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Surgery

Canine hip dysplasia treated by juvenile pubic symphysiodesis. Part II: two year clinical results.

Summary:

To determine the clinical effects of juvenile pubic symphysiodesis (JPS) treatment in hip dysplasia-prone puppies with comparison to similar untreated control puppies.

Conclusion:

In JPS dogs with preoperative mild to moderate hip laxity (DI = 0.40-0.69), insignificant osteoarthritis occurred at two years. Juvenile pubic symphysiodesis surgery also improved other clinical criteria (Ortolani, HRA, hip pain, N-DIS). Osteoarthritis was generally not prevented by JPS in dogs with initial severely lax hips (DI≥0.70). Juvenile pubic symphysiodesissurgery at 12 to 24 weeks of age was an effective and safe pre-emptive bilateral treatment for mild to moderate hip dysplasia.

Author & Journal:Dueland RT, et al, VCOT 2010
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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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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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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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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
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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
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