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Lateral Approach and Plate Rod Sliding Humeral Osteotomy in Dogs-A Short Case Series. Vet Sci 2023; 10:vetsci10020070. [PMID: 36851374 PMCID: PMC9966408 DOI: 10.3390/vetsci10020070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/21/2023] Open
Abstract
Five dogs of different breeds and ages were diagnosed with medial compartment disease of the elbow (MCDE). To resolve the condition, a modified technique using a lateral approach and plate/rod sliding humeral osteotomy (SHO) was considered. All dogs recovered uneventfully after surgery. There were no major complications, and all dogs were significantly improved compared to pre-operative condition. This novel technique of adding a pin, based on the alteration of the original technique, optimized resistance to fixation failure. An additional benefit was that the lateral approach was surgically familiar and easily allowed bone grafting. All five dogs treated with the novel approach had improved scores for pain and lameness. This study showed that SHO was more stable and less technically demanding with the addition of an intramedullary pin. This is the first report of a lateral approach and plate rod sliding humeral osteotomy to treat MCDE in dogs.
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Seidler S, Rhode M, Volk H, Harms O. Comparative evaluation of radiographic and computed tomographic findings in dogs with bilateral medial coronoid disease (MCD) presenting with unilateral forelimb lameness. PLoS One 2023; 18:e0282656. [PMID: 37036860 PMCID: PMC10085011 DOI: 10.1371/journal.pone.0282656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 02/21/2023] [Indexed: 04/11/2023] Open
Abstract
OBJECTIVES The purpose of this study was to compare the radiographic and computed tomographic (CT) findings of dogs with diagnosed bilateral medial coronoid disease, which showed clinically only unilateral lameness of the forelimbs. MATERIALS AND METHODS Medical records, including radiographs and CT images of dogs with diagnosed bilateral MCD showing only a unilateral forelimb lameness clinically were reviewed retrospectively. Depending on the gait of each dog we established two groups to investigate their radiographs and CT data comparatively. Group I: affected non-lame limb. Group II: affected lame limb. Several evaluation systems were used to assess which factors are important for clinical decision making and a patient tailored therapeutic plan. RESULTS Data from 84 affected elbow joints (42 dogs) diagnosed with MCD by computed tomography were included. Both the radiological and the CT analysis showed that there are significant differences between Groups I and II. Group I had a lower modified International Elbow Working Group Score (IEWG), the values of the Trochlear notch sclerosis were only slightly deviated, and this group showed less often a dislocation of the fragment compared to group II. Furthermore, the size of the fragment (both the median and the mean value) of the forelimbs from group II was almost twice as big as the one from group I. The following sizes of the fragments were calculated (group I versus (vs.) group II)-median: 0.09 cm2 vs. 0.16 cm2, mean value: 0.112 cm2 vs. 0.202 cm2. It could be shown that a larger fragment is more likely to dislocate than a smaller one. CLINICAL SIGNIFICANCE This study provides some evidence towards a better understanding of which diagnostic parameters and findings might be important in clinical decision making. Nevertheless, a "decision tree" for the correct therapy of MCD could not be determined in this study.
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Affiliation(s)
- Sophia Seidler
- Department of Surgery/Orthopaedics, Clinic for Small Animals, University of Veterinary Medicine Hannover Foundation, Hannover, Niedersachsen, Germany
- Clinic for Small Animals, Ludwigsburg Ossweil, Baden-Württemberg, Germany
| | - Michaela Rhode
- Department of Surgery/Orthopaedics, Clinic for Small Animals, University of Veterinary Medicine Hannover Foundation, Hannover, Niedersachsen, Germany
- Tierarztpraxis für Kleintierchirurgie, Neuenrade, Nord-Rhein Westfalen, Germany
| | - Holger Volk
- Department of Surgery/Orthopaedics, Clinic for Small Animals, University of Veterinary Medicine Hannover Foundation, Hannover, Niedersachsen, Germany
| | - Oliver Harms
- Department of Surgery/Orthopaedics, Clinic for Small Animals, University of Veterinary Medicine Hannover Foundation, Hannover, Niedersachsen, Germany
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Alves-Pimenta S, Soares S, Colaço B, Ginja M. Effect Of Elbow Angle And Weight-Bearing On The Evaluation Of Joint Congruence In Dogs. Anat Rec (Hoboken) 2022; 305:3398-3409. [PMID: 35438239 DOI: 10.1002/ar.24937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Revised: 03/20/2022] [Accepted: 04/05/2022] [Indexed: 11/09/2022]
Abstract
Joint congruence is relevant for the assessment of elbow dysplasia, a development disorder in dogs. However, quantification of its variation with joint angle and weight bearing, important factors in quadrupedal locomotion, is lacking. Our objective was to estimate those effects on the alignment of humeroradioulnar joint surfaces. The usual protocol for screening elbow dysplasia, including mediolateral extended and flexed elbow views, was preceded by a weight-bearing lateromedial standing radiographic view, without sedation. Minimum distances were measured at established points of the humeroradioulnar joints classified with a grade zero of dysplasia. Sixty elbows (30 Portuguese Pointer dogs) were studied. The joint space between the anconeal process and the ulnar trochlear notch increased with flexion, decreasing with weight bearing (P<0.001). The distance between the humeral trochlea and the trochlear notch at the widest point, increased with weight bearing, while it decreased with flexion. Step and distance between the radial head and the base of the medial coronoid process increased with flexion and decreased with weight bearing. At this point, physiological changes occurred at the humeroulnar joint space. The methodology allowed to quantify the variations on joint spaces with the elbow angle and weight bearing, important for the interpretation of congruence in diagnosis and treatment of dysplasia. Reference absolute and indexed values obtained allow future comparisons with other breeds and dysplastic dogs. Physiological variations denoted that radioulnar joint became more incongruent under flexion, and more congruent under weight bearing, while humeroulnar joint became more congruent under flexion, and more incongruent under weight bearing.
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Affiliation(s)
- Sofia Alves-Pimenta
- Department of Animal Science, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal.,CECAV - Veterinary and Animal Research Centre, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal.,CITAB - Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Sofia Soares
- Department of Veterinary Science, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Bruno Colaço
- Department of Animal Science, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal.,CECAV - Veterinary and Animal Research Centre, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal.,CITAB - Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
| | - Mário Ginja
- Department of Veterinary Science, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal.,CECAV - Veterinary and Animal Research Centre, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Associate Laboratory for Animal and Veterinary Sciences (AL4AnimalS), Portugal.,CITAB - Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro, Vila Real, Portugal
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4
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Danielski A, Yeadon R. Humero-anconeal elbow incongruity in spaniel breed dogs with humeral intracondylar fissure: Arthroscopic findings. Vet Surg 2021; 51:117-124. [PMID: 34581450 PMCID: PMC9293410 DOI: 10.1111/vsu.13728] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 07/31/2021] [Accepted: 08/22/2021] [Indexed: 12/02/2022]
Abstract
Objective To report arthroscopic findings in dogs with humeral intracondylar fissure (HIF) and compare these findings in joints of dogs not affected by HIF on preoperative CT images. Study design Controlled clinical study. Animals Dogs with HIF (14 dogs, 21 elbows) and dogs without HIF (20 dogs, 31 elbows). Methods A caudo‐medial arthroscope portal was used to inspect all elbow joints. Arthroscopic features of 21 joints of dogs with HIF were compared with 31 control elbows of HIF‐ negative dogs. Results All elbows with HIF showed a focal cartilage lesion on the caudal aspect of the humeral condyle. The lesions ranged from a simple indentation into the articular surface to a full thickness cartilage erosion. Humero‐anconeal incongruity was identified in all elbows with HIF as absence of joint space at the point of contact between the tip of the anconeal process and the cartilage lesion, with a wider joint space distally within the ulnar trochlear notch. None of the elbows without HIF showed the cartilage lesion or evidence of humero‐anconeal incongruity. Conclusion Use of a novel arthroscope portal allowed description of a previously unreported cartilage lesion on the caudal humeral condyle of dogs with HIF. The lesion was found in all dogs with HIF but in no dogs without HIF. Clinical significance Humero‐anconeal incongruity and an associated cartilage lesion appear to be present in dogs with HIF. We propose that this lesion may be associated with humero‐anconeal incongruity. This may be considered as a possible future therapeutic target for HIF.
