1
|
Scharpf M, Theyse LFH. Assessment of Outcome of Arthroscopic Subtotal Coronoidectomy in Treating Medial Coronoid Disease and Effect of Concurrent Autologous Conditioned Plasma in Dogs Using Force Plate Analysis. Vet Comp Orthop Traumatol 2024; 37:83-89. [PMID: 37967845 DOI: 10.1055/s-0043-1776785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
OBJECTIVE The aim of this study was to assess the outcome of arthroscopic subtotal coronoidectomy in treating medial coronoid disease and the effect of concurrent autologous conditioned plasma (ACP) in dogs using force plate analysis. STUDY DESIGN This study included 16 dogs with unilateral medial coronoid disease based on computed tomographic imaging. Treatment consisted of an arthroscopic subtotal coronoidectomy. As concurrent therapy, eight dogs received ACP at the end of the arthroscopy and eight dogs a placebo. Force plate analysis, including vertical forces, braking and propulsive forces, corresponding impulses and symmetry indices, was performed prior to arthroscopy and at 4, 12 and 26 weeks postoperatively. RESULTS After an initial reduction of all force plate analysis parameters, vertical and propulsive parameters gradually improved to the level of healthy dogs at 26 weeks postoperatively. In contrast, braking parameters did not reach normal values at 26 weeks, demonstrating ongoing loss of elbow joint function. The ACP and placebo group did not show any significant difference in force plate analysis parameters during the 26 weeks study period. CONCLUSION Arthroscopic subtotal coronoidectomy did not result in complete normalization of ground reaction forces, impulses and symmetry indices. Concurrent treatment with ACP, immediately after arthroscopy, did not improve outcome. Our results show that outcome of arthroscopic subtotal coronoidectomy in treating medial coronoid disease is less favourable than previously reported.
Collapse
Affiliation(s)
- Marlene Scharpf
- Department for Small Animals, College of Veterinary Medicine, University of Leipzig, Soft Tissue and Orthopaedic Surgery Service, Leipzig, Germany
| | - Lars F H Theyse
- Department for Small Animals, College of Veterinary Medicine, University of Leipzig, Soft Tissue and Orthopaedic Surgery Service, Leipzig, Germany
| |
Collapse
|
2
|
Glück T, Zablotski Y, Meyer-Lindenberg A. Microcomputed tomographic analysis of the ulnar trochlear notch in medium- and large-breed canine cadavers with and without medial coronoid disease. Res Vet Sci 2024; 166:105108. [PMID: 38101086 DOI: 10.1016/j.rvsc.2023.105108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/18/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023]
Abstract
Medial coronoid disease (MCD) is a common disease often associated with thoracic limb lameness in medium- and large-breed dogs. The term MCD includes subchondral changes of the medial coronoid process (MCP), as well as pathologies of both cartilaginous surfaces. As there are only a few comprehensive and detailed studies on the trabecular structure of the medial coronoid, the goal of this study was to compare the trabecular structure of the ulnar trochlear notch of canine cadavers with and without MCD using different micro-computed tomographic (micro-CT) parameters. Fifty-eight elbow joints from 29 canine cadavers of MCD-predisposed and non-predisposed breeds (control group) were examined radiographically, macroscopically and by microcomputed tomography. The study included elbow joints of eight Labrador Retrievers (21.6-37 kg), seven Golden Retrievers (26.3-42 kg), seven Bernese Mountain dogs (31-47 kg) and seven dogs of non-predisposed breeds (19.7-52 kg) (control group). The final diagnosis of MCD was based on necropsy and micro-computed tomographic examinations. Micro-CT examinations were performed using XtremeCT II (Scanco Medical, Zurich, Switzerland) and the following parameters were examined: bone volume fraction (BV/TV), trabecular thickness (Tb.Th), trabecular separation (Tb.Sp), trabecular number (Tb.N), connectivity density (Conn.D) and degree of anisotropy (DA). Twenty-four elbows of 44 elbows of the predisposed breeds (Labrador Retrievers, Golden Retrievers Bernese Mountain dogs) showed subchondral changes and lesions of the cartilage surfaces. The result of this study is a higher density (BV/TV) of the trabecular bone of the ulnar trochlear notch in elbows affected by MCD compared to the control group. The increased density due to trabecular reconstruction in the ulnar trochlear notch is likely the result of selectively increased loading during life.
