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Retrospective study of 476 tibial plateau levelling osteotomy procedures. Vet Comp Orthop Traumatol 2017; 24:333-41. [DOI: 10.3415/vcot-10-07-0109] [Citation(s) in RCA: 77] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2010] [Accepted: 06/01/2011] [Indexed: 11/17/2022]
Abstract
SummaryObjective: To determine the rate of subsequent ‘pivot shift’, meniscal tear and risk factors associated with complications of tibial plateau levelling osteotomy (TPLO) and to assess clinical and owner perception outcome.Study design: Retrospective study.Sample population: Three hundred and forty-eight dogs that had undergone TPLO surgical procedures (n = 476 stifles).Methods: Medical records were reviewed for the retrieval of information on breed, sex, age, body weight, clinical history, radiograph findings, pre- and postoperative tibial plateau angle, limb alignment, unilateral versus bilateral disease, condition of cranial cruciate ligament (CCL) and menisci, implant material, healing time and complications. Clinical and owner-assessed questionnaire outcomes were also recorded.Results: Forty-six (9.7%) postoperative complications were reported. Twenty (4.2%) were classified as major complications requiring an additional surgical intervention, and 26 (5.5%) as minor complications. No risk factors associated with postoperative complications were identified. Ten (2.1%) subsequent meniscal injuries in the stifles with normal unaltered menisci at time of TPLO were reported with a median postoperative time of 9.5 months. Signs of postoperative ‘pivot shift’ were reported in 15 (3.1%) stifles. All stifles with a ‘pivot shift’ had a complete CCL rupture or a debrided partial CCL rupture a medial menisectomy was identified as a risk factor for a ‘pivot shift’ (p = 0.02). Dogs with intact medial meniscus had a significantly higher activity level (p <0.0001) and a shorter time to peak function (p = 0.02) than dogs that underwent menisectomy according to an owner questionnaire.Conclusions: Dogs with TPLO and intact meniscus seemed to have a better and faster recovery than dogs with TPLO and menisectomy based on owner questionnaires. ‘Pivot shift’ was infrequent after TPLO surgery. All dogs with a ‘pivot shift’ had a complete CCL rupture or a debrided partial CCL rupture and menisectomy was identified as a risk factor for its occurrence.Clinical relevance: Considering the relatively low rate of subsequent meniscal injury after TPLO, systematic medial meniscal release with TPLO may be unnecessary. The ‘pivot shift’ deserved further investigation to completely understand its mechanism, to identify its anatomic components and potential consequences on the stifle joint.
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Sabanci SS, Ocal MK. Categorization of the pelvic limb standing posture in nine breeds of dogs. Anat Histol Embryol 2017; 47:58-63. [DOI: 10.1111/ahe.12324] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 10/17/2017] [Indexed: 11/28/2022]
Affiliation(s)
- S. S. Sabanci
- Faculty of Veterinary Medicine; Department of Anatomy; Kırıkkale University; Kırıkkale Turkey
| | - M. K. Ocal
- Faculty of Veterinary Medicine; Department of Anatomy; Near East University; Nicosia Cyprus
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Fonseca R, Lobo-Jr A, Santana M. Measurements of femoral angles, femur length, and hip width in cat radiographs. ARQ BRAS MED VET ZOO 2017. [DOI: 10.1590/1678-4162-9583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
ABSTRACT Femoral angle, femur length, and hip width were measured in radiographs of 92 intact domestic cats, males and females of mixed breed from the Center for Zoonosis Control of the Federal District. The animals showed no trauma, orthopedic diseases or angular deformities and had closed physeal lines. Accordingly, we measured aLPFA (anatomical lateral proximal femoral angle, aLDFA (anatomical lateral distal femoral angle), mLPFA (mechanical lateral proximal femoral angle), mLDFA (mechanical lateral distal femoral angle), IA (femoral inclination angle), FL (femur length) and HW (hip width) using ventrodorsal radiographs, with both hindlimbs in a single exposure to an X-ray beam centered on the hip. The mean values of the variables were: mLPFA: 82.5±3.62°; aLPFA: 80.1±4.29°; mLDFA: 96.1±3.51° (males) and 97.3±2.05° (females); aLDFA: 94,3±3.43°; IA: 136.6±3.86°; FL: 12.9±0.55cm (males) and 13.4±0.66cm (females); and HW: 3.1cm±0.23 (males) and 3.5±0.26cm (females). These values will serve as a reference for the diagnosis of angular deformities and as support for planning corrective osteotomies in domestic cats.