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Affiliation(s)
- Alan Danielski
- The Ralph Veterinary Referral Centre, Marlow, UK.,Department of Veterinary Medicine and Animal Sciences, University of Naples "Federico II", Naples, Italy
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5
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Rohwedder T. Biomechanics of the Canine Elbow Joint. Vet Med Sci 2021. [DOI: 10.5772/intechopen.99569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The canine elbow joint is a complex joint, whose musculoskeletal anatomy is well investigated. During the last 30 years kinematic analysis has gained importance in veterinary research and kinematics of the healthy and medial coronoid disease affected canine elbow joint are progressively investigated. Video-kinematographic analysis represents the most commonly used technique and multiple studies have investigated the range of motion, angular velocity, duration of swing and stance phase, stride length and other kinematic parameters, mostly in the sagittal plane only. However, this technique is more error-prone and data gained by video-kinematography represent the kinematics of the whole limb including the soft tissue envelope. A more precise evaluation of the in vivo bone and joint movement can only been achieved using fluoroscopic kinematography. Based on recent studies significant differences in the motion pattern between healthy joints and elbows with medial coronoid disease could be detected. Thereby not only adaptive changes, caused by pain and lameness, could be described, but primary changes in the micromotion of the joint forming bones could be found, which potentially represent new factors in the pathogenesis of medial coronoid disease. This chapter gives a review of current literature on elbow joint kinematics, with particular focus onto pathologic biomechanics in dysplastic canine elbows.
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Hebel M, Panek WK, Ruszkowski JJ, Nabzdyk M, Niedzielski D, Pituch KC, Jackson AM, Kiełbowicz M, Pomorska-Mól M. Computed tomography findings in a cohort of 169 dogs with elbow dysplasia - a retrospective study. BMC Vet Res 2021; 17:296. [PMID: 34488762 PMCID: PMC8419939 DOI: 10.1186/s12917-021-02997-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 08/19/2021] [Indexed: 11/17/2022] Open
Abstract
Background Canine elbow dysplasia (CED) is a complex developmental skeletal disorder associated with a number of pathological conditions within the cubital joint. Because CED is a heritable disease, it is important to identify and remove the affected animals from breeding. The first objective of this study was to describe the prevalence of medial coronoid process disease (MCPD) without (MCD) or with (FMCP) fragmented medial coronoid process, osteochondrosis (OC) and/or osteochondritis dissecans (OCD), ununited anconeal process (UAP), radio-ulnar incongruence (INC R-U) and humero-ulnar incongruence (INC H-U) in dogs with the use of CT imaging. The second aim was to determine the influence of demographics on the prevalence of investigated pathologies in dogs with clinical evidence of elbow dysplasia. Results In this retrospective study, CT data records of 169 dogs of different breeds presented to the small animal veterinary clinic from 2012 to 2018 were included. 69.23% of dogs diagnosed with CED were young (≤ 2 years old). The mean age of dogs presented with INC R-U was 1.68 ± 1.82 years, while in dogs without INC R-U the mean age was 2.64 ± 2.59 years. The mean age of dogs with INC H-U was 1.94 ± 2.06 years, while without INC H-U 3.29 ± 2.09 years. Labrador Retrievers, German Shepherd and Bernese Mountain dogs were most frequently presented with CED-associated lameness. In 122 dogs OA of varying severity was found. Conclusion INC H-U, FMCP and MCD were among the most frequently found components of CED found in the present study. OCD and UAP were the least frequently diagnosed. Dogs presented with INC R-U and INC H-U were significantly younger than dogs without these CED components. Boxers, Dog de Bordeaux, American Staffordshire terriers and mixed-breed dogs were diagnosed later in life than the other breeds. OA of varying severity was found in 72.18% of dogs. Males accounted for more than 75% of the study population.
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Affiliation(s)
- Mateusz Hebel
- Department of Internal Diseases and Diagnostics, Poznan University of Life Sciences, ul. Wołyńska 35, 60-637, Poznań, Poland
| | - Wojciech K Panek
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, North Carolina, 27607, USA
| | - Jakub J Ruszkowski
- Department of Animal Anatomy, Poznan University of Life Sciences, ul. Wojska Polskiego 71C, 60-625, Poznań, Poland. .,University Centre for Veterinary Medicine, Szydłowska 43, 60-656, Poznan, Poland.
| | - Maria Nabzdyk
- Department of Animal Anatomy, Poznan University of Life Sciences, ul. Wojska Polskiego 71C, 60-625, Poznań, Poland
| | - Dariusz Niedzielski
- Small Animal Veterinary Clinic, Klinika Psa i Kota, ul. Bolesława Krzywoustego 105/21, 51-166, Wrocław, Poland
| | - Katarzyna C Pituch
- Department of Neurological Surgery, Feinberg School of Med, 676 N St. Clair, Suite 2210, Chicago, IL, 60611, USA
| | - Aaron M Jackson
- Department of Small Animal Surgery, Medvet Chicago, 3123 N. Clybourn Ave, Chicago, IL, 60618, USA
| | - Maciej Kiełbowicz
- Department of Internal Diseases and Diagnostics, Poznan University of Life Sciences, ul. Wołyńska 35, 60-637, Poznań, Poland
| | - Małgorzata Pomorska-Mól
- Department of Preclinical Sciences and Infectious Diseases, Poznan University of Life Sciences, ul. Wołyńska 35, 60-637, Poznań, Poland
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Rohwedder T, Böttcher P. Relation of Computed Tomography-Based Static Axial Radioulnar Incongruence Measurements under General Anaesthesia and Dynamic, In Vivo RUI during the Walk in Canine Elbow Joints with and without Medial Coronoid Process Disease. Vet Comp Orthop Traumatol 2021; 34:386-393. [PMID: 34344054 DOI: 10.1055/s-0041-1731811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study aimed to evaluate the correlation of static axial radioulnar incongruence (sRUI) measured under general anaesthesia with the real in vivo dynamic RUI (dRUI) during walking. STUDY DESIGN This was a prospective clinical study that included 6 sound elbows (5 dogs) and 7 medial coronoid process disease (MCPD) affected elbows (6 dogs). MATERIALS AND METHODS Static axial radioulnar incongruence was measured using the sphere fitting technique on computed tomography-based three-dimensional (3D) models of radius and ulna. The in vivo pose of radius and ulna was derived from radiostereometric analysis during the walk and transferred onto previously calculated 3D models. Dynamic RUI was measured on those adjusted models using the sphere fitting technique, providing a measurement of RUI over time during walk. RESULTS Mean sRUI was 0.2 mm (standard deviation [SD]: 0.30) in control and 1.4 mm (SD: 0.73) in elbow joints with MCPD; being significantly different (p = 0.0035; confidence interval [CI]: 0.4772-1.8824). Mean dRUI in controls (-0.4 mm; SD: 0.47) was significantly different (p = 0.0004; CI: 0.9918-2.5225) from dRUI in the affected elbows (1.4 mm; SD: 0.73). Comparison of sRUI and dRUI within each group showed difference in the control group (0.2 vs. -0.4 mm; p = 0.0138; CI: 0.1820-1.0014). In affected elbows, no difference between sRUI and dRUI was found (1.4 vs. 1.4 mm; p = 0.8963). CONCLUSION In normal elbow joints, sRUI does not represent the in vivo condition during weight bearing. Dynamic and slightly negative RUI occurs during loading (0.2 mm positive to -0.4 mm negative RUI). In MCPD affected elbows with sRUI, no dynamic change of RUI occurs during the walk.
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Vezzoni A, Benjamino K. Canine Elbow Dysplasia: Ununited Anconeal Process, Osteochondritis Dissecans, and Medial Coronoid Process Disease. Vet Clin North Am Small Anim Pract 2021; 51:439-474. [PMID: 33558015 DOI: 10.1016/j.cvsm.2020.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Elbow dysplasia is a major cause of front limb lameness in medium to large dog breeds. Underlying causes include ununited anconeal process, medial coronoid process disease, and osteochondritis dissecans. When a definitive diagnosis of elbow dysplasia is made, the surgeon can improve elbow function but cannot entirely prevent progression of osteoarthrosis. Conventional surgical treatment with joint debridement and removal of loose osteocartilaginous bodies is not rewarding if joint incongruity persists; the result is overloading and subchondral bone exposure with erosion of the cartilage of the medial humeral condyle and medial coronoid area of the ulna leading to medial compartment disease.
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Affiliation(s)
- Aldo Vezzoni
- Clinica Veterinaria Vezzoni srl, via delle Vigne 190, Cremona 26100, Italy.
| | - Kevin Benjamino
- MedVet Medical and Cancer Centers for Pets, Columbus, 8155 Markhaven Drive, Columbus, OH 43235, USA
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Hersh-Boyle RA, Chou PY, Kapatkin AS, Spriet M, Filliquist B, Garcia TC, Marcellin-Little DJ. Comparison of needle arthroscopy, traditional arthroscopy, and computed tomography for the evaluation of medial coronoid disease in the canine elbow. Vet Surg 2021; 50 Suppl 1:O116-O127. [PMID: 33576043 DOI: 10.1111/vsu.13581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 12/07/2020] [Accepted: 12/16/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the diagnostic value of still images of needle arthroscopy (SNAR), still images of traditional arthroscopy (STAR), and computed tomography (CT) to diagnose medial coronoid process (MCP) pathology. STUDY DESIGN Prospective clinical trial. ANIMALS Dogs (n = 17) presented for evaluation of elbow dysplasia. METHODS For each case, two SNAR and STAR images of the MCP were reviewed independently and in random order by three board-certified surgeons. Computed tomographic images were reviewed by one board-certified radiologist. Reviewers were blinded to surgical and clinical findings. Surgical findings from real-time TAR with palpation were used as the gold standard. Receiver operating characteristic (ROC) curves and concordance statistics tests for the diagnostic accuracy of MCP fissure, MCP fragment, medial compartment condition, and cartilage score were calculated. RESULTS Images of 27 elbows joints were reviewed. For MCP fissure detection, areas under the ROC curves for CT (0.84), STAR (0.73), and SNAR (0.57) did not differ. For the detection of MCP fragment, STAR had a larger area under the ROC curve (0.93) compared with SNAR (0.74, P = .015) and CT (0.54, P < .001). Still images of TAR and SNAR had comparable concordance for cartilage score (0.80 and 0.77, respectively) and medial compartment pathology (0.80 and 0.73, respectively). CONCLUSION Still images of NAR, STAR, and CT had similar diagnostic value to identify MCP fissures. Still images of TAR was superior to SNAR and CT to identify MCP fragments. CLINICAL SIGNIFICANCE The diagnostic accuracy of SNAR varied on the basis of the coronoid lesion being evaluated.