Collapse
Affiliation(s)
- Tim Glück
- Clinic of Small Animal Surgery and Reproduction, Ludwig-Maximilians-University, Veterinärstr. 13, 80539 Munich, Germany.
| | - Yury Zablotski
- Clinic of Small Animal Surgery and Reproduction, Ludwig-Maximilians-University, Veterinärstr. 13, 80539 Munich, Germany
| | - Andrea Meyer-Lindenberg
- Clinic of Small Animal Surgery and Reproduction, Ludwig-Maximilians-University, Veterinärstr. 13, 80539 Munich, Germany
| |
Collapse
|
3
|
Seidler S, Siedenburg J, Rhode M, Volk HA, Harms O. Dogs with Bilateral Medial Coronoid Disease Can Be Clinically Sound after Unilateral Arthroscopic Fragment Removal-Preliminary Study. Animals (Basel) 2023; 13:3803. [PMID: 38136840 PMCID: PMC10741036 DOI: 10.3390/ani13243803] [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: 09/05/2023] [Revised: 11/10/2023] [Accepted: 12/04/2023] [Indexed: 12/24/2023] Open
Abstract
The purpose of this study was to assess the outcome of dogs with bilateral medial coronoid disease (MCD) treated with arthroscopic intervention for the clinically more severely affected side and conservative management for the contralateral side. The medical records of dogs with bilateral medial coronoid disease diagnosed using computed tomography (CT) and treated using arthroscopic intervention on one elbow and conservative management on the other elbow were retrospectively reviewed. The outcome evaluation included clinical re-examination; follow-up radiographic-visible osteophytic lesions; as well as sclerotic changes and Liverpool osteoarthritis in a dogs questionnaire. Data from 48 clinically affected elbow joints (24 dogs) with bilateral MCD diagnosed using CT were included. Every dog underwent arthroscopic intervention on the elbow joint, which was clinically more severely affected, and the other side was treated with conservative management. A fragment of the medial coronoid was diagnosed using CT in all elbows, whereas 19 elbows (39.4%) showed a dislocation of the fragment and the other 29 elbows (60.4%) did not. There are no findings regarding the radioulnar Incongruence. Initially, 86% of all radiographs had the same degree of osteophytes. At the time of follow-up, the arthroscopic-treated limbs had more severe radiological changes in comparison to the conservatively treated limbs. Lameness improved after arthroscopic therapy in walking. The conservative group showed a largely unchanged gait pattern. Radiological changes do not necessarily reflect the severity of clinical signs. Arthroscopic intervention showed an improvement of the clinical gait pattern, even though the radiographic changes worsened.
Collapse
Affiliation(s)
- Sophia Seidler
- Clinic for Small Animals, University of Veterinary Medicine Hannover Foundation, 30559 Hannover, Germany
- Clinic for Small Animals, 71640 Ludwigsburg, Germany
| | - Johannes Siedenburg
- Clinic for Small Animals, University of Veterinary Medicine Hannover Foundation, 30559 Hannover, Germany
| | - Michaela Rhode
- Tierarztpraxis für Kleintierchirurgie, 58809 Neuenrade, Germany
| | - Holger A. Volk
- Clinic for Small Animals, University of Veterinary Medicine Hannover Foundation, 30559 Hannover, Germany
| | - Oliver Harms
- Clinic for Small Animals, University of Veterinary Medicine Hannover Foundation, 30559 Hannover, Germany
| |
Collapse
|
4
|
Kähn H, Zablotski Y, Meyer-Lindenberg A. Therapeutic success in fragmented coronoid process disease and other canine medial elbow compartment pathology: a systematic review with meta-analyses. Front Vet Sci 2023; 10:1228497. [PMID: 38026645 PMCID: PMC10666176 DOI: 10.3389/fvets.2023.1228497] [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: 05/24/2023] [Accepted: 10/24/2023] [Indexed: 12/01/2023] Open
Abstract