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Impact of femoral varus on complications and outcome associated with corrective surgery for medial patellar luxation. Vet Comp Orthop Traumatol 2017. [PMID: 28636061 DOI: 10.3415/vcot-16-09-0132] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES To evaluate the association of femoral varus with postoperative complications and outcome following standard corrective surgery for medial patellar luxation (MPL) without distal femoral osteotomy (DFO) in dogs. METHODS In a retrospective study spanning a 12 year period, 87 stifles with MPL that were treated by standard surgical techniques were included. Inclination angle (ICA), femoral varus angle (FVA), anatomical lateral distal femoral angle (aLDFA), and mechanical lateral distal femoral angle (mLDFA) were measured. Postoperative complications were noted and outcome evaluated. Associations between potential risk factors and both complication rate and outcome were assessed. RESULTS Postoperative complications occurred in 19 stifles, five of which were major. There was no evidence of an association between FVA (p = 0.41) or aLDFA (p = 0.38) and any complication. There was also no evidence of an association between FVA (p = 0.31) or aLDFA (p = 0.38) and any major complication. Dogs with a larger aLDFA had increased odds of a poorer outcome (p = 0.01) as did dogs that suffered a major complication (p = 0.0001). CLINICAL SIGNIFICANCE Based on radiographic measurements, there is no evidence of an association between FVA and the incidence of postoperative complications following standard MPL correction. Traditional surgical techniques appear to be appropriate for most cases of MPL and further work is required to better define selection criteria for including DFO in the treatment of these cases.
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Pelvic limb alignment measured by computed tomography in purebred English Bulldogs with medial patellar luxation. Vet Comp Orthop Traumatol 2017; 30:200-208. [PMID: 28474728 DOI: 10.3415/vcot-16-07-0116] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2016] [Accepted: 03/02/2017] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The aim of the study was to describe the differences in pelvic limb alignment between healthy purebred English Bulldogs and those with medial patellar luxation through the measurement of femoral and tibial angles on computed tomography images in multiplanar reconstruction modality (MPR-CT). METHODS Twenty-one purebred English Bulldogs were included and divided into two groups: one including healthy dogs (15 limbs) and the other including those with medial patellar luxation (24 limbs). Three different observers used MPR-CT to measure the following angles: anatomical lateral proximal femoral angle (aLPFA), anatomical lateral distal femoral angle (aLDFA), mechanical lateral proximal femoral angle (mLPFA), mechanical lateral distal femoral angle (mLDFA), angle of inclination of the femoral neck (AI), angle of anteversion (AA), mechanical medial proximal tibial angle (mMPTA), mechanical medial distal tibial angle (mMDTA), mechanical caudal distal tibial angle (mCdDTA), mechanical caudal proximal tibial angle (mCdPTA), and the tibial torsion angle (TTA). A Mann-Whitney U test was used to compare each variable in both groups. RESULTS The values for aLDFA and mLDFA in the medial patellar luxation population were significantly increased compared to healthy subjects (p <0.05). No significant differences were observed for the other variables. CLINICAL SIGNIFICANCE In our population, an increased distal femoral varus was associated with medial patellar luxation. Our results could be useful to determine whether or not angular deformity of the femur is present and help determine the degree of correction necessary to restore alignment.
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Computed tomographic evaluation of femoral and tibial conformation in English Staffordshire Bull Terriers with and without congenital medial patellar luxation. Vet Comp Orthop Traumatol 2017; 30:191-199. [PMID: 28331928 DOI: 10.3415/vcot-16-12-0162] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2016] [Accepted: 03/02/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To compare hindlimb conformation of English Staffordshire Bull Terriers with and without medial patellar luxation using computed tomography. METHODS Hindlimb computed tomography (CT) was performed on six English Staffordshire Bull Terriers with grade II or III medial patellar luxation, and six without medial patellar luxation. Inclination angle, femoral condyle trochanteric angle, anteversion angle (AA), distal anteversion angle (DAA), proximal anteversion angle (PAA), femoral varus angle (FVA), tibial valgus angle (TVA), and tibial torsion angle (TTA) were measured. Student's T-test was conducted to compare normal limbs to limbs with medial patellar luxation, all limbs of dogs with medial patellar luxation to limbs of the control group, and medial patellar luxation affected limbs (normal limbs of unilaterally affected dogs excluded) to the control group. P-values less than 0.05 were considered significant. RESULTS Two dogs with medial patellar luxation were only affected unilaterally. Limbs of English Staffordshire Bull Terriers with medial patellar luxation had significantly diminished AA and DAA, in addition to decreased TVA. These differences were similar regardless of how the unaffected limbs from affected dogs were treated in our analysis. DISCUSSION AND CONCLUSION Medial patellar luxation in this population of English Staffordshire Bull Terriers was characterized by a decrease in femoral anteversion, external rotation of the femoral diaphysis, and decreased tibial valgus. These findings may help inform clinical decision making when performing osteotomy for treatment of medial patellar luxation in this breed.
