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Management

Complications with and owner assessment of the outcome of tibial plateau leveling osteotomy for treatment of cranial cruciate ligament rupture in dogs: 193 cases (1997-2001).

Summary:

To identify complications associated with tibial plateau leveling osteotomy (TPLO) for treatment of cranial cruciate ligament rupture in dogs and assess owner perceptions of outcome.

Conclusion:

Results indicated that complications developed in approximately 25% of dogs undergoing TPLO for treatment of a cranial cruciate ligament injury but that most complications responded to appropriate treatment, and development of complications did not affect owner assessments of outcome. There was a higher incidence of complications when bilateral TPLOs were performed during a single anesthetic episode.

Author & Journal:Priddy NH 2nd, et al, J Am Vet Med Assoc. 2003 Jun 15;222(12):1726-32.
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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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Comparison of owner satisfaction between stifle joint orthoses and tibial plateau leveling osteotomy for the management of cranial cruciate ligament disease in dogs.

Summary:

To compare owner satisfaction between custom-made stifle joint orthoses and tibial plateau leveling osteotomy (TPLO) for the management of medium- and large-breed dogs with cranial cruciate ligament disease (CCLD). DESIGN Owner survey.

Conclusion:

Results indicated high owner satisfaction rates for both interventions. Owners considering nonsurgical management with an orthosis should be advised about potential complications such as persistent lameness, skin lesions, patient intolerance of the device, and the need for subsequent surgery.

Author & Journal:Hart JL, et al, J Am Vet Med Assoc 2016;249(4):391-398
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Stabilization of the CORA based leveling osteotomy for treatment of cranial cruciate ligament injury using a bone plate augmented with a headless compression screw.

Summary:

To report the effectiveness of a bone plate/headless compression screw (HCS) construct in preventing tibial plateau angle (TPA) shift postoperatively and to describe radiographic healing of the osteotomy.

Conclusion:

Stabilization of the CBLO using a bone plate augmented with a HCS was effective in maintaining PostTPA and achieving satisfactory radiographic healing.

Author & Journal:Raske M, et al, Vet Surg 42: 759-764, 2013
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Comparison of conservative management and juvenile pubic symphysiodesis in the early treatment of canine hip dysplasia

Summary:

To evaluate the efficacy of juvenile pubic symphysiodesis (JPS) in a clinical setting for the early treatment of canine hipdysplasia (CHD), and to identify its indications and contraindications.

Conclusion:

In group 1, 43.2% of the puppies had regression or a lack of progression of the disease in the final evaluation (Grade A & B), 25.9% had mild CHD (Grade C) and 30.9% had moderate and severe CHD (Grade D & E). In group 2, 23.6% of the puppies did not show any development of the disease (Grade A & B), 21.1% had mild CHD (Grade C) and 55.3% developed moderate to severe CHD (Grade D & E). Further investigation was done by comparing the severity of early signs of susceptibility to CHD with the final FCI Grades at adulthood in both groups.

Author & Journal:Vezzoni A, et al, VCOT 2008
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Tibial tuberosity advancement for stabilization of the canine cranial cruciate ligament-deficient stifle joint: surgical technique, early results, and complications in 101 dogs.

Summary:

To describe the surgical technique, early results and complications of tibial tuberosity advancement (TTA) for treatment for cranial cruciate ligament (CrCL)-deficient stifle joints in dogs.

Conclusion:

TTA is a procedure comparable with alternate methods of CrCL repair with expected good to excellent functional outcome.

Author & Journal:Lafaver S, et al, Vet Surg. 2007 Aug;36(6):573-86.
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Conservative versus arthroscopic management for medial coronoid process disease in dogs: a prospective gait evaluation.

Summary:

To investigate, using objective gait analysis, the long-term outcome of dogs with medial coronoid process disease (MCPD) treated with conservative management (CM) versus arthroscopic treatment (AT).

Conclusion:

AT dogs had increased mechanical asymmetry at 4 and 8 weeks compared to the CM group revealing surgery worsened limb function. There was no significant difference in mechanical symmetry between groups at 26 and 52 weeks.

Author & Journal:Burton NJ, et al, Vet Surg 2011 40:972-980
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Systemic administration of glycosaminoglycan polysulphate (arteparon) provides partial protection of articular cartilage from damage produced by meniscectomy in the canine.

Summary:

Bilateral medial meniscectomy was undertaken in 14 mature beagles. Another two underwent arthrotomy (sham-operated controls).

Conclusion:

The results indicated that Arteparon provided some protective effect to AC in the meniscectomised compartment as demonstrated histologically by reduced surface fibrillation, diminished chondrocyte cloning, and maintenance of alcianophilia. The levels of PGs and hexuronate-protein ratios in medial AC of drug-treated meniscectomised animals were found to be comparable to sham controls, whereas these parameters in the nondrug-treated meniscectomized group were depressed.

Author & Journal:Hannan N, et al, J Orthop Res 1987; 5:47-49
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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
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