Introduction The correct treatment of elbow dysplasia is controversial in modern small animal orthopedics. The aim of this study was to compile all relevant literature of the therapy of fragmented coronoid process and other hereditary disorders of the medial elbow compartment and to statistically evaluate the therapeutic results in three meta-analyses. Methods The basis for the systematic literature review was a comprehensive database search of Web of Science, PubMed and Medline. Studies on living patients with above mentioned degenerative joint disease were included in the initial literature search. The data from the final studies, selected according to the PRISMA guidelines, was subsequently extracted. Finally, the success of the different therapies was compared and analyzed by three meta-analyses: success rate, mean difference and standardized mean difference. Results Fourteen of 494 publications covered by the systematic literature search remained. Their overall truth was: In studies where surgery outcomes was determined by clinical examination and owner questionnaires, it was found that surgical intervention had a significant positive outcome in the presence of fragmented coronoid process and medial compartment disease. Surgical outcomes were also good in three cross-over studies that investigated treatment success using computerized gait analysis. In contrast, comparative studies between surgical and conservative management yielded controversial results. The meta-analysis found no significant difference between medical and surgical therapy. Discussion The positive results of studies investigating owner satisfaction and veterinary clinical examination of surgical therapy for medial compartment disease were confirmed by two meta-analyses. However, their study designs were susceptible to observer biases. A third meta-analysis of standardized mean difference differentiating computerized gait analysis results of surgical and conservative management found no evidence of significant superiority of each treatment modality. It however had a limited number of subjects. More comparative studies of high evidence are needed to better understand medial compartment disease and provide the clinician with more accurate diagnostics to separate pathology that should be treated surgically from pathology that can benefit from conservative therapy similarly. Given the invasiveness a more cautious approach might be warranted regarding generally recommending surgery for pathology of the medial elbow compartment.
Collapse
Affiliation(s)
- Hubertus Kähn
- Clinic of Small Animal Surgery and Reproduction, Centre for Clinical Veterinary Medicine, LMU Munich, Munich, Germany
| | - Yury Zablotski
- Centre for Clinical Veterinary Medicine, LMU Munich, Munich, Germany
| | - Andrea Meyer-Lindenberg
- Clinic of Small Animal Surgery and Reproduction, Centre for Clinical Veterinary Medicine, LMU Munich, Munich, Germany
| |
Collapse
|
5
|
Obel C, Bergström A, Comin A, Engdahl K. Long-term outcomes in dogs with elbow dysplasia, assessed using the canine orthopaedic index. Vet Rec 2023; 193:e2950. [PMID: 37138533 DOI: 10.1002/vetr.2950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/21/2023] [Accepted: 03/26/2023] [Indexed: 05/05/2023]
Abstract
BACKGROUND Elbow dysplasia (ED) is an important cause of lameness in dogs. This study aimed to report long-term outcomes in dogs with elbow osteoarthritis. METHODS Demographic data, medical management, and scores from The American College of Veterinary Surgeons' Canine Orthopaedic Index (COI) were collected from owners of dogs radiographically screened for ED, graded as normal, mild, or moderate. Telephone interviews were performed in 2017 (Q1), followed by an email survey in 2020 (Q2). The association between ED grade and deterioration in COI scores over time was evaluated with logistic regression. RESULTS A total of 765 replies were collected for Q1 and 293 for Q2. At Q2, 222 dogs (76%) were alive, with a median age of 8 years (range 5-12 years). No association was found between ED and changes in COI score over time or between ED and survival (p = 0.071). Dogs with mild and moderate ED were treated with analgesic medications to a higher degree than dogs without ED (p < 0.05). LIMITATIONS Only owner-assed data were assessed; no clinical orthopaedic examination or follow-up radiographic evaluation was performed. CONCLUSIONS No association was found between the grade of ED and the worsening of clinical signs in dogs with elbow osteoarthritis.