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The effect of valgus and varus femoral osteotomies on measures of anteversion in the dog. Vet Comp Orthop Traumatol 2017; 30:184-190. [PMID: 28127618 DOI: 10.3415/vcot-16-09-0138] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 01/12/2017] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine whether femoral osteotomies that change frontal plane alignment without affecting torsion influence anteversion and inclination. METHODS Femurs without deformity were scanned to create three-dimensional reconstructions. The femoral head-neck axis was identified by placement of a virtual intramedullary pin. A proximal osteotomy was simulated to create three conditions while keeping torsion constant: Normal, Coxa Valga (neck-shaft angle increased by 12°), and Coxa Vara (neck-shaft angle decreased by 12°). Femoral anteversion was measured from an axial image in all three conditions. Femoral inclination was calculated for all conditions using the neck-shaft and anteversion angles. Changes in anteversion and inclination were calculated and compared using a one-way repeated measures analysis of variance. Distal femoral osteotomies were then simulated with the native femurs, inducing 18° of distal varus with no change to torsion. Changes in anteversion and inclination for the Normal and Distal Varus conditions were calculated and compared by a paired t-test. RESULTS Version changed by a mean of 13.9° (± 1.5; p <0.0001) from the Coxa Valga to Coxa Vara conditions while inclination changed by a mean of 1.3° (± 0.39; p <0.01). Version changed by a mean of 6.6° (± 0.7; p <0.0001) between the Distal Varus and Normal conditions while inclination changed by a mean of -3.8° (± 0.75; p <0.001). CLINICAL SIGNIFICANCE Femoral version changes with changing frontal plane alignment even when torsion is constant. This should be considered when correcting femoral deformities.
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Distal femoral lateral closing wedge osteotomy as a component of comprehensive treatment of medial patellar luxation and distal femoral varus in dogs. Vet Comp Orthop Traumatol 2016; 30:20-27. [PMID: 27935008 DOI: 10.3415/vcot-16-07-0103] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Accepted: 08/01/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To describe a cohort of dogs with medial patellar luxation managed with a distal femoral lateral closing wedge ostectomy (DFO) as a component of comprehensive treatment, and to report radiographic and long-term clinical outcome of this technique. METHODS Medical records of dogs that had a lateral closing wedge DFO as part of management of medial patellar luxation at three veterinary teaching hospitals were reviewed. Surgical reports as well as the preoperative, postoperative, and follow-up radiographs were reviewed. The anatomical lateral distal femoral angle (aLDFA) was determined. Long-term clinical outcome was assessed by telephone interview with the owner. RESULTS A lateral closing wedge DFO was performed on 66 limbs. The mean pre- and postoperative aLDFA was 107.6° ± 5.8° and 94.1° ± 4.2°, respectively. Cranial cruciate ligament disease was identified in 28/66 affected limbs. Tibial angular deformity, torsional deformity, or both was identified in nine of the 66 limbs. Ostectomy healing was confirmed radiographically in 51/66 limbs. The mean time to union was 73 ± 37 days. All patellae were in the normal position and stable. Complications included infection (2/51), fixation failure (1/51), delayed healing (2/51), and persistent lameness (1/51). CLINICAL SIGNIFICANCE In this cohort of cases, DFO was a highly successful and repeatable component of surgical treatment for dogs with medial patellar luxation associated with femoral varus. This study also provides more evidence of the high rate of concurrent cranial cruciate ligament disease in cases of medial patellar luxation complicated by femoral varus, and supports an association between stifle instability and medial patellar luxation.