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Affiliation(s)
- Rebecca A Hersh-Boyle
- William R Prichard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California Davis, Davis, California
| | - Po-Yen Chou
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California
| | - Amy S Kapatkin
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California
| | - Mathieu Spriet
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California
| | - Barbro Filliquist
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California
| | - Tanya C Garcia
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California
| | - Denis J Marcellin-Little
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California
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Amadio A, Corriveau KM, Norby B, Stephenson TR, Saunders WB. Effect of proximal abducting ulnar osteotomy (PAUL) on frontal plane thoracic limb alignment: An ex vivo canine study. Vet Surg 2020; 49:1437-1448. [PMID: 32463515 DOI: 10.1111/vsu.13425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 02/10/2020] [Accepted: 03/18/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the effect of proximal abducting ulnar osteotomy (PAUL) on frontal plane thoracic limb alignment in standing and recumbent positions. STUDY DESIGN Ex vivo cadaveric study. SAMPLE POPULATION Canine thoracic limbs (n = 15 limb pairs). METHODS Limbs were acquired from healthy Labrador retrievers that had been euthanized for reasons unrelated to this study. A limb press was used to obtain standing and recumbent caudocranial radiographs before and after PAUL. Foot lateralization and rotation were directly measured in standing position. Mechanical joint angles were determined using full limb radiographic montages and the center of rotation of angulation (CORA) method for pre-PAUL (Pre), 2-mm PAUL (PAUL2), and 3-mm PAUL (PAUL3). Data are reported as mean ± SD and 95% CI. Mixed linear modeling was used to identify differences in limb alignment values and foot position, with significance established at P ≤ .004. RESULTS There were differences in five of 12 limb alignment values pre-PAUL and post-PAUL in standing and recumbent positions. In the standing position, there was an increase in mechanical medial proximal radioulnar angle (Pre, 80.6° ± 2.5°; PAUL2, 82.6° ± 2.4°; PAUL3, 84° ± 2.4°) and a decrease in elbow compression angle (Pre, 1.4° ± 1.3°; PAUL2, 1° ± 0.9°; PAUL3, 0.8° ± 1°). There was a movement of mechanical humeral radioulnar angle (Pre, -8.9° ± 2.8°; PAUL2, -6.1° ± 2.7°; PAUL3, -5.2 ± 2.7°), mechanical thoracic humeral angle (Pre, 3.9° ± 1.7°; PAUL2, 2.4° ± 1.4°; PAUL3, 2.6° ± 1.5°), and elbow mechanical axis deviation (Pre, 1.9% ± 1.1%; PAUL2, 0.9% ± 1.1%; PAUL3, 0.4% ± 1.4%) toward a value of "0" representing coaxial alignment of the limb. The foot underwent lateralization (Pre, 1.4 ± 0.6 cm; PAUL2, 1.8 ± 0.7 cm; PAUL3, 2.3 ± 0.7 cm) and external rotation (Pre, 10.5° ± 4.7°; PAUL2, 13.7° ± 5.1°; PAUL3, 16° ± 6.6°). CONCLUSION In the ex vivo setting, PAUL resulted in translation of the mechanical axis of the thoracic limb from a medial to lateral direction through alterations in limb alignment values associated with the elbow, humerus, and proximal radius/ulna. CLINICAL SIGNIFICANCE Additional studies are required to determine whether PAUL alters thoracic limb alignment in client-owned dogs.
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Affiliation(s)
- Alexandra Amadio
- Department of Animal Medicine, Production and Health, University of Padua, Padua, Italy.,Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Kayla M Corriveau
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Bo Norby
- Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Timothy R Stephenson
- College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - W Brian Saunders
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
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Baud K, Griffin S, Martinez-Taboada F, Burton NJ. CT evaluation of elbow congruity in dogs: radial incisure versus apical medial coronoid process fragmentation. J Small Anim Pract 2020; 61:224-229. [PMID: 32017094 DOI: 10.1111/jsap.13110] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 12/06/2019] [Accepted: 12/18/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To compare elbow congruity in two cohorts of Labrador retrievers affected with either radial incisure or apex fragmentation of the medial coronoid process. MATERIALS AND METHODS Dogs were included if they had elbow lameness and a CT diagnosis of a fissure or fragmentation of the medial coronoid process occurring either along the radial incisure or at the coronoid apex. Radioulnar joint space was measured incrementally from the lateral to the medial coronoid process on transverse slice images. Axial radioulnar congruency was also measured at the apex and mid-coronoid in the dorsal plane and at the base of the coronoid in the sagittal plane. RESULTS We studied 99 elbows (in 66 dogs) of which 56 had a fissure or fragmentation along the radial incisure and 43 had an apical fragment. No difference was found between the two groups at the different measuring points - with the exception of a transverse plane radioulnar joint space measurement in the radial incisure group that was smaller adjacent to the lateral coronoid process. CLINICAL SIGNIFICANCE Abnormal ulnar morphology in the radial incisure group could result in a fulcrum effect within the radioulnar joint, overloading the radial incisure and predisposing to osteochondral damage at this site.
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Affiliation(s)
- K Baud
- Wear Referrals, Bradbury, Stockton-on-Tees, TS21 2ES, UK
| | - S Griffin
- Willows Referral Service, Solihull, West Midlands, B90 4NH, UK
| | - F Martinez-Taboada
- University Veterinary Teaching Hospital, School of Veterinary Science, University of Sydney, Sydney, NSW, 2050, Australia
| | - N J Burton
- Wear Referrals, Bradbury, Stockton-on-Tees, TS21 2ES, UK
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12
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Petkov EP, Lesser AS, Lozier SM, Maguire PJ, Fischetti AJ, Ahn J. Radial torsion in dogs with medial compartment disease. Vet Surg 2019; 48:869-877. [PMID: 30820996 DOI: 10.1111/vsu.13180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 01/06/2019] [Accepted: 01/23/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate the magnitude and direction of radial torsion (RT) in dogs with medial compartment disease (MCD). STUDY DESIGN Case-control study. SAMPLE POPULATION Twenty-eight healthy dogs and 28 dogs with confirmed MCD. METHODS Computed tomography images of each dog's antebrachium were evaluated. Radial torsion was measured by using previously described landmarks on the proximal and distal radius. Differences between groups were tested with Student's t tests and Wilcoxon rank-sum tests. RESULTS Healthy dogs had a mean RT angle of 3.44° (range, 1.28°-5.44°). Dogs with MCD had a mean RT angle of 11.84° (range, 2.31°-26.55°). Both groups included similar proportions of dogs with external (76% vs 77%) and internal (24% vs 23%) torsion. The direction of torsion (P = .21 and P = .69) did not appear to affect the magnitude of the RT angle. CONCLUSION Dogs with MCD had an increased RT angle compared with healthy controls. The direction of torsion varied similarly between groups regardless of the disease status of dogs in this study. CLINICAL SIGNIFICANCE The fourfold increase in the RT seen in dogs with MCD may contribute to the rotational overload proposed recently, potentially modifying the orientation of the elliptical radial head and the ligaments crossing the elbow joint.