Collapse
Affiliation(s)
| | - Annika Bergström
- AniCura Albano Small Animal Hospital, Stockholm, Sweden
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Arianna Comin
- Department of Disease Control and Epidemiology, National Veterinary Institute, Uppsala, Sweden
| | - Karolina Engdahl
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| |
Collapse
|
6
|
Burton NJ. Review of minimally invasive surgical procedures for assessment and treatment of medial coronoid process disease. Vet Surg 2023; 52:790-800. [PMID: 37592746 DOI: 10.1111/vsu.13986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/07/2023] [Accepted: 06/14/2023] [Indexed: 08/19/2023]
Abstract
OBJECTIVE To summarize the current peer-reviewed publications on minimally invasive surgery (MIS) for medial coronoid process disease (MCPD) in dogs. STUDY DESIGN Invited review. METHODS Pubmed, CAB Abstracts and Scopus databases were utilized for literature review (1990-2023). RESULTS More than 60 papers have been published that involve MIS evaluation or treatment of MCPD. Six prospective trials incorporated quantitative gait analysis evaluating outcome following MCPD debridement, of which three included a control group. Whilst case numbers were limited, all studies employing a control group failed to demonstrate superiority of surgery over nonsurgical management. Of three studies employing gait analysis and no control group, all documented some improvement in function compared to pretreatment lameness. Multiple studies document progression of osteoarthritis in dogs following MCPD debridement although this may not be synonymous with worsened function. Subtotal coronoid osteotomy (SCO) is described as an alternative to MCP fragment removal, although the long-term biomechanical consequences are currently unclear and quantitative data on the efficacy of this treatment in isolation for MCPD is awaited. CONCLUSION Arthroscopy of the canine elbow joint is a safe means by which to evaluate MCP pathology. Quantitative longitudinal analysis of outcome following minimally invasive surgery for MCPD is required. Correlation with clearly defined subclassification inclusion criteria such as age, incongruity and the precise arthroscopic findings in each case are required to more accurately differentiate any superiority of surgery over nonsurgical management for this disease.
Collapse
|
7
|
Domaniza M, Hluchy M, Cizkova D, Humenik F, Slovinska L, Hudakova N, Hornakova L, Vozar J, Trbolova A. Two Amnion-Derived Mesenchymal Stem-Cells Injections to Osteoarthritic Elbows in Dogs-Pilot Study. Animals (Basel) 2023; 13:2195. [PMID: 37443993 DOI: 10.3390/ani13132195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2023] [Revised: 06/14/2023] [Accepted: 06/22/2023] [Indexed: 07/15/2023] Open
Abstract
The aim of the study was to investigate the potential of cell-based regenerative therapy for elbow joints affected by osteoarthritis. Interest was focused on two intra-articular applications of amnion-derived mesenchymal stem cells (A-MSCs) to a group of different breeds of dogs with elbow osteoarthritis (13 joints). Two injections were performed 14 days apart. We evaluated synovial fluid biomarkers, such as IFN-γ, IL-6, IL-15, IL-10, MCP-1, TNF-α, and GM-CSF, by multiplex fluorescent micro-bead immunoassay in the treated group of elbows (n = 13) (day 0, day 14, and day 28) and in the control group of elbows (n = 9). Kinematic gait analysis determined the joint range of motion (ROM) before and after each A-MSCs application. Kinematic gait analysis was performed on day 0, day 14, and day 28. Kinematic gait analysis pointed out improvement in the average range of motion of elbow joints from day 0 (38.45 ± 5.74°), day 14 (41.7 ± 6.04°), and day 28 (44.78 ± 4.69°) with statistical significance (p < 0.05) in nine elbows. Correlation analyses proved statistical significance (p < 0.05) in associations between ROM (day 0, day 14, and day 28) and IFN-γ, IL-6, IL-15, MCP-1, TNF-α, and GM-CSF concentrations (day 0, day 14, and day 28). IFN-γ, IL-6, IL-15, MCP-1, GM-CSF, and TNF- α showed negative correlation with ROM at day 0, day 14, and day 28, while IL-10 demonstrated positive correlation with ROM. As a consequence of A-MSC application to the elbow joint, we detected a statistically significant (p < 0.05) decrease in concentration levels between day 0 and day 28 for IFN-γ, IL-6, and TNF-α and statistically significant increase for IL-10. Statistical significance (p < 0.05) was detected in TNF-α, IFN-γ, and GM-CSF concentrations between day 14 and the control group as well as at day 28 and the control group. IL-6 concentrations showed statistical significance (p < 0.05) between day 14 and the control group.