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Savio G, Baroni T, Concheri G, Baroni E, Meneghello R, Longo F, Isola M. Computation of Femoral Canine Morphometric Parameters in Three-Dimensional Geometrical Models. Vet Surg 2016; 45:987-995. [PMID: 27716955 DOI: 10.1111/vsu.12550] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2015] [Accepted: 05/12/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To define and validate a method for the measurement of 3-dimensional (3D) morphometric parameters in polygonal mesh models of canine femora. STUDY DESIGN Ex vivo/computerized model. SAMPLE POPULATION Sixteen femora from 8 medium to large-breed canine cadavers (mean body weight 28.3 kg, mean age 5.3 years). METHODS Femora were measured with a 3D scanner, obtaining 3D meshes. A computer-aided design-based (CAD) software tool was purposely developed, which allowed automatic calculation of morphometric parameters on a mesh model. Anatomic and mechanical lateral proximal femoral angles (aLPFA and mLPFA), anatomic and mechanical lateral distal femoral angles (aLDFA and mLDFA), femoral neck angle (FNA), femoral torsion angle (FTA), and femoral varus angle (FVA) were measured in 3D space. Angles were also measured onto projected planes and radiographic images. RESULTS Mean (SD) femoral angles (degrees) measured in 3D space were: aLPFA 115.2 (3.9), mLPFA 105.5 (4.2), aLDFA 88.6 (4.5), mLDFA 93.4 (3.9), FNA 129.6 (4.3), FTA 45 (4.5), and FVA -1.4 (4.5). Onto projection planes, aLPFA was 103.7 (5.9), mLPFA 98.4 (5.3), aLDFA 88.3 (5.5), mLDFA 93.6 (4.2), FNA 132.1 (3.5), FTA 19.1 (5.7), and FVA -1.7 (5.5). With radiographic imaging, aLPFA was 109.6 (5.9), mLPFA 105.3 (5.2), aLDFA 92.6 (3.8), mLDFA 96.9 (2.9), FNA 120.2 (8.0), FTA 30.2 (5.7), and FVA 2.6 (3.8). CONCLUSION The proposed method gives reliable and consistent information about 3D bone conformation. Results are obtained automatically and depend only on femur morphology, avoiding any operator-related bias. Angles in 3D space are different from those measured with standard radiographic methods, mainly due to the different definition of femoral axes.
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Affiliation(s)
- Gianpaolo Savio
- Laboratory of Design Tools and Methods in Industrial Engineering, Department of Civil, Architectural and Environmental Engineering, University of Padova, Padova, Italy.
| | | | - Gianmaria Concheri
- Laboratory of Design Tools and Methods in Industrial Engineering, Department of Civil, Architectural and Environmental Engineering, University of Padova, Padova, Italy
| | | | - Roberto Meneghello
- Department of Management and Engineering, University of Padova, Vicenza, Italy
| | - Federico Longo
- Department of Animal Medicine, Production and Health, University of Padova, Padova, Italy
| | - Maurizio Isola
- Department of Animal Medicine, Production and Health, University of Padova, Padova, Italy
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Dunlap AE, Kim SE, Lewis DD, Christopher SA, Pozzi A. Outcomes and complications following surgical correction of grade IV medial patellar luxation in dogs: 24 cases (2008–2014). J Am Vet Med Assoc 2016; 249:208-13. [DOI: 10.2460/javma.249.2.208] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Peters KM, Hutter E, Siston RA, Bertran J, Allen MJ. Surgical Navigation Improves the Precision and Accuracy of Tibial Component Alignment in Canine Total Knee Replacement. Vet Surg 2016; 45:52-9. [DOI: 10.1111/vsu.12429] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
| | - Erin Hutter
- Department of Mechanical and Aerospace Engineering; The Ohio State University; Columbus Ohio
| | - Robert A. Siston
- Department of Mechanical and Aerospace Engineering; The Ohio State University; Columbus Ohio
| | | | - Matthew J. Allen
- Department of Veterinary Clinical Sciences
- Department of Veterinary Medicine; University of Cambridge; Cambridge UK
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Risk factors for loosening of cementless threaded femoral implants in canine total hip arthroplasty. Vet Comp Orthop Traumatol 2014; 28:48-53. [PMID: 25396226 DOI: 10.3415/vcot-14-02-0027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2014] [Accepted: 10/13/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To determine the incidence and potential risk factors of femoral implant loosening in the canine Helica® total hip replacement (THR) system. METHOD Sixteen dogs with a Helica THR were included. Medical records were reviewed for signalment and size of implants. Stem angle, stem collar to lateral cortex distance, tip to cortex distance, stem collar to lateral cortex distance at a stem angle of 150°, lever arm distance, and the distance on the diaphysis measurements were calculated from the one year postoperative radiographs. Three ratios were determined from these measurements to take into account the size of the femur in relation to the size of the implant. Femoral implant loosening was identified by radiographic and clinical signs, and confirmed at the time of surgical explantation. Differences in the successful and femoral stem failure groups were compared using either a students t-test or a Mann Whitney test. Significance was set at p <0.003. RESULTS Six of the 16 dogs had loosening of the femoral prostheses within one year post-implantation. One dog had evidence of a septic cause for loosening. No significant risk factors could be identified in this group of dogs with Helica stem loosening. CLINICAL SIGNIFICANCE Helica femoral stem loosening was a common complication within one year post-implantation in this group of dogs. No risk factors were identified to potentially decrease the incidence of loosening. Therefore, due to this unacceptably high complication rate, the authors do not recommend this model of the Helica THR.