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Affiliation(s)
- Emanouil P Petkov
- Small Animal Surgery, New York Veterinary Specialty Center, Farmingdale, New York
| | - Arnold S Lesser
- Small Animal Surgery, New York Veterinary Specialty Center, Farmingdale, New York
| | - Scott M Lozier
- Small Animal Surgery, VCA Northwest Veterinary Specialists, Clackamas, Oregon
| | - Patrick J Maguire
- Small Animal Surgery, New York Veterinary Specialty Center, Farmingdale, New York
| | | | - Jaeil Ahn
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University Medical Center, Washington, DC
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Preston T, Wills A. A single hydrotherapy session increases range of motion and stride length in Labrador retrievers diagnosed with elbow dysplasia. Vet J 2018; 234:105-110. [DOI: 10.1016/j.tvjl.2018.02.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 02/15/2018] [Accepted: 02/21/2018] [Indexed: 11/15/2022]
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Griffon DJ, Mostafa AA, Blond L, Schaeffer DJ. Radiographic, computed tomographic, and arthroscopic diagnosis of radioulnar incongruence in dogs with medial coronoid disease. Vet Surg 2018. [DOI: 10.1111/vsu.12783] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Dominique J. Griffon
- College of Veterinary Medicine; Western University of Health Sciences; Pomona California
| | - Ayman A. Mostafa
- Department of Small Animal Surgery, Faculty of Veterinary Medicine; Cairo University; Cairo Egypt
| | - Laurent Blond
- Département des Sciences Cliniques, Faculty of Veterinary Medicine; University of Montreal; Saint-Hyacinthe Quebec Canada
| | - David J. Schaeffer
- Department of Veterinary Clinical Medicine, College of Veterinary Medicine; University of Illinois; Urbana-Champaign Illinois
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Radiographic and computed tomographic assessment of the development of the antebrachia and elbow joints in Labrador Retrievers with and without medial coronoid disease. Vet Comp Orthop Traumatol 2017; 28:186-92. [DOI: 10.3415/vcot-14-09-0144] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 03/02/2015] [Indexed: 11/17/2022]
Abstract
SummaryObjectives: To compare the development, monitored by radiography and computed tomography, of the antebrachia and elbow joints in seven Labrador Retrievers with healthy elbow joints and in seven Labrador Retrievers that developed medial coronoid disease (MCD), in order to determine whether disturbances in the development of the antebrachia and elbow joints, between the age of six and 17 weeks may lead to medial coronoid disease.Methods: A prospective study of 14 Labrador Retrievers in their active growth stage was performed. The development of the antebrachia and elbow joints was assessed between six and 17 weeks of age using radio graphy and computed tomography determining the development of secondary ossification centres, radioulnar length ratio, radial angulation, and inter-relationship between the humerus, ulna and radius.Results: For the parameters of ossification of secondary ossification centres, radioulnar length ratio, radial angulation, and joint congruence evaluation, there was no significant difference in the development of the ante-brachia and elbow joints of seven Labrador Retrievers positive and seven Labrador Retrievers negative for MCD at the age of six to 17 weeks.Clinical significance: These findings demonstrate that the development of MCD in the Labrador Retrievers in our study was not related to any disturbance in the development of the antebrachia and elbow joints during the rapid growth phase.
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Computed tomographic evaluation of elbow congruity during arthroscopy in a canine cadaveric model. Vet Comp Orthop Traumatol 2017; 28:19-24. [DOI: 10.3415/vcot-14-02-0017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2014] [Accepted: 11/04/2014] [Indexed: 11/17/2022]
Abstract
SummaryObjective: To assess the effect of arthro-scope insertion, using a carbon-fibre rod model, on humero-radial, humero-ulnar and radio-ulnar congruity, as assessed by computed tomography (CT).Methods: Cadaveric Greyhound elbow joints were assessed at a flexion angle of 135 ± 5° using CT. For condition 1, a 36 mm fulcrum induced cubital valgus, as used to aid arthro-scope insertion. For conditions 2 and 3, a single 1.8 or 2.5 mm diameter rod was inserted under arthroscopic guidance to simulate arthroscope position for assessment of the medial coronoid process. Repeat CT scans were obtained for all conditions and parasagittal sections were reconstructed to evaluate medial, axial and lateral positions within the elbow. Humero-radial, humeroulnar, and radio-ulnar congruity measurements were obtained. Differences between groups were assessed using repeated measures analysis of variance.Results: Mean (±SD) change in radio-ulnar step between conditions 1 and 3 was 0.6 ± 0.3 mm (axial), 0.8 ± 0.6 mm (medial), and 0.5 ± 0.1 mm (lateral). Insertion of rods induced a significant decrease in radio-ulnar step in all planes. Significant differences were also identified between groups for humero-radial, humero-ulnar, and radio-ulnar congruity.Clinical significance: Insertion of carbon-fibre rods as a model for elbow arthroscope insertion induces elbow incongruity. Changes in radio-ulnar congruity are small but the effect of arthroscope diameter should be considered when assessing elbow congruity.
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Kinematic gait analysis of the canine thoracic limb using a six degrees of freedom marker set. Vet Comp Orthop Traumatol 2017; 27:461-9. [DOI: 10.3415/vcot-14-03-0051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 07/29/2014] [Indexed: 11/17/2022]
Abstract
SummaryObjectives: To determine if the use of a six degrees of freedom marker set would allow new kinematic data of the canine thoracic limbs to be calculated. To identify any significant differences in thoracic limb gait patterns in all planes of motion, between the normal canine population and patients with confirmed medial coronoid disease (MCD).Method: Two groups of dogs were selected representing the normal Labrador Retriever population (n = 13) and Labrador Retrievers with confirmed MCD (n = 13). Normal dogs had “normal” hip and elbow radiographic scores in line with the International Elbow Working Group and British Veterinary Association guidelines. Medial coronoid disease was confirmed using arthroscopy after kinematic analysis was performed with a six degrees of freedom marker set.Results: The diseased elbow was nine degrees more extended between 43%-55% of the gait cycle and 16° more supinated prior, early during and after foot strike. The antebrachium was nine degrees more supinated during foot strike and three degrees more abducted during early stance. None of the other parameters were significantly different.Clinical significance: The use of a six degrees of freedom marker set made it possible for the elbow and antebrachium to be reliably tracked in more than one plane of motion. Significant differences were identified between the normal canine population and those affected by MCD. These data may help elucidate biomechanical factors contributing to aetiopathogenesis of MCD.
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Computerized measurements of radiographic anatomical parameters of the elbow joint in Bernese Mountain Dogs. Vet Comp Orthop Traumatol 2017; 25:250-61. [DOI: 10.3415/vcot-11-06-0082] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2011] [Accepted: 11/11/2011] [Indexed: 11/17/2022]
Abstract
SummaryObjective: Comparison of two methods for evaluation of anatomical parameters of elbow joints in Bernese Mountain Dogs.Study design: Radiographic analysis.Animals: Nine hundred and thirty-one radiographs of elbow joints from 305 Bernese Mountain Dogs.Material and methods: The angles OL, PA, RA and UL were measured according to the Mues method and the Radius of the humeral condyle, Opening angle beta, Quotient Q and Ae, Area X, Step 1 and Step 2 according to the Viehmann method. The radiographs were divided according to their angle of flexion into five groups: 0–30°, 31–60°, 61–90°, 91–120° and >120°. The difference and the correlation between measured values and the elbow dysplasia (ED) score was calculated and compared.Results: The average values of angle OL, PA and RA, Area X, Step 1 and Step 2 were significantly different within the different elbow flexion angle groups. The values of Opening angle beta, Quotients Q and Ae as well as Radius of the humeral condyle varied independently from the degree of the elbow flexion on the radiograph. The angles OL, PA and RA and the Radius of the humeral condyle, the Opening angle beta, the Quotients Q and Ae, Step 1 and Step 2 correlated with the ED score.Conclusion: In contrast to the method of Mues, the majority of the measured parameters of the method of Viehmann were not influenced by the degree of flexion of the elbow joint and correlated with the ED score. Clinical relevance: The method of Viehmann warrants consideration for the evaluation of radiographs of elbow joints in the Bernese Mountain Dog for ED.This article is based on a study first reported in S. Stein's doctoral thesis, which was presented on 08.05.2007 and published thereafter in full by Mensch & Buch Verlag. This abridged and translated version is now being published with the kind permission of Mensch & Buch Verlag.
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Prevalence of incomplete ossification of the humeral condyle and other abnormalities of the elbow in English Springer Spaniels. Vet Comp Orthop Traumatol 2017; 25:211-6. [DOI: 10.3415/vcot-11-05-0066] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2011] [Accepted: 11/27/2011] [Indexed: 11/17/2022]
Abstract
SummaryObjectives: To determine the prevalence of incomplete ossification of the humeral condyle (IOHC) and other osseous abnormalities of the elbow in English Springer Spaniels with no history of lameness.Methods: Prospective observational study of English Springer Spaniels with no recent history of lameness. Computed tomography scans of both elbows were obtained from dogs older than six months of age which were anaesthetized or sedated for reasons unrelated to this study. Computed tomography scans were reviewed for the presence of IOHC and other abnormalities of the elbow. Radioulnar incongruity (RUI) measurements from normal elbows were compared to elbows with IOHC and elbows with medial coronoid process (MCP) abnormalities.Results: Computed tomography scans from 50 dogs (100 elbows) were reviewed. The prevalence of IOHC was 14% (8 elbows in 7 dogs). All condylar fissures were incomplete with a mean length of 2.6 mm. Fifty percent of the dogs (44% of elbows) had abnormalities of the medial coronoid process and 60% of the elbows had periarticular osteophytes. Group RUI meansurements for IOHC and MCP were not significantly different from normal elbows.Clinical significance: Small IOHC fissures, periarticular osteophytes and MCP abnormalities may be identified in English Springer Spaniels without forelimb lameness. Abnormalities of the MCP are more common than IOHC.Presented in part at the BVOA Spring Meeting, Birmingham, UK, March 2011.
