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References

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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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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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 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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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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Computed tomography versus arthroscopy for detection of canine elbow dysplasia lesions.

Summary:

To describe associations between computed tomography (CT) and arthroscopy in dogs with elbow dysplasia lesions.

Conclusion:

Some CT signs are significantly associated with arthroscopic features of elbow dysplasia lesions in dogs; however, other CT signs were not associated with arthroscopic findings, and CT and arthroscopy can provide contradictory information. Osteophyte size is moderately correlated with cartilage erosion of the medial joint compartment.

Author & Journal:Moores AP, et al, Vet Surg 2008 37:390-398
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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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Correlation of healing capacity with vascular response in the anterior cruciate and medial collateral ligaments of the rabbit.

Summary:

In clinical terms, functional recovery after anterior cruciate ligament (ACL) injury is generally poorer than after medial collateral ligament (MCL) injury. In experimental studies of injury, the early phases of ligament healing require an augmented blood supply. We hypothesized that the differences in healing properties of the ACL and MCL would be reflected in the magnitude of their vascularresponses to partial injury.

Conclusion:

The superior capacity of the MCL to increase its blood supply through angiogenesis and increased flow is essential for ligament healing to occur, and may be the major difference in healingpotential between the ACL and MCL.

Author & Journal:Bray RC, et al, J Orthop Research 2003;21:1118-1123
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Coxofemoral joint laxity from distraction radiography and its contemporaneous and prospective correlation with laxity, subjective score, and evidence of degenerative joint disease from conventional hip-extended radiography in dogs

Summary:

A 3-year prospective study of large-breed dogs (4 months to 3 years of age) was conducted to evaluate the influence of radiographic positioning and age on coxofemoral joint (hip) laxity, subjective hip score, and development of degenerative joint disease (DJD). The dogs (n = 142) were breeder- or client-owned and represented 14 breeds.

Conclusion:

Results of the study indicated that at a specific age (4, 6, 12, 24, or 36 months), all methods of hip evaluation correlated with each other at a moderate level (P < 0.05). The strength of contemporaneous correlation tended to increase with age of evaluation. Longitudinally, the between-method correlations were usually significant (P < 0.05), but not at a sufficiently high level to permit reliable between-method prediction. Prospective intraclass (within-method) statistical analysis of the various hip-scoring methods indicated that DI was superior to NA and OFA/WHR in comparability of score over time. The intraclass correlation coefficient ranged from 0.55 to 0.91 for DI in contrast to 0.40 to 0.78 for NA, and 0.06 to 0.39 for OFA/WHR over the age intervals of the study. For reference, the highest Kappa of 0.39 for the subjective OFA/WHR scoring reflected a maximal level of agreement between time intervals, only slightly better than chance. The associated large error questions the predictive use of the 7-point, subjective hip-scoring scheme, particularly prior to the age of 2 years.

Author & Journal:Smith GK, et al, Am J Vet Res 1993
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Cranial cruciate ligament disease in dogs: biology versus biomechanics.

Summary:

The stifle joint of dogs is an organ comprised of multiple tissue types that must work in concert to maintain joint health and function. Cruciate disease in dogs is caused by a spectrum of causal and risk factors that result in a final common pathway of abnormal biomechanics and abnormal biology causing osteoarthritis, or organ failure, of the stifle and the clinical signs of lameness, pain, and limbdysfunction.

Conclusion:

It is vital to understand the components of the biologic and biomechanical pathologies to improve our understanding of cruciate disease in dogs so that we can improve preventative, diagnostic, and therapeutic strategies for our canine patients.

Author & Journal:Cook JL, Vet Surg. 2010 Apr;39(3):270-7
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