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Barnes DM, Anderson AA, Frost C, Barnes J. Repeatability and Reproducibility of Measurements of Femoral and Tibial Alignment Using Computed Tomography Multiplanar Reconstructions. Vet Surg 2014; 44:85-93. [DOI: 10.1111/j.1532-950x.2014.12265.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Accepted: 06/01/2014] [Indexed: 11/28/2022]
Affiliation(s)
| | - Angus A. Anderson
- Anderson Abercromby Veterinary Referrals; Ockley Surrey United Kingdom
| | - Chris Frost
- Department of Medical Statistics; London School of Hygiene and Tropical Medicine; London United Kingdom
| | - Josephine Barnes
- Department of Neurodegenerative Diseases; UCL Institute of Neurology; London United Kingdom
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Aiken M, Barnes D. Are the fabellae bisected by the femoral cortices in a true craniocaudal pelvic limb radiograph? J Small Anim Pract 2014; 55:465-70. [DOI: 10.1111/jsap.12253] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2014] [Revised: 06/11/2014] [Accepted: 06/12/2014] [Indexed: 11/29/2022]
Affiliation(s)
- M. Aiken
- Anderson Abercromby Veterinary Referrals; Ockley Surrey RH5 5RR
| | - D. Barnes
- Anderson Abercromby Veterinary Referrals; Ockley Surrey RH5 5RR
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Wood MC, Fox DB, Tomlinson JL. Determination of the Mechanical Axis and Joint Orientation Lines in the Canine Humerus: A Radiographic Cadaveric Study. Vet Surg 2014; 43:414-7. [DOI: 10.1111/j.1532-950x.2014.12134.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Accepted: 09/01/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Mirae C. Wood
- Comparative Orthopedic Laboratory; Veterinary Medical Teaching Hospital; University of Missouri-Columbia; Columbia Missouri
| | - Derek B. Fox
- Comparative Orthopedic Laboratory; Veterinary Medical Teaching Hospital; University of Missouri-Columbia; Columbia Missouri
| | - James L. Tomlinson
- Comparative Orthopedic Laboratory; Veterinary Medical Teaching Hospital; University of Missouri-Columbia; Columbia Missouri
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Kim SE, Lewis DD. Corrective osteotomy for procurvatum deformity caused by distal femoral physeal fracture malunion stabilised with String-of-Pearls locking plates: results in two dogs and a review of the literature. Aust Vet J 2014; 92:75-80. [DOI: 10.1111/avj.12149] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/08/2013] [Indexed: 11/29/2022]
Affiliation(s)
- SE Kim
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville FL 32610 USA
| | - DD Lewis
- Department of Small Animal Clinical Sciences; College of Veterinary Medicine; University of Florida; Gainesville FL 32610 USA
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Goodrich ZJ, Norby B, Eichelberger BM, Friedeck WO, Callis HN, Hulse DA, Kerwin SC, Fox DB, Saunders WB. Thoracic limb alignment in healthy labrador retrievers: evaluation of standing versus recumbent frontal plane radiography. Vet Surg 2014; 43:791-803. [PMID: 24467231 DOI: 10.1111/j.1532-950x.2014.12140.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2013] [Accepted: 06/01/2013] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To report thoracic limb alignment values in healthy dogs; to determine if limb alignment values are significantly different when obtained from standing versus recumbent radiographic projections. STUDY DESIGN Prospective cross-sectional study. ANIMALS Labrador Retrievers (n = 45) >15 months of age. METHODS Standing and recumbent radiographs were obtained and limb montages were randomized before analysis by a single investigator blinded to dog, limb, and limb position. Twelve limb alignment values were determined using the CORA methodology. Measurements were performed in triplicate and intra-observer variability was evaluated by intra-class correlation coefficient (ICC). Limb alignment values were reported as mean ± SD and 95% confidence intervals. Linear mixed models were used to determine if significant associations existed between limb alignment values and limb, limb position, gender, age, weight, and body condition score. RESULTS There were significant differences in standing and recumbent limb alignment values for all values except elbow mechanical axis deviation (eMAD). Limb, gender, age, body weight, and body condition score had no effect. ICC values ranged from 0.522 to 0.758, indicating moderate to substantial agreement for repeated measurements by a single investigator. CONCLUSIONS Limb alignment values are significantly different when determined from standing versus recumbent radiographs in healthy Labrador Retrievers.