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20
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Analysis of risk factors for elbow dysplasia in giant breed dogs. Vet Comp Orthop Traumatol 2017; 29:369-77. [DOI: 10.3415/vcot-15-05-0175] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2015] [Accepted: 05/26/2016] [Indexed: 11/17/2022]
Abstract
SummaryObjective: Identify radiographic risk factors for development of elbow dysplasia in giant breed dogs less than one year of age.Methods: Twenty-five giant breed puppies (Bernese Mountain dogs, English Mastiff, and Newfoundland) were studied. Both elbows of each dog were radiographed monthly from two to six months of age, then every other month until radial and ulnar physeal closure, followed two months later by bilateral elbow computed tomography. Radiographic parameters measured included the presence or absence of a separate centre of ossification of the anconeal process (SCOAP), medial coronoid disease (MCD), ununited anconeal process, humeral osteochondrosis, elbow incongruity, as well as the length of the radius and ulna, radius-to-ulna ratio, and date of closure of the radial and ulnar physes.Results: Fifteen dogs completed the study. Two Bernese Mountain dogs were diagnosed with MCD. Risk factors significantly associated with medial coronoid disease included dyssynchronous physeal closure and a decreased radius-to-ulna ratio, both detected between eight to 11 months of age. A separate centre of ossification of the anconeal process was present in 60% of the dogs, and was not a risk factor for development of elbow dysplasia.Clinical significance: Transient, dyssynchronous growth of the radius and ulna may be a risk factor for development of MCD in Bernese Mountain dogs. Dyssynchronous physeal closure or decreased radius-to-ulna ratio prior to radiographic closure of the distal ulnar and radial physes warrants further study in Bernese Mountain dogs and other breeds subject to MCD development.
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Rohwedder T, Fischer M, Böttcher P. In vivo fluoroscopic kinematography of dynamic radio-ulnar incongruence in dogs. Open Vet J 2017; 7:221-228. [PMID: 28795018 PMCID: PMC5538087 DOI: 10.4314/ovj.v7i3.4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 07/06/2017] [Indexed: 11/17/2022] Open
Abstract
Aim of the study was to investigate dynamic radio-ulnar incongruence (dRUI) in the
canine elbow joint comparing orthopedic healthy and dysplastic dogs in a prospective
in vivo study design. In 6 orthopedic sound elbow joints (5 dogs, median age 17
months & mean body weight 27.9 kg) and 7 elbow joints with medial coronoid
disease (6 dogs, median age 17.5 months & mean body weight 27.6 kg) 0.8 mm
Ø tantalum beads were surgically implanted into radius, ulna and humerus for
dynamic radiosteriometric analysis (RSA) using high-speed biplanar fluoroscopy with
the dogs walking on a treadmill. dRUI, in the form of proximo-distal translation of
the radius relative to the ulna, was measured for the first third of stance phase and
compared between groups using unpaired t-testing. Healthy elbow joints exhibited a
relative radio-ulnar translation of 0.7 mm (SD 0.31 mm), while dysplastic joints
showed a translation of 0.5 mm (SD 0.30 mm). No significant difference between groups
was detected (p = 0.2092, confidence interval -0.6 – 0.2). Based on these
findings dRUI is present in every canine elbow joint, as part of the physiological
kinematic pattern. However, dysplastic elbow joints do not show an increased
radio-ulnar translation, and therfore dRUI cannot be considered causative for medial
coronoid disease.
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Affiliation(s)
- Thomas Rohwedder
- Department of Small Animal Medicine, University of Leipzig, An den Tierkliniken 23, 04103 Leipzig, Germany
| | - Martin Fischer
- Institute of Systematic Zoology and Evolutionary Biology with Phyletic Museum, Friedrich-Schiller-University, Jena, Germany
| | - Peter Böttcher
- Department of Small Animal Medicine, University of Leipzig, An den Tierkliniken 23, 04103 Leipzig, Germany
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Sendyk-Grunkraut A, Martín CM, Souza AN, Patrício GCF, Lorigados CA, Matera JM, Fonseca-Pinto AC. Avaliação morfológica e morfométrica da articulação umerorradioulnar em cães através de exames radiográficos e por tomografia computadorizada. PESQUISA VETERINÁRIA BRASILEIRA 2017. [DOI: 10.1590/s0100-736x2017000200011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
RESUMO: Este estudo teve como objetivo apresentar de forma detalhada dados morfológicos e morfométricos da articulação umerorradioulnar de cães de raça definida avaliados por meio de exames físicos, radiográficos e tomográficos. A amostra dessa pesquisa constituiu-se de 44 cotovelos de cães com idades variadas. Para análise de informações obtidas, o coeficiente kappa e de correlação interclasse e associação foram realizados. Constatou-se que o desempenho individual de cada projeção radiográfica teve pobre concordância com o exame tomográfico; não houve concordância entre os observadores para as mensurações do ângulo da incisura ulnar ao exame radiográfico e tomográfico. Porém houve boa/moderada concordância para mensuração da incongruência radioulnar no plano sagital entre os observadores. Concluiu-se que nenhuma das cinco incidências radiográficas foi superior para análise radiográfica, uma vez que cada projeção apresentou melhor identificação de um compartimento do cotovelo. Medidas ao exame tomográfico para incongruência radioulnar não apresentaram reprodutibilidade no plano de reconstrução frontal, entretanto no corte sagital apresentaram boa e moderada concordância entre os observadores e que a mensuração do ângulo da incisura ulnar não apresentou repetibilidade ao exame radiográfico e nem reprodutibilidade ao exame tomográfico. Esses resultados contribuem para melhor utilização de cada exame de acordo com a região a ser avaliada bem como ressaltam a necessidade da somatória de múltiplos exames de imagem para a correta avaliação desta afecção.
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Breiteneicher AH, Norby B, Schulz KS, Kerwin SC, Hulse DA, Fox DB, Saunders WB. The Effect of Sliding Humeral Osteotomy (SHO) on Frontal Plane Thoracic Limb Alignment: An Ex Vivo Canine Cadaveric Study. Vet Surg 2016; 45:1095-1107. [DOI: 10.1111/vsu.12574] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 07/24/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Adam H. Breiteneicher
- Department of Small Animal Clinical Sciences; Texas A&M University, College Station; Texas
| | - Bo Norby
- Department of Large Animal Clinical Sciences; Michigan State University; East Lansing Michigan
| | | | - Sharon C. Kerwin
- Department of Small Animal Clinical Sciences; Texas A&M University, College Station; Texas
| | - Don A. Hulse
- Department of Small Animal Clinical Sciences; Texas A&M University, College Station; Texas
| | - Derek B. Fox
- Department of Veterinary Medicine and Surgery; University of Missouri; Columbia Missouri
| | - W. Brian Saunders
- Department of Small Animal Clinical Sciences; Texas A&M University, College Station; Texas
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Coppieters E, Van Ryssen B, van Bree H, Verhoeven G, Broeckx B, de Bakker E, Deforce D, Gielen I. COMPUTED TOMOGRAPHIC FINDINGS IN CANINE ELBOWS ARTHROSCOPICALLY DIAGNOSED WITH EROSION OF THE MEDIAL COMPARTMENT: AN ANALYTICAL METHOD COMPARISON STUDY. Vet Radiol Ultrasound 2016; 57:572-581. [PMID: 27699921 DOI: 10.1111/vru.12425] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 08/09/2016] [Indexed: 01/11/2023] Open
Abstract
Medial compartment erosion is an advanced stage of medial coronoid disease, an important cause of elbow lameness in dogs, with treatment and the expected prognosis depending on the extent of the cartilage lesions. The identification of specific computed tomographic (CT) findings might facilitate the nonsurgical diagnosis and add to treatment decision making. Aims of this retrospective, analytical, method comparison study were to describe CT findings in elbows of dogs arthroscopically diagnosed with medial compartment erosion and to compare CT vs. arthroscopic findings. A total of 56 elbows met inclusion criteria. Elbows with focal (n = 13), diffuse (n = 11), and complete (n = 32) erosion were compared. Prevalence findings for CT lesions were as follows: periarticular osteophytosis (100%), abnormal shape of the medial coronoid process of the ulna (96.4%), and subchondral bone defect of the medial part of the humeral condyle (MHC; 96.4%). The three groups significantly differed for presence of medial coronoid process fragmentation, radial head subchondral bone sclerosis, and widening of the humeroulnar joint space. No significant agreement was found between CT and arthroscopy for presence of a subchondral bone defect of the MHC. A significant agreement was found between CT and arthroscopy for presence of fragmentation of the medial coronoid process. However, some of the calcified body/fragment(s) visualized on CT in the region of the medial coronoid process could not be identified via arthroscopy. Findings indicated that an accurate estimation of the extent of the elbow cartilage lesions still requires arthroscopic joint inspection.