Collapse
Affiliation(s)
- Michal Domaniza
- Small Animal Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 041 81 Kosice, Slovakia
| | - Marian Hluchy
- Small Animal Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 041 81 Kosice, Slovakia
| | - Dasa Cizkova
- Centre of Experimental and Clinical Regenerative Medicine, University of Veterinary Medicine and Pharmacy, Komenskeho 68/73, 041 81 Kosice, Slovakia
| | - Filip Humenik
- Centre of Experimental and Clinical Regenerative Medicine, University of Veterinary Medicine and Pharmacy, Komenskeho 68/73, 041 81 Kosice, Slovakia
| | - Lucia Slovinska
- Associated Tissue Bank, Faculty of Medicine, P.J. Safarik University and L.Pasteur University Hospital, Trieda SNP 1, 040 11 Kosice, Slovakia
| | - Nikola Hudakova
- Centre of Experimental and Clinical Regenerative Medicine, University of Veterinary Medicine and Pharmacy, Komenskeho 68/73, 041 81 Kosice, Slovakia
| | - Lubica Hornakova
- Small Animal Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 041 81 Kosice, Slovakia
| | - Juraj Vozar
- Centre of Experimental and Clinical Regenerative Medicine, University of Veterinary Medicine and Pharmacy, Komenskeho 68/73, 041 81 Kosice, Slovakia
| | - Alexandra Trbolova
- Small Animal Hospital, University of Veterinary Medicine and Pharmacy, Komenskeho 73, 041 81 Kosice, Slovakia
| |
Collapse
|
8
|
Brandstetter V, Wunderlin N, Günther C. Detection of fragment migration into the biceps tendon sheath originating from a humeral osteochondrosis lesion - A case report and review of the literature. TIERARZTLICHE PRAXIS. AUSGABE K, KLEINTIERE/HEIMTIERE 2023; 51:123-130. [PMID: 37230117 DOI: 10.1055/a-2055-9436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The purpose of this report is to demonstrate that radiographic evaluation of the canine shoulder joint alone is not sensitive enough to detect migrated osteochondral fragments within the biceps tendon sheath, as a sequela to osteochondrosis dissecans of the caudal humeral head. A 6-months-old, male, 35 kg Hovawart was referred due to chronic intermittent lameness on the left forelimb. Survey radiographs revealed a semilunar radiolucency surrounded by a moderately sclerotic rim at the caudal aspect of the left humeral head, referred to as osteochondrosis dissecans. However, only computed tomography combined with ultrasonography could clearly confirm a dislodged osteochondral fragment within the left biceps tendon sheath and a consequent tenosynovitis. Arthroscopic treatment on the clinically affected left forelimb followed by an additional approach over the left biceps tendon sheath to remove the migrated fragment resulted in a complete remission of the lameness until the last follow-up one year after surgery. In our opinion, computed tomography should be applied in the medical work up of canine shoulder osteochondrosis (OC) as standard. Combined with ultrasonography, it can further aid in complete evaluation of the shoulder joint and reliable exclusion of displaced osteochondral fragments, which might also be missed during arthroscopy when located too far distally.
