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Management

Patellar luxation in dogs and cats: Management and prevention.

Summary:

Patellar luxation in dogs with clinical signs of lameness is managed by surgical correction. Treatment consists of a combination of bone reconstruction and soft tissue correction techniques, Bone reconstruction procedures include mainly trochleoplasty and transposition of the tibial tuberosity. Release and imbrication of the joint capsule and fascia, antirotational suture or posterolateral capsulorrhaphy, and transposition of the quadriceps muscle are the main soft tissue reconstruction procedures.

Conclusion:

The prognosis for animals that receive surgical correction is considered good. Animals with patellar luxation must be excluded from breeding to prevent this condition in future generations.

Author & Journal:L’Eplattenier H, et al, Compend 2002 24(4)292-299
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Effects of treatment with polysulfated glycosaminoglycan on serum cartilage oligomeric matrix protein and C-reactive protein concentrations, serum matrix metalloproteinase-2 and -9 activities, and lameness in dogs with osteoarthritis.

Summary:

To investigate the effects of polysulfated glycosaminoglycan (PSGAG) treatment on serum cartilage oligomeric matrix protein (COMP) concentration, matrix metal-loproteinase-2 (MMP-2) and -9 (MMP-9) activities, C-reactive protein (CRP) concentration, and lameness scores in dogs with osteoarthritis.

Conclusion:

IM administration of PSGAG inhibited COMP degradation in dogs with osteoarthritis. Results indicate that decreases in serum COMP concentrations might be related to improvement in lameness after PSGAG treatment.

Author & Journal:Fujiki M, et al, Am J Vet Res 2007;68:827–833
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Comparison of lateral fabellar suture and tibial plateau leveling osteotomy techniques for treatment of dogs with cranial cruciate ligament disease.

Summary:

To compare 1-year outcomes after lateral fabellar suture stabilization (LFS) and tibial plateau leveling osteotomy (TPLO) for the treatment of dogs with cranial cruciate ligament disease.

Conclusion:

Kinematic and owner satisfaction results indicated dogs that underwent TPLO had better outcomes than those that underwent LFS.

Author & Journal:Gordon-Evans WJ, et al, J Am Vet Med Assoc 243:675-680, 2013
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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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Evaluation of the clinical effects of diet and physical rehabilitation in dogs following tibial plateau leveling osteotomy

Summary:

To assess clinical effects of an omega-3 fatty acid and protein-enriched diet, physical rehabilitation, or both in dogs following tibial plateau leveling osteotomy (TPLO) and arthroscopic surgery for cranial cruciate ligament (CCL) disease.

Conclusion:

Feeding the TF and providing physical rehabilitation during the first 6 months after TPLO were associated with improvements in some indices of clinical outcome and function in dogs. Significant interactions between time and some outcome variables were observed, indicating further research is warranted.

Author & Journal:Baltzer WI, et al, J Am Vet Med Assoc 252:686-700, 2018
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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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Comparison of trochlear block recession and trochlear wedge recession for canine patellar luxation using a cadaver model.

Summary:

To compare trochlear block recession (TBR) to trochlear wedge recession (TWR) with regards to patellar depth (percentage of patellar volume under the trochlear ridges), patellar articular contact, percentage of recessed trochlear surface area, and resistance to patellar luxation.

Conclusion:

TBR increases proximal patellar depth, increases patellar articular contact with the recessed proximal trochlea, recesses a larger percentage of trochlear surface area, and results in a greater resistance to patellar luxation in an extended position as compared with TWR.

Author & Journal:Johnson AL, et al, Vet Surg 2001 30:140-150
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Tibial plateau leveling osteotomy for repair of cranial cruciate ligament rupture in the canine

Summary:

A new technique for correcting the cranial cruciate deficient stifle, the tibial plateau leveling osteotomy, is introduced by the author.

Conclusion:

The technique is described and illustrated. Clinical results of 394 cases are described.

Author & Journal:Slocum B, Slocum T., 1. Vet Clin N Am-Small 23:777–95, 1993
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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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