Disease-related and overall survival in dogs with cranial cruciate ligament disease, a historical cohort study

Long-term outcome in dogs with cranial cruciate ligament disease evaluated using the canine orthopaedic index

BACKGROUND

Cranial cruciate ligament disease (CCLD) is common in dogs, but studies on the long-term treatment outcome are scarce.

METHODS

The long-term outcome in a cohort of 71 dogs with CCLD treated with tibial plateau levelling osteotomy (TPLO, n = 18), tibial tuberosity advancement (TTA, n = 23) or lateral fabellotibial suture (LFS, n = 30) was evaluated using the canine orthopaedic index.

RESULTS

The risk of stiffness and lameness was increased in dogs treated with TPLO (stiffness: incidence rate ratio [IRR] 1.33, p = 0.015; lameness: IRR 1.34, p = 0.020) or TTA (stiffness: IRR 1.26, p = 0.035; lameness: IRR 1.31, p = 0.026) when compared to LFS at a median follow-up time of 4.6 years.

LIMITATIONS

No follow-up veterinary examination was performed. Data were collected from only two university animal hospitals, and thus, a referral bias towards more complicated cases is possible, which may limit the generalisability of the results.

CONCLUSION

Clinicians can use the results to inform dog owners about the expected long-term outcome in dogs with CCLD.

Degree of osteophyte formation seen on radiographs provides useful prognostic information for dogs with cruciate ligament disease

BACKGROUND

Concurrent osteoarthritis is generally present in the stifle joints of dogs with cranial cruciate ligament disease (CCLD), but it is not known if the degree of osteoarthritis-related changes affects the prognosis. Development of osteophytes is a key radiographic feature of osteoarthritis. The aim of this study was to evaluate the association between the degree of osteophyte formation seen on radiographs and CCLD-related euthanasia in dogs with CCLD.

METHODS

A retrospective cohort study including 226 dogs treated for CCLD at two university animal hospitals was performed. Clinical and follow-up information was retrieved, and stifle radiographs taken during the 31 days before treatment for the CCLD were graded for osteophyte formation by three veterinary radiologists. A multivariable Cox proportional hazards model was applied to assess the association between the degree of osteophyte formation and CCLD-related euthanasia.

RESULTS

An association between the degree of osteophyte formation and CCLD-related euthanasia was found, with increased osteophyte formation associated with an increased hazard of CCLD-related euthanasia (hazard ratio 1.06, 95% confidence interval 1.01-1.11, p = 0.01).

LIMITATIONS

No clinical assessment of the outcome was performed.

CONCLUSION

The findings suggest that evaluation of stifle radiographs for osteophyte formation could provide useful prognostic information for dogs with CCLD.

Patellar Proximo-Distal Displacement following Modified Maquet Technique Is Not Predictive of Patellar Luxation

OBJECTIVE

The aim of this study was to test the low sensitivity of the Allberg and Miles index to the stifle opening angle, evaluate the displacement of the patella after a Modified Maquet Technique using this index and assess the incidence of patellar luxation post-Modified Maquet Technique in dogs.

STUDY DESIGN

 Medical records were reviewed from 2012 to 2017. Allberg Miles index were determined for each stifle pre- and postoperatively, as well as the stifle joint opening of each case. Occurrence of patellar luxation was recorded.

RESULTS

 137 stifles on 116 dogs were reviewed. The stifle opening angle did not influence the Allberg Miles index. Pre- and postoperative index showed a distal displacement of the patella after a Modified Maquet Procedure, especially at 135° of stifle opening angle. Only 1/137 cases demonstrated patellar luxation after the surgery.

CONCLUSION

 Based on our statistical analysis, we were able to conclude that within the maximum stifle opening angle range recorded in our series of cases; the Allberg Miles index variation was not significant. While patellar baja is clearly induced by the Modified Maquet Technique, the latter did not seem to predispose patients to post-operative patellar luxation in our study population.