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Affiliation(s)
- Eva Coppieters
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820, Belgium.
| | - Bernadette Van Ryssen
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820, Belgium
| | - Henri van Bree
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820, Belgium
| | - Geert Verhoeven
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820, Belgium
| | - Bart Broeckx
- Laboratory for Pharmaceutical Biotechnology, Faculty of Pharmaceutical Sciences, Ghent University, Ghent 9000, Belgium
| | - Evelien de Bakker
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820, Belgium
| | - Dieter Deforce
- Laboratory for Pharmaceutical Biotechnology, Faculty of Pharmaceutical Sciences, Ghent University, Ghent 9000, Belgium
| | - Ingrid Gielen
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820, Belgium
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Ballegeer EA. Computed Tomography of the Musculoskeletal System. Vet Clin North Am Small Anim Pract 2016; 46:373-420, v. [DOI: 10.1016/j.cvsm.2015.12.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Caron A, Fitzpatrick N. Bi-Oblique Dynamic Proximal Ulnar Osteotomy: Surgical Technique and Clinical Outcome in 86 Dogs. Vet Surg 2016; 45:356-63. [PMID: 27008917 DOI: 10.1111/vsu.12464] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 10/05/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the technique of bi-oblique dynamic proximal ulnar osteotomy (BODPUO) and report the clinical outcome in a series of dog with medial compartment disease and other developmental elbow diseases. STUDY DESIGN Retrospective case series. ANIMALS Dogs (n=86; 120 elbows) treated for elbow disease with BODPUO. METHODS Medical records and diagnostic images were reviewed. Type and frequency of complications and treatment required were recorded. Force plate data were reported in dogs for which data had been recorded preoperatively and at follow-up. RESULTS Mean (standard deviation) final follow-up was 23.4 (35.6) weeks. There were minor complications in 15 elbows (12%, 14 dogs). There were no major complications. The caudo-cranial and latero-medial mean osteotomy angles were 55° (7°) and 48° (10°), respectively. The most caudo-proximal point of the osteotomy was located at a mean of 39% (5%) of the total ulnar length from the olecranon. Sixty of 68 elbows (88%) were considered healed by 4 months postoperative based on radiographs. Subjective lameness scores were significantly decreased by final follow-up for all dogs. For dogs treated with BODPUO alone for medial compartment disease, peak vertical force was significantly higher at 6 months postoperative. CONCLUSION Dogs with medial compartment disease undergoing BODPUO showed clinical improvement in the 6 month follow-up. No complications required surgical intervention.
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Bräuer S, Böttcher P. Focal humero-ulnar impingement following subtotal coronoid ostectomy in six dogs with fragmented medial coronoid process. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2015; 43:156-60. [PMID: 26013600 DOI: 10.15654/tpk-140606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 01/08/2015] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To report acute eburnation of joint cartilage at the humeral trochlea following subtotal coronoid ostectomy (SCO) in a clinical case series of six elbows. MATERIAL AND METHODS Six dogs (median BW 27.1 kg; median age 7.5 months) with fragmented medial coronoid process (FCP) and varying degree of radio-ulnar incongruence (RUI) (mean 2 mm) were treated with SCO using an arthroscopic burr. Second look arthroscopy 4-12 weeks later was performed either because of recurrent or persistent lameness in three dogs. In the others, second-look arthroscopy was scheduled prospectively because of RUI, which was thought to be a risk factor for the observed humero-ulnar impingement. RESULTS All six elbows had a 1-2 mm wide line of focal full-thickness cartilage loss along the edge of the SCO, while the opposing trochlea had diffuse cartilage damage of Outerbridge grade III-IV, indicating focal humero-ulnar impingement. None of the elbows showed repeated FCP. CONCLUSION In some cases SCO might lead to focal humero-ulnar impingement along the osteotomy line. CLINICAL SIGNIFICANCE Whether this relays to variations in respect the amount of resected bone (too much vs. too less) or concomitant joint pathologies like RUI or joint instability remains unknown and warrants further studies.
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Affiliation(s)
| | - P Böttcher
- Prof. Dr. Peter Böttcher, Klinik für Kleintiere, der Universität Leipzig, An den Tierkliniken 23, 04103 Leipzig, Germany,
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Lau SF, Theyse LF, Voorhout G, Hazewinkel HA. Radiographic, Computed Tomographic, and Arthroscopic Findings in Labrador Retrievers With Medial Coronoid Disease. Vet Surg 2014; 44:511-20. [DOI: 10.1111/j.1532-950x.2014.12291.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2012] [Accepted: 05/01/2014] [Indexed: 11/30/2022]
Affiliation(s)
- Seng Fong Lau
- Division of Diagnostic Imaging; Faculty of Veterinary Medicine; Utrecht University; Utrecht The Netherlands
| | - Lars F.H. Theyse
- Department of Clinical Sciences of Companion Animals; Faculty of Veterinary Medicine; Utrecht University; Utrecht The Netherlands
| | - George Voorhout
- Division of Diagnostic Imaging; Faculty of Veterinary Medicine; Utrecht University; Utrecht The Netherlands
| | - Herman A.W. Hazewinkel
- Department of Clinical Sciences of Companion Animals; Faculty of Veterinary Medicine; Utrecht University; Utrecht The Netherlands
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29
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Gendler A, Keuler NS, Schaefer SL. COMPUTED TOMOGRAPHIC ARTHROGRAPHY OF THE NORMAL CANINE ELBOW. Vet Radiol Ultrasound 2014; 56:144-52. [DOI: 10.1111/vru.12195] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2014] [Accepted: 05/07/2014] [Indexed: 11/28/2022] Open
Affiliation(s)
- Andrew Gendler
- WestVet Emergency and Specialty Center; Garden City ID 83714
| | - Nicholas S. Keuler
- Department of Statistics; University of Wisconsin-Madison; Madison WI 53706
| | - Susan L. Schaefer
- Department of Surgical Sciences, School of Veterinary Medicine; University of Wisconsin-Madison; Madison WI 53706
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Barthélémy NP, Griffon DJ, Ragetly GR, Carrera I, Schaeffer DJ. Short- and long-term outcomes after arthroscopic treatment of young large breed dogs with medial compartment disease of the elbow. Vet Surg 2014; 43:935-43. [PMID: 25088613 DOI: 10.1111/j.1532-950x.2014.12255.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2012] [Accepted: 11/01/2013] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To report short- and long-term outcomes after arthroscopic treatment in young large breed dogs affected by medial coronoid process disease (MCPD) and identify variables affecting outcome. STUDY DESIGN Prospective observational case series. ANIMALS Large breed dogs <3 years old (n = 15; 23 elbows). METHODS MCPD was confirmed by radiography, computed tomography, and arthroscopy. Dogs were treated by arthroscopy. Variables recorded at time of treatment included radioulnar incongruity (RUI) and degree of cartilage erosion. Variables recorded before, 6 weeks, and ≥23 months after surgery included radiographic score for osteoarthritis, trochlear notch sclerosis, muscle circumference, range of motion (ROM), and the load distribution of vertical ground reaction forces between thoracic and pelvic limbs. RESULTS A greater load distribution to the pelvic limbs was identified preoperatively in dogs with RUI than in dogs with congruent elbows. Load distribution was not significantly improved at 6 weeks compared with preoperatively. Muscle circumference and vertical impulse distributions were improved at long-term evaluation despite an increased osteoarthritis score. This improvement was more obvious in dogs with RUI or a high degree of cartilage erosion at initial presentation. CONCLUSION Some evidence of improvement in long-term function was found in dogs with MCPD after arthroscopic treatment. RUI and cartilage erosion at the time of diagnosis were associated with more lameness preoperatively but did not affect the final gait assessment or osteoarthritis score in this small cohort.
