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Management

Effect of meniscal release on rate of subsequent meniscal tears and owner-assessed outcome in dogs with cruciate disease treated with tibial plateau leveling osteotomy.

Summary:

To determine and compare rates of meniscal tears after tibial plateau leveling osteotomy (TPLO) among 3 groups of dogsbased on treatment method: arthrotomy with meniscal release (openR), arthrotomy without meniscal release (openNR), arthroscopy without meniscal release (scopeNR), and compare long term owner-assessed outcomes for the same groups.

Conclusion:

Meniscal release did not reduce the rate of subsequent meniscal tears when compared with cases treatedarthroscopically or when compared with all cases combined, but may be advantageous when meniscal pathology cannot be comprehensively assessed in the cranial cruciate deficient stifle. Meniscal release had no effects on owner-assessed outcome as determined in this study.

Author & Journal:Thieman K M, et al, Vet Surg. 2006 Dec;35(8):705-10
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Femoral Head and Neck Excision.

Summary:

Femoral head and neck excision is a surgical procedure that is commonly performed in small animal patients. It is a salvage procedure that is done to relieve pain in the coxofemoral joint and restore acceptable function of the limb. Femoral head and neck excision is most commonly used to treat severe osteoarthritis in the coxofemoral joint and can be done in dogs and cats of any size or age.

Conclusion:

The procedure should not be overused and ideally should not be done when the integrity of the coxofemoral joint can be restored.

Author & Journal:Harper TAM, Vet Clin North Am Small Anim Pract 2017
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Assessment of the effects of diet and physical rehabilitation on radiographic findings and markers of synovial inflammation in dogs following tibial plateau leveling osteotomy

Summary:

To determine the effects of an omega-3 fatty acid and protein-enriched diet, physical rehabilitation, or both on radiographicfindings and markers of synovial inflammation in dogs following tibial plateau leveling osteotomy and arthroscopic surgery for treatment of cranial cruciate ligament disease. DESIGN Randomized, prospective clinical trial. ANIMALS 48 dogs with unilateral cranial cruciate ligament disease.

Conclusion:

Results suggested that feeding the TF can result in lower synovial fluid PGE2 concentrations and that both the TF and rehabilitation can reduce progression of osteoarthritis in the 6 months following tibial plateau leveling osteotomy; clinical relevance of slower osteotomy healing in dogs fed the TF was unclear.

Author & Journal:Verpaalen VD, et al, J Am Vet Med Assoc 252:701-709, 2018
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Management of concurrent patellar luxation and cranial cruciate ligament rupture using modified tibial plateau levelling.

Summary:

To evaluate a novel surgery aimed at managing concurrent medial patellar luxation (MPL) and cranial cruciate ligament(CCL) ruptures in dogs weighing more than 30 kg.

Conclusion:

Thirteen surgeries were performed in 12 dogs with a mean weight of 39.8 kg. The mean postoperative tibial plateau slope was 8.1 degrees. Additional surgery was required in two cases, one due to failure of fixation and another due to screw breakage. The mean lameness score was 3.5 (out of 5) before surgery, 0.7 after 8 to 12 weeks, and 0.3 at final follow-up. Median follow-up was 1115 days (range, 270 to 2040 days). No patella luxated after surgery.

Author & Journal:Langenbach A, et al, J Small Anim Prac 2010 51:97-103
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Effect of surgical technique on limb function after surgery for rupture of the cranial cruciate ligament in dogs

Summary:

To determine the outcome and effect of surgical technique on limb function after surgery for rupture of the cranial cruciate ligament (RCCL) and injury to the medial meniscus in Labrador Retrievers.

Conclusion:

Surgical technique can influence limb function after surgery. Labrador Retrievers treated via LSS, ICS, or TPLO for repair for of RCCL and medial meniscal injury managed with partial or complete meniscectomy infrequently achieve normal function. Results of LSS and TPLO are similar and superior to ICS.

Author & Journal:Conzemius MG, et al, J Am Vet Med Assoc. 2005 Jan 15;226(2):232-6
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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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Ununited anconeal process: lag-screw fixation with proximal ulnar osteotomy

Summary:

The aim of this study was to determine if internal fixation of the anconeus combined with a proximal ulnar osteotomy was more likely to result in fusion of the anconeus to the ulna compared with a proximal ulnar osteotomy alone.

Conclusion:

total of 47 elbows (44 dogs) were identified. Of these, 28 cases (average age 7.6 months) were treated with proximal ulnarosteotomy (of which eight were stabilised with an intramedullary pin) alone. Nineteen cases (average age 7.1 months) were treated with proximal ulnar osteotomy + internal fixation. The two groups were not significantly different in age (P=0.638, Mann-Whitney U test). Fourteen of 28 cases with proximal ulnar osteotomy alone displayed anconeal union at follow-up compared with 16 of 19 cases of proximal ulnar osteotomy + internal fixation, and this difference was statistically significant (P=0.029, Fisher’s exact test).

Author & Journal:Krotscheck U, et al, V Comp Ortho Trauma 13:212-216
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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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