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Affiliation(s)
- Zachary J Goodrich
- Department of Veterinary Small Animal Clinical Sciences, Texas A&M University College of Veterinary Medicine and Biomedical Sciences, College Station, Texas
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Oxley B, Gemmill TJ, Pink J, Clarke S, Parry A, Baines S, Malcolm McKee W. Precision of a Novel Computed Tomographic Method for Quantification of Femoral Varus in Dogs and an Assessment of the Effect of Femoral Malpositioning. Vet Surg 2013; 42:751-8. [DOI: 10.1111/j.1532-950x.2013.12032.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 05/01/2013] [Indexed: 11/27/2022]
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Coutin JV, Lewis DD, Kim SE, Reese DJ. Bifocal femoral deformity correction and lengthening using a circular fixator construct in a dog. J Am Anim Hosp Assoc 2013; 49:216-23. [PMID: 23535751 DOI: 10.5326/jaaha-ms-5836] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 7 mo old male rottweiler was evaluated for a right hind limb lameness caused by malunion of a Salter-Harris type II fracture. Radiographs and computed tomography (CT) revealed that the right distal femur had valgus, procurvatum, external rotation, and was 35% (70 mm) shorter than the contralateral femur. Distal femoral wedge ostectomies were performed to acutely correct the angular and rotational deformities. Lengthening of the femur was accomplished by distraction osteogenesis performed over 53 days at a second, proximal diaphyseal osteotomy using a circular fixator construct. This bifocal approach yielded approximately 30 mm of femoral lengthening and a confluent column of regenerate bone that bridged the distraction gap. When evaluated 14 mo after surgery, the dog held the right hip, stifle, and hock in a slightly extended posture when standing and had a subtle asymmetric hind limb gait. The stride of the right hind limb was slightly shortened with compensatory circumduction of the left hind limb during the swing phase of the stride.
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Affiliation(s)
- Julia V Coutin
- Virginia-Maryland Regional College of Veterinary Medicine, Blacksburg, VA, USA
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Jackson GM, Wendelburg KL. Evaluation of the Effect of Distal Femoral Elevation on Radiographic Measurement of the Anatomic Lateral Distal Femoral Angle. Vet Surg 2012. [DOI: 10.1111/j.1532-950x.2012.01059.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Swanson EA, Tomlinson JL, Dismukes DI, Fox DB. Measurement of Femoral and Tibial Joint Reference Angles and Pelvic Limb Alignment in Cats. Vet Surg 2012; 41:696-704. [DOI: 10.1111/j.1532-950x.2012.00996.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Elizabeth A. Swanson
- Department of Veterinary Medicine and Surgery; College of Veterinary Medicine; University of Missouri; Columbia; MO
| | - James L. Tomlinson
- Department of Veterinary Medicine and Surgery; College of Veterinary Medicine; University of Missouri; Columbia; MO
| | | | - Derek B. Fox
- Department of Veterinary Medicine and Surgery; College of Veterinary Medicine; University of Missouri; Columbia; MO
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Morphometric assessment of the hip joint in the Estrela Mountain Dog breed. Vet Comp Orthop Traumatol 2012; 25:202-10. [PMID: 22367104 DOI: 10.3415/vcot-11-07-0101] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Accepted: 11/24/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To study the radiographic projected hip parameters of the proximal femur and acetabulum in young and adult Estrela Mountain Dogs with normal and abnormal hip joints. The parameters evaluated were: femoral angles of inclination and anteversion (FAI and FAA), femoral neck length and width (FNL and FNW), acetabular depth (AD) and acetabular angle of retrotorsion (AAR). METHODS Five hundred and twenty-five standard hip-extended ventrodorsal radiographic views and 622 mediolateral views of the right and left femur were used to measure the FAI, FAA, FNL, FNW, AD, AAR and modified AAR (mAAR). RESULTS The FAI decreased in adult dysplastic dogs, in females and in right femora; FAA decreased with age; FNL was characterized by a greater relative size in normal adult animals; FNW was greater in abnormal hips in young and adult animals; AD was less in adult dysplastic dogs and in right hips; AAR was similar in the studied groups; mAAR was greater in abnormal hips and in left hips. CLINICAL SIGNIFICANCE The data may be used in future studies, which compare this breed to others. Morphological variations in femoral neck and acetabular morphometric parameters were present, and these variables in dogs with different ages and with hips in varying states of health should not be compared.