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31
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Villamonte-Chevalier AA, Soler M, Sarria R, Agut A, Gielen I, Latorre R. Ultrasonographic and Anatomic Study of the Canine Elbow Joint. Vet Surg 2014; 44:485-93. [DOI: 10.1111/j.1532-950x.2014.12249.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 05/01/2014] [Indexed: 12/01/2022]
Affiliation(s)
| | - Marta Soler
- Department of Animal Medicine and Surgery; University of Murcia; Murcia Spain
| | - Ricardo Sarria
- Department of Anatomy and Comparative Pathological Anatomy; University of Murcia; Murcia Spain
| | - Amalia Agut
- Department of Animal Medicine and Surgery; University of Murcia; Murcia Spain
| | - Ingrid Gielen
- Department of Veterinary Medical; Imaging and Small Animal Orthopaedics; University of Ghent; Merelbeke Belgium
| | - Rafael Latorre
- Department of Anatomy and Comparative Pathological Anatomy; University of Murcia; Murcia Spain
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32
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Eljack H, Böttcher P. Relationship Between Axial Radioulnar Incongruence With Cartilage Damage in Dogs With Medial Coronoid Disease. Vet Surg 2014; 44:174-9. [DOI: 10.1111/j.1532-950x.2014.12234.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 04/01/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Hamdi Eljack
- Department of Small Animal Medicine; University of Leipzig; Leipzig Germany
| | - Peter Böttcher
- Department of Small Animal Medicine; University of Leipzig; Leipzig Germany
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33
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Kunst CM, Pease AP, Nelson NC, Habing G, Ballegeer EA. COMPUTED TOMOGRAPHIC IDENTIFICATION OF DYSPLASIA AND PROGRESSION OF OSTEOARTHRITIS IN DOG ELBOWS PREVIOUSLY ASSIGNED OFA GRADES 0 AND 1. Vet Radiol Ultrasound 2014; 55:511-20. [DOI: 10.1111/vru.12171] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2013] [Accepted: 01/15/2014] [Indexed: 11/26/2022] Open
Affiliation(s)
| | - Anthony P. Pease
- Department of Small Animal Clinical Sciences
- College of Veterinary Medicine; Michigan State University; East Lansing MI 48823
| | | | - Greg Habing
- Department of Veterinary Preventative Medicine; Ohio State University; Columbus OH 43210
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34
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Franklin SP, Schulz KS, Karnes J, Cook JL. Theory and development of a unicompartmental resurfacing system for treatment of medial compartment disease of the canine elbow. Vet Surg 2014; 43:765-73. [PMID: 24479943 DOI: 10.1111/j.1532-950x.2014.12154.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Accepted: 07/25/2013] [Indexed: 11/28/2022]
Abstract
Medial compartment disease (MCompD) of the canine elbow can be defined as clinical signs attributable to articular cartilage loss of the medial coronoid process (MCP) of the ulna and medial aspect of the humeral condyle without significant lateral compartment pathology. Whereas outcomes associated with treatment of defined cohorts of dogs with MCompD have not been published, the impressions of many surgeons are that non-surgical management or surgical treatment of the MCP alone does not result in long term highly functional outcomes. Thus, alternative surgical options for treatment of MCompD have been developed including various osteotomies and total elbow replacement (TER) with "successful" outcomes reported in case series. Results and data on safety have been reported for relatively few of these procedures and when reported, major complication rates have been >10% and catastrophic complications have been reported. Accordingly, we sought to develop a surgical technique with the objective of obtaining higher levels of safety and efficacy in the treatment of dogs with MCompD. This report describes the rationale for, and development of, a unicompartmental resurfacing system for treatment of MCompD in the canine elbow.
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Affiliation(s)
- Samuel P Franklin
- Comparative Orthopaedic Laboratory, University of Missouri, Columbia, Missouri
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35
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Krotscheck U, Kalafut S, Meloni G, Thompson MS, Todhunter RJ, Mohammed HO, van der Meulen MC. Effect of Ulnar Ostectomy on Intra-Articular Pressure Mapping and Contact Mechanics of the Congruent and Incongruent Canine ElbowEx Vivo. Vet Surg 2014; 43:339-46. [DOI: 10.1111/j.1532-950x.2014.12137.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2013] [Accepted: 06/01/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Ursula Krotscheck
- Department of Clinical Sciences; Cornell University; Ithaca New York
| | - Sarah Kalafut
- Department of Clinical Sciences; Cornell University; Ithaca New York
| | - Gregory Meloni
- Sibley School of Mechanical and Aerospace Engineering; Cornell University; Ithaca New York
| | | | - Rory J. Todhunter
- Department of Clinical Sciences; Cornell University; Ithaca New York
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36
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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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37
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Krotscheck U, Böttcher PB, Thompson MS, Todhunter RJ, Mohammed HO. Cubital Subchondral Joint Space Width and CT Osteoabsorptiometry in Dogs With and Without Fragmented Medial Coronoid Process. Vet Surg 2014; 43:330-8. [DOI: 10.1111/j.1532-950x.2014.12121.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2012] [Accepted: 05/01/2013] [Indexed: 11/30/2022]
Affiliation(s)
- Ursula Krotscheck
- Department of Clinical Sciences; Cornell University; Ithaca New York
| | - Peter B. Böttcher
- Department of Small Animal Medicine; University of Leipzig; Leipzig Germany
| | | | - Rory J. Todhunter
- Department of Clinical Sciences; Cornell University; Ithaca New York
| | - Hussni O. Mohammed
- Department of Population Medicine and Diagnostic Sciences; Cornell University; Ithaca New York
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38
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Farrell M, Heller J, Solano M, Fitzpatrick N, Sparrow T, Kowaleski M. Does Radiographic Arthrosis Correlate With Cartilage Pathology in Labrador Retrievers Affected by Medial Coronoid Process Disease? Vet Surg 2014; 43:155-65. [DOI: 10.1111/j.1532-950x.2014.12092.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Accepted: 03/17/2013] [Indexed: 11/28/2022]
Affiliation(s)
| | - Jane Heller
- Department of Epidemiology and Public Health; School of Animal and Veterinary Studies; Charles Sturt University; Wagga Wagga Australia
| | | | | | - Tim Sparrow
- Fitzpatrick Referrals; Eashing United Kingdom
| | - Mike Kowaleski
- Tufts Cummings School of Veterinary Medicine; North Grafton Massachusetts
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39
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Bitton E, Joseph R, Portman L, Segev G, Meiner Y, Shipov A, Milgram J. The effect of extension and loading of the carpus on radial rotation. Vet Surg 2013; 42:909-17. [DOI: 10.1111/j.1532-950x.2013.12071.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 12/10/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Erez Bitton
- Laboratory of Biomechanics; Veterinary Teaching Hospital; Koret School of Veterinary Medicine; The Hebrew University of Jerusalem; Rehovot Israel
| | - Rotem Joseph
- Laboratory of Biomechanics; Veterinary Teaching Hospital; Koret School of Veterinary Medicine; The Hebrew University of Jerusalem; Rehovot Israel
| | - Lena Portman
- Laboratory of Biomechanics; Veterinary Teaching Hospital; Koret School of Veterinary Medicine; The Hebrew University of Jerusalem; Rehovot Israel
| | - Gilad Segev
- Laboratory of Biomechanics; Veterinary Teaching Hospital; Koret School of Veterinary Medicine; The Hebrew University of Jerusalem; Rehovot Israel
| | - Yaron Meiner
- Laboratory of Biomechanics; Veterinary Teaching Hospital; Koret School of Veterinary Medicine; The Hebrew University of Jerusalem; Rehovot Israel
| | - Anna Shipov
- Laboratory of Biomechanics; Veterinary Teaching Hospital; Koret School of Veterinary Medicine; The Hebrew University of Jerusalem; Rehovot Israel
| | - Joshua Milgram
- Laboratory of Biomechanics; Veterinary Teaching Hospital; Koret School of Veterinary Medicine; The Hebrew University of Jerusalem; Rehovot Israel
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40
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Coggeshall JD, Reese DJ, Kim SE, Pozzi A. Arthroscopic-guided ulnar distraction for the correction of elbow incongruency in four dogs. J Small Anim Pract 2013; 55:46-51. [PMID: 24032426 DOI: 10.1111/jsap.12126] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/26/2013] [Indexed: 11/29/2022]
Abstract
Four skeletally immature, small breed dogs (five elbows) with elbow incongruency were evaluated for forelimb lameness. Findings on clinical examination included pain, effusion and decreased range of motion of the affected elbow. Radiography, computed tomography and arthroscopy demonstrated elbow incongruency in all dogs. Fragmented medial coronoid process was diagnosed arthroscopically in three dogs (four elbows). Arthroscopic subtotal coronoidectomy was performed in all cases of fragmented medial coronoid process. Incongruency was corrected with acute ulnar lengthening under arthroscopic visualisation. The ulna was stabilised with a plate following correction. In two elbows an ostectomy of the anconeal process was performed to prevent impingement against the olecranon fossa. All dogs demonstrated improvement in lameness scores and client-scored visual analogue scale scores. Postoperative computed tomography showed significant improvement in elbow incongruency in all dogs. Arthroscopic-guided ulnar lengthening may be considered as a valid treatment in severe cases of elbow incongruency.