Non-invasive methods to assess muscle function in dogs: A scoping review

Skeletal muscle function can be affected by multiple disorders in dogs of which cranial cruciate ligament rupture or disease (CCLD) is one of the most common. Despite the significance of this condition only sparse research exists regarding assessment of muscle function in dogs. This scoping review aimed to identify the non-invasive methods for canine muscle function assessments that have been reported in the literature in the past 10 years. A systematic literature search was conducted 1st March 2022 across six databases. After screening, 139 studies were considered eligible for inclusion. Among the included studies, 18 different muscle function assessment categories were identified, and the most frequently reported disease state was CCLD. We included an attempt to elucidate the clinical applicability of the 18 reported methods, as experts were asked to subjectively assess the methods for their clinical relevance as well as their practical applicability in dogs with CCLD.

Determination of the Stifle Angle at Standing Position in Dogs

Simple Summary

The cranial cruciate ligament rupture is one of the most common orthopaedic diseases encountered in dogs. Surgical techniques have been developed to stabilize the stifle, with an overall accepted benefit of tibial osteotomies, among which is the tibial tuberosity advancement. Prior to surgery, the required tibial tuberosity advancement must be determined on a strict lateral radiographical view of the affected stifle with femur and tibia at an angle of 135° as initially recommended. We sought to determine if this particular stifle angle around mid-stance phase was similar among multiple dog breeds. A mean value of stifle angle of 145° was obtained. Mean stifle angle at mid-stance phase in a healthy dog is regularly higher than 135° and is likely breed and individual dependent. The pre-operative measurement of the required advancement made on stifles in 145° extension, a value close to full physiological extension, could contribute to decreasing the incidence of late post-operative meniscal lesion, consecutive to the underestimation of the tibial tuberosity advancement.

Abstract

Background: The cranial cruciate ligament rupture is one of the most common orthopaedic diseases encountered in dogs. Surgical techniques have been developed to stabilize the stifle, with an overall accepted benefit of tibial osteotomies among which is the tibial tuberosity advancement (TTA). Prior to surgery, the required TTA must be determined on a strict lateral radiographical view of the affected stifle with femur and tibia at an angle of 135° as initially recommended. This value, initially determined in only two dog breeds, has been considered the mean standard value of the canine stifle angle during the mid-stance phase. Methods: We sought to determine if this particular stifle angle around mid-stance phase was similar among multiple dog breeds. We built up a custom-made radiographic system for stifle angle measurement in standing dogs. Results: A mean value of stifle angle of 145° was obtained. Mean stifle angle at mid-stance phase in a healthy dog is regularly higher than 135° and is likely breed and individual dependent. Conclusions: The pre-operative measurement of the required TTA made on stifles in 145° extension, a value close to full physiological extension could contribute to decreasing the incidence of late post-operative meniscal lesion, consecutive to underestimation of TTA.

The epidemiology of cruciate ligament rupture in an insured Swedish dog population

Cruciate ligament rupture (CLR) is a common orthopedic disorder in dogs. The study objectives were to evaluate incidence rate (IR), cause-specific mortality rate (CSMR) and risk factors for CLR in insured dogs. A single cohort study of dogs insured in Agria Pet Insurance in Sweden (2011–2016) was performed. Age at diagnosis, IR, CSMR and relative risk (RR) for CLR was calculated overall and per breed. The cohort included just over 600,000 dogs. The IR of CLR was 23.8 (95% confidence interval, 23.1–24.6) cases per 10,000 DYAR. The breeds with highest RR of CLR were Boerboel and Dogo Canario, while the breeds with lowest RR were Standard Dachshund and Miniature Pinscher. Dogue de Bordeaux had highest RR of euthanasia due to CLR. The median age at veterinary care claim for CLR was 7.1 (range 0.3–16.0) years and 6.6 (0.3–12) years at life insurance settlement. Large and giant breeds were generally diagnosed and euthanized due to CLR at a younger age compared to smaller breeds. The majority of the breeds with increased RR of CLR diagnosis and CLR-related euthanasia were large or giant. A pattern of increasing size and decreasing age at diagnosis/CLR-related euthanasia was observed.