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Radiographic measurement for femoral varus in Pomeranian dogs with and without medial patellar luxation. Vet Comp Orthop Traumatol 2012; 25:197-201. [PMID: 22286063 DOI: 10.3415/vcot-11-04-0057] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Accepted: 11/23/2011] [Indexed: 11/17/2022]
Abstract
OBJECTIVES To measure radiographically the inclination angle (ICA), femoral varus angle (FVA), anatomical lateral distal femoral angle (aLDFA), and mechanical lateral distal femoral angle (mLDFA) in Pomeranian dogs with and without medial patellar luxation (MPL). MATERIALS AND METHODS Stifles of 34 Pomeranian dogs were graded and allocated into three groups: normal, grades I-II MPL, and grade III MPL. Angle values were measured from craniocaudal radiographs of the hindlimbs by each of the three examiners on three separate occasions. RESULTS Each of the three groups consisted of 15 stifles. Means ± SD for the ICA, FVA, aLDFA and mLDFA in the normal stifles were 136.46 ± 7.12°, 5.85 ± 3.18°, 95.21 ± 3.48° and 99.46 ± 4°, respectively. No significant differences (p>0.05) in the measured values for the ICA between groups were observed. The FVA, aLDFA and mLDFA values in grade III MPL group were significantly (p<0.05) greater than those in the other two groups. Significant differences in the three angles between the normal and grades I-II MPL groups were not observed. CLINICAL SIGNIFICANCE Significant change of distal femoral varus exists in Pomeranian dogs with grade III MPL.
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Petazzoni M, Palmer RH. Femoral angular correction and lengthening in a large-breed puppy using a dynamic unilateral external fixator. Vet Surg 2012; 41:507-14. [PMID: 22239681 DOI: 10.1111/j.1532-950x.2011.00944.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To report treatment of a large-breed puppy with combined distal femoral valgus and length deficit caused by partial distal physeal closure. STUDY DESIGN Clinical report. ANIMALS Bernese Mountain Dog (4.5-month-old male). METHODS The puppy was admitted for evaluation of a progressive severe left pelvic limb lameness (grade 3/4) of 6-week duration. Distal femoral valgus and severe length deficit deformity were treated by acute angular correction using a closing wedge ostectomy and progressive rapid-rate callus distraction using a dynamic, telescoping unilateral External Skeletal Fixator (ESF) designed for people. After acute angular correction and a 3-day latency period, a mean linear distraction rate of 3 mm/day was maintained for 3 weeks. The dynamic ESF (dESF) was removed at 4 weeks, after a 1-week consolidation phase. RESULTS The dESF was stable and functional during distraction and bone healing. Distal femoral valgus conformation improved 50° (from 41° to 91°) and femoral length increased 42 mm at dESF removal (from 158 mm to 200 mm; 27%). After cessation of bone growth, no valgus and minimal (6%) length deficit were detected. At 4, 5, 6, 12, and 24 months after surgery, the dog was walking, trotting, and galloping normally. CONCLUSION Acute angular correction and progressive rapid-rate callus distraction using a unilateral dESF allowed satisfactory treatment of combined distal femoral valgus and length deficit in a large-breed puppy.
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Franklin SP, Franklin AL, Wilson H, Schultz L, Sonny Bal B, Cook JL. The Relationship of the Canine Femoral Head to the Femoral Neck: An Anatomic Study with Relevance for Hip Arthroplasty Implant Design and Implantation. Vet Surg 2011; 41:86-93. [DOI: 10.1111/j.1532-950x.2011.00923.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
| | | | - Howard Wilson
- Department of Veterinary Medicine and Surgery; University of Missouri; Columbia MO
| | - Loren Schultz
- Department of Veterinary Medicine and Surgery; University of Missouri; Columbia MO
| | - B. Sonny Bal
- Comparative Orthopaedic Laboratory; University of Missouri; Columbia MO
- Department of Orthopaedic Surgery; University of Missouri; Columbia MO
| | - James L. Cook
- Comparative Orthopaedic Laboratory; University of Missouri; Columbia MO
- Department of Veterinary Medicine and Surgery; University of Missouri; Columbia MO
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Palmer RH, Ikuta CL, Cadmus JM. Comparison of Femoral Angulation Measurement Between Radiographs and Anatomic Specimens Across a Broad Range of Varus Conformations. Vet Surg 2011. [DOI: 10.1111/j.1532-950x.2011.00895.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Witte PG, Scott HW. Treatment of lateral patellar luxation in a dog by femoral opening wedge osteotomy using an interlocking nail. Vet Rec 2011; 168:243. [DOI: 10.1136/vr.c6376] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- P. G. Witte
