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Surgery

Effect of surgical technique on radiographic fusion of the anconeus in the treatment of ununited anconeal process

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:

A total of 47 elbows (44 dogs) were identified. Of these, 28 cases (average age 7.6 months) were treated with proximal ulnar osteotomy (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:Pettitt RA, et al, J Small Anim Prac 2009 50:545-548
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Tibial tuberosity advancement in 65 canine stifles.

Summary:

The tibial tuberosity advancement (TTA) procedure was developed to treat dogs with cranial cruciate ligament deficient stifles. A retrospective, descriptive study was performed on 57 dogs that underwent unilateral or bilateral TTA.

Conclusion:

TTA subjectively appears to be a useful alternative in the management of cranial cruciate ligament disease. Few severe complications were encountered. Good clinical outcome and owner satisfaction was reported with the procedure in this set of cases.

Author & Journal:2. Hoffmann DE, et al, Vet Comp Orthop Traumatol 19:219–227, 2006
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Canine hip dysplasia treated by juvenile pubic symphysiodesis. Part I: two year results of computed tomography and distraction index.

Summary:

To measure one and two year effects of juvenile pubic symphysiodesis (JPS) in puppies defined as ‘at-risk’ for canine hip dysplasia (CHD) using the following objective hip conformation criteria: Acetabular angle (AA), dorsal acetabular rim angle (DARA) and hip laxity (PennHIP© distraction index (DI).

Conclusion:

Juvenile pubic symphysiodesis surgery at 12-24 weeks of age significantly improved hip conformation and decreased laxity in at-risk CHD dogs. Early-age (12 to 16 week) recognition of hip laxity offered greater JPS benefits than surgery performed at 19- to 24-weeks-old. Dogs with severe laxity (DI≥0.70) continued to increase in osteoarthritis. An early (12-16 weeks) positive laxity test (Ortolani) should alert one to obtain objective laxity determinations (PennHIP© DI).

Author & Journal:Dueland RT, et al, VCOT 2010
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Long-term radiographic comparison of tibial plateau leveling osteotomy versus extracapsular stabilization for cranial cruciate ligament rupture in the dog.

Summary:

Comparison of 2 methods of surgical management of cranial cruciate ligament (CCL) injury in large-breed dogs using a radiographic osteoarthrosis (OA) scoring system.

Conclusion:

Based on logistic regression analysis, dogs with larger OA score differences were 5.78 times more likely to have had ECR than TPLO.

Author & Journal:Lazar TP, et al, Vet Surg. 2005 Mar-Apr;34(2):133-41
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Arthroscopic documentation of elbow cartilage pathology in dogs with clinical lameness without changes on standard radiographic projections.

Summary:

To document cartilage damage associated with elbow lameness in dogs without radiographic signs.

Conclusion:

Elbow pathology not associated with radiographic changes can be identified by CT and scintigraphy. Coronoid pathology is the most likely diagnosis.

Author & Journal:Punke JP, et al, Vet Surg 2009 38:209-212
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Tibial osteotomies for cranial cruciate ligament insufficiency in dogs.

Summary:

To review the biomechanical considerations, experimental investigations, and clinical data pertaining to tibial osteotomyprocedures for treatment of cranial cruciate ligament (CrCL) insufficiency in dogs.

Conclusion:

Currently available data does not allow accurate comparisons between different tibial osteotomy procedures, or with traditional methods of stabilizing the CrCL-deficient stifle. Carefully designed long-term clinical studies and further biomechanical analyses are required to determine the optimal osteotomy technique, and whether these procedures are superior to other stabilization methods.

Author & Journal:Kim SE, et al, Vet Surg 37:111–125, 2008
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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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