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Affiliation(s)
- J D Coggeshall
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL, 32610, USA
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41
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The early development of medial coronoid disease in growing Labrador retrievers: Radiographic, computed tomographic, necropsy and micro-computed tomographic findings. Vet J 2013; 197:724-30. [DOI: 10.1016/j.tvjl.2013.04.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2012] [Revised: 03/25/2013] [Accepted: 04/07/2013] [Indexed: 11/19/2022]
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Cuddy LC, Lewis DD, Kim SE, Conrad BP, Banks SA, Horodyski M, Fitzpatrick N, Pozzi A. Ex vivo contact mechanics and three-dimensional alignment of normal dog elbows after proximal ulnar rotational osteotomy. Vet Surg 2013. [PMID: 23198918 DOI: 10.1111/j.1532-950x.2012.01038.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To evaluate the effect of proximal ulnar rotational osteotomy (PURO) on the contact mechanics and 3-dimensional (3D) alignment of cadaveric normal dog elbows. STUDY DESIGN Ex vivo biomechanical study. ANIMALS Unpaired thoracic limbs from 12 dogs (mean ± SD weight, 26 ± 4 kg). METHODS PURO consisted of a transverse osteotomy with 30° external rotation of the proximal segment. With the limb under 200 N axial load, contact area (CA), mean contact pressure (CP) and peak contact pressure (PCP) were measured using digital pressure sensors in the medial and lateral compartments and 3D static elbow poses were obtained, before and after PURO. Each specimen was tested at 115°, 135°, and 155° elbow flexion, with the antebrachium in neutral rotation, in 28° supination, and in 16° pronation. Repeated measures ANOVAs with post-hoc Bonferroni (P ≤ .05) were performed. RESULTS PURO caused significant changes, mostly at 135° elbow flexion and neutral antebrachial rotation, characterized by decreased CP (10%) and PCP (10%) in the medial compartment, and increased CP (27%) and PCP (23%) in the lateral compartment. The apex of the medial coronoid process translated 3.4 mm caudally, 1.7 mm abaxially, and rotated 1.8° externally relative to the radial head. Humeroradial varus angulation reduced by 6.7°. CONCLUSIONS In limited poses, PURO displaces the medial coronoid process caudally and abaxially and shifts contact pressures towards the lateral elbow compartment by decreasing varus angulation.
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Affiliation(s)
- Laura C Cuddy
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, Gainesville, FL 32610-0126, USA
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43
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Fitzpatrick N, Caron A, Solano MA. Bi-Oblique Dynamic Proximal Ulnar Osteotomy in Dogs: Reconstructed Computed Tomographic Assessment of Radioulnar Congruence over 12 weeks. Vet Surg 2013; 42:727-38. [DOI: 10.1111/j.1532-950x.2013.12014.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Accepted: 04/01/2012] [Indexed: 11/28/2022]
Affiliation(s)
| | - Alexandre Caron
- Fitzpatrick Referrals Ltd; Eashing, Godalming; United Kingdom
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44
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Eljack H, Werner H, Böttcher P. Sensitivity and Specificity of 3D Models of the Radioulnar Joint Cup in Combination With a Sphere Fitted to the Ulnar Trochlear Notch for Estimation of Radioulnar IncongruenceIn Vitro. Vet Surg 2013; 42:365-70. [DOI: 10.1111/j.1532-950x.2013.01096.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2012] [Accepted: 07/01/2012] [Indexed: 11/27/2022]
Affiliation(s)
- Hamdi Eljack
- Department of Small Animal Medicine; University of Leipzig; Leipzig; Germany
| | - Hinnerk Werner
- Department of Small Animal Medicine; University of Leipzig; Leipzig; Germany
| | - Peter Böttcher
- Department of Small Animal Medicine; University of Leipzig; Leipzig; Germany
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45
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Michelsen J. Canine elbow dysplasia: Aetiopathogenesis and current treatment recommendations. Vet J 2013; 196:12-9. [DOI: 10.1016/j.tvjl.2012.11.009] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2012] [Revised: 11/07/2012] [Accepted: 11/10/2012] [Indexed: 10/27/2022]
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Böttcher P, Bräuer S, Werner H. Estimation of Joint Incongruence in Dysplastic Canine Elbows Before and After Dynamic Proximal Ulnar Osteotomy. Vet Surg 2013; 42:371-6. [DOI: 10.1111/j.1532-950x.2013.01085.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2012] [Accepted: 11/01/2012] [Indexed: 11/30/2022]
Affiliation(s)
- Peter Böttcher
- Department of Small Animal Medicine; University of Leipzig; Leipzig; Germany
| | - Sabine Bräuer
- Department of Small Animal Medicine; University of Leipzig; Leipzig; Germany
| | - Hinnerk Werner
- Department of Small Animal Medicine; University of Leipzig; Leipzig; Germany
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47
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Arthroscopic treatment of fragmented coronoid process with severe elbow incongruity. Long-term follow-up in eight Bernese Mountain Dogs. Vet Comp Orthop Traumatol 2012; 26:27-33. [PMID: 23154671 DOI: 10.3415/vcot-11-06-0087] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2011] [Accepted: 07/16/2012] [Indexed: 11/17/2022]
Abstract
The purpose of this study was to investigate the long-term treatment results of fragmented coronoid process (FCP) in joints with a radio-ulnar step greater than 3 mm. Treatment of these patients only consisted of fragment removal, without correction of the incongruity. The eight Bernese Mountain Dogs (11 joints) included in this study showed obvious clinical signs of elbow disease and were diagnosed with severe elbow incongruity and concomitant FCP in the time period from 1999-2003. At that time, elbow radiography, computed tomography, and arthroscopy were performed. The mean follow-up period was 5.6 years. The follow-up consisted of a telephone questionnaire combined with a clinical and radiographic re-evaluation at our clinic. The questionnaire revealed that all dogs were either free of lameness or only lame following heavy exercise. One dog sporadically required medication after heavy exercise. The owner satisfaction rate was 100%. The clinical re-evaluation did not reveal any signs of pain or lameness in all cases. Range-of- motion was decreased in nine of the 11 elbows. Radiographs revealed an increase in severity of osteoarthritis in every case.In this case series, arthroscopic fragment removal without treatment of incongruity was demonstrated to be a valuable treatment option and may provide a satisfactory long-term outcome.
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48
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Computed tomography of ununited anconeal process in the dog. Vet Comp Orthop Traumatol 2012; 25:498-505. [PMID: 22828947 DOI: 10.3415/vcot-11-10-0138] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Accepted: 06/13/2012] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The purpose of this study was to describe computed tomography (CT) features of the ununited anconeal process and relate them with the following elbow dysplasia signs: medial coronoid disease, medial humeral condyle changes, osteoarthritis (OA), and radioulnar incongruence. METHODS Computed tomographic images of dogs older than six months with an ununited anconeal process were evaluated (n = 13). Ununited anconeal process features were described as being complete or incomplete, and the degree of displacement, volume, and presence of cysts and sclerosis were also evaluated. Medial coronoid disease was defined as an irregular medial coronoid process shape, presence of sclerosis and fragmentation. Medial humeral condyle changes were defined as subchondral bone flattening, lucencies, and sclerosis. Osteoarthritis was graded depending on the osteophytes size. Radioulnar incongruence was measured on a sagittal view at the base of the medial coronoid process. RESULTS Eleven elbows had a complete and two had an incomplete ununited anconeal process. All ununited anconeal processes had cystic and sclerotic lesions. Seven ununited anconeal processes were displaced and six were non-displaced. Mean ununited anconeal process volume was 1.35 cm3 (0.61 cm³ - 2.08 cm³). Twelve elbows had signs of medial coronoid disease (4 of them with a fragmented medial coronoid process), and one elbow did not show any evidence of medial coronoid disease. Ten elbows had medial humeral condyle changes. One elbow had grade 1 OA, seven elbows had grade 2, and five elbows grade 3. All elbows had radioulnar incongruence: three elbows had a negative and 10 elbows had a positive radioulnar incongruence. Mean radioulnar incongruence was 1.49 mm (0.63 mm - 2.61 mm). Computed tomographic findings were similar in the majority of the elbows studied: complete ununited anconeal processes with signs of medial coronoid disease, positive radioulnar incongruence, high grade of OA, sclerotic medial humeral condyle changes, and large ununited anconeal process volumes. CLINICAL SIGNIFICANCE Incomplete small ununited anconeal process volumes could be associated with a lower incidence of medial coronoid disease or medial humeral condyle changes. We recommend performing preoperative CT of elbows with an ununited anconeal process to evaluate concurrent lesions.
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49
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Gutbrod A, Guerrero TG. Effect of External Rotational Humeral Osteotomy on the Contact Mechanics of the Canine Elbow Joint. Vet Surg 2012; 41:845-52. [DOI: 10.1111/j.1532-950x.2012.00995.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Andreas Gutbrod
- 1; Department for Small Animal Surgery; Vetsuisse Faculty, University of Zurich; Zurich; Switzerland
| | - Tomás G. Guerrero
- 1; Department for Small Animal Surgery; Vetsuisse Faculty, University of Zurich; Zurich; Switzerland
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50
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Samoy Y, Gielen I, Van Caelenberg A, van Bree H, Duchateau L, Van Ryssen B. Computed Tomography Findings in 32 Joints Affected with Severe Elbow Incongruity and Fragmented Medial Coronoid Process. Vet Surg 2012; 41:486-94. [DOI: 10.1111/j.1532-950x.2011.00950.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Yves Samoy
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; Belgium
| | - Ingrid Gielen
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; Belgium
| | - Annemie Van Caelenberg
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; Belgium
| | - Henri van Bree
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; Belgium
| | - Luc Duchateau
- Department of Physiology and Biometrics; Faculty of Veterinary Medicine; Ghent University; Belgium
| | - Bernadette Van Ryssen
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics; Faculty of Veterinary Medicine; Ghent University; Belgium
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