- 6 Forest Corner Farm, Hangersley Ringwood Hampshire BH24 3JW
| | - H. W. Scott
- 6 Forest Corner Farm, Hangersley Ringwood Hampshire BH24 3JW
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Ganz SM, Jackson J, VanEnkevort B. Risk Factors for Femoral Fracture after Canine Press-Fit Cementless Total Hip Arthroplasty. Vet Surg 2010; 39:688-95. [DOI: 10.1111/j.1532-950x.2010.00694.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Griffon DJ. A Review of the Pathogenesis of Canine Cranial Cruciate Ligament Disease as a Basis for Future Preventive Strategies. Vet Surg 2010; 39:399-409. [DOI: 10.1111/j.1532-950x.2010.00654.x] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Allen MJ, Leone KA, Lamonte K, Townsend KL, Mann KA. Cemented total knee replacement in 24 dogs: surgical technique, clinical results, and complications. Vet Surg 2009; 38:555-67. [PMID: 19573056 DOI: 10.1111/j.1532-950x.2009.00528.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To characterize the performance of cemented total knee replacement (TKR) in dogs. STUDY DESIGN Preclinical research study. ANIMALS Skeletally mature, male Hounds (25-30 kg; n=24) with no preexisting joint pathology. METHODS Dogs had unilateral cemented TKR and were evaluated at 6, 12, 26, or 52 weeks (6 dogs/time point) by radiography, bone density analysis, visual gait assessment, and direct measurement of thigh circumference and stifle joint range of motion as indicators of functional recovery. At study end, the stability of the cemented tibial component was determined by destructive mechanical testing. RESULTS Joint stability was excellent in 16 dogs (67%) and good in 8 dogs. None of the tibial components had evidence of migration or periprosthetic osteolysis whereas 1 femoral component was loose at 52 weeks. There was an early and significant decrease in tibial bone density, likely because of disuse of the operated limb. Dogs returned to full activity by 12 weeks. The tibial cement-bone interface maintained its strength over 52 weeks. CONCLUSIONS Cement provides stable fixation of the tibial component in canine TKR. CLINICAL RELEVANCE Cemented TKR yields adequate clinical function and stifle joint excursion in the dog. Clinical studies are needed to determine the long-term fate of cemented TKR implants, to assess the influence of implant design on implant fixation and wear, and to obtain objective functional data.
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Affiliation(s)
- Matthew J Allen
- Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA.
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Dismukes DI, Tomlinson JL, Fox DB, Cook JL, Witsberger TH. Radiographic measurement of canine tibial angles in the sagittal plane. Vet Surg 2008; 37:300-5. [PMID: 18394079 DOI: 10.1111/j.1532-950x.2008.00381.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE To describe a method for radiographic measurement of the mechanical joint angles of the tibia in the sagittal plane and report reference ranges for a population of dogs with cranial cruciate ligament disease, and specifically for Labrador Retrievers. STUDY DESIGN Retrospective evaluation of radiographs. ANIMALS Canine tibia (n=150) of dogs evaluated for cranial cruciate ligament disease; 104 tibiae were from Labrador Retrievers, 46 tibiae were from other medium- to large-breed dogs. METHODS Medial-lateral radiographs were used to establish anatomic landmarks and measure the mechanical cranial distal tibial angle (mCrDTA) and mechanical caudal proximal tibial angle (mCaPTA). RESULTS For all tibiae mean mCrDTA was 81.6 degrees and mCaPTA, 63.6 degrees . For Labrador Retriever tibiae mean mCrDTA was 81.7 degrees and mCaPTA, 63.8 degrees . For non-Labradors, means mCrDTA was 81.5 degrees and mCaPTA, 63 degrees . Labrador Retrievers were significantly younger than non-Labradors in our study population. No significant differences were noted between Labrador Retrievers and non-Labradors for mCrDTA or mCaPTA and correlations between mCrDTA and mCaPTA were neither strong nor significant. CONCLUSION A method was established for radiographic measurement of mechanical joint angles of the canine tibia in the sagittal plane. Reference ranges are reported for a population of Labrador Retrievers and a population of non-Labradors with cranial cruciate ligament disease. CLINICAL RELEVANCE Measurement method and reference ranges provided for mechanical tibial angles may be used to aid in diagnosis, surgical planning, and postoperative critique for hindlimb angular deformities.
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Affiliation(s)
- David I Dismukes
- Comparative Orthopaedic Laboratory, Veterinary Medical Teaching Hospital, University of Missouri-Columbia, Columbia, MO 65211, USA.
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