Collapse
|
9
|
Garnier P, Dekerle B, Vial J, Maurice E, Manassero M, Viateau V. Evaluation of a small-bore needle arthroscope for diagnosis and treatment of medial coronoid disease in dogs: a pilot study with short-term assessment. N Z Vet J 2023; 71:152-158. [PMID: 36786654 DOI: 10.1080/00480169.2023.2181239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
CASE HISTORY Dogs (n = 15) that were presented to a single veterinary teaching hospital with elbow dysplasia-associated lameness between September 2021 and May 2022, and were determined to require arthroscopy based on imaging results, were prospectively recruited into the study. The median duration of lameness was 4 (min 1, max 24) months. CLINICAL FINDINGS Various breeds were represented with a median body weight of 31.6 (min 15, max 46.4) kg and median age at presentation of 14 (min 8, max 83) months. Results of imaging modalities (CT) were consistent with medial coronoid disease with fissured or fragmented medial coronoid process in all dogs. ARTHROSCOPIC FINDINGS Feasibility of the needle arthroscopy (NA) procedure was firstly assessed in a preliminary cadaveric study in forelimbs (n = 10) collected from 10 adult dogs euthanised for reasons unrelated to the study. Elbow exploration was performed through a medial approach beginning with NA (1.9 mm 0° angle scope) followed by standard arthroscopy (SA; 2.4 mm 30° angle scope). The quality and extent of visualisation (scored through the number of anatomical structures visualised) were recorded and statistically compared. As the cadaver study indicated that NA allowed safe inspection of all structures in medial/caudal compartments, this procedure was then used in the dogs requiring treatment. In the clinical setting, elbow exploration was successful in all dogs and the treatment (removal of osteochondral fragments) was performed without requiring conversion into SA. One month after surgery, all dogs had an improvement in their lameness score (0-5) and 12/15 dogs were no longer lame. There was a reduction in Canine Orthopaedic Index scores measured a median of 99 (min 47, max 180) days after surgery (24 (IQR 19.5-31.5)) compared to the pre-operative period (49 (IQR 46.5-57); p < 0.001). CLINICAL RELEVANCE Needle arthroscopy-assisted removal of osteochondral fragments was performed in all dogs with satisfactory short-term clinical outcome. NA is a feasible technique for diagnosis and lesion assessment in dogs with a fissured or fragmented coronoid process. Larger clinical studies with longer follow-up are necessary to validate the NanoScope operative arthroscopy system as an alternative strategy to SA for video-assisted treatment of medial coronoid disease.
Collapse
Affiliation(s)
- P Garnier
- Department of Small Animal Surgery, Centre Hospitalier Universitaire Vétérinaire d'Alfort (ChuvA), École Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - B Dekerle
- Department of Small Animal Surgery, Centre Hospitalier Universitaire Vétérinaire d'Alfort (ChuvA), École Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - J Vial
- Department of Small Animal Surgery, Centre Hospitalier Universitaire Vétérinaire d'Alfort (ChuvA), École Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - E Maurice
- Department of Small Animal Surgery, Centre Hospitalier Universitaire Vétérinaire d'Alfort (ChuvA), École Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - M Manassero
- Department of Small Animal Surgery, Centre Hospitalier Universitaire Vétérinaire d'Alfort (ChuvA), École Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| | - V Viateau
- Department of Small Animal Surgery, Centre Hospitalier Universitaire Vétérinaire d'Alfort (ChuvA), École Nationale Vétérinaire d'Alfort, Maisons-Alfort, France
| |
Collapse
|
10
|
Rhode M, Harms O, Finck Y, Dautzenberg P, Schweizer J, Lüpke M, Freise F, Fehr M. Performing a Three-Dimensional Finite Element Analysis (FEA) to Simulate and Quantify the Contact Pressure in the Canine Elbow Joint: A Pilot Study. Vet Comp Orthop Traumatol 2022; 35:279-288. [PMID: 35785818 DOI: 10.1055/s-0042-1748876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE The aim of this study was to measure surface pressures and force distribution on radius and ulna in healthy and dysplastic elbow joints in different positions using the finite element analysis (FEA). STUDY DESIGN FEA was performed on computed tomographic data of healthy and fragmented coronoid process diseased elbow joints of Labrador Retrievers. It considered the articular cartilage, collateral ligaments, triceps and biceps muscle. The analysis of each joint was performed in four positions (standing position: 145 degrees and three positions of the stance phase of gait: beginning: 115 degrees, middle: 110 degrees, end: 145 degrees joint angle) in consideration of different ground reaction forces (standing: 88.3 N; stance phase of gait: 182.5 N). RESULTS Mean values of total force of 317.5 N (standing), 590.7 N (beginning), 330.9 N (middle) and 730.9 N (end) were measured. The percentual force distribution resulted in a total of 49.56 ± 26.58% on the ulna with a very inhomogeneous distribution. A significant difference was detected between the positions 'standing' and 'end' (p = 0.0497) regardless of the joint condition. In some FEA results, visual assessment of the surface pressures indicated an increase in pressure in the region of the medial compartment without a uniform pattern. An increase in pressure resulted in an area increase in the pressure marks on the joint surface and measurable pressure was increased at a larger joint angle. CLINICAL SIGNIFICANCE FEA can provide information about the transmission of force in the joint. Prior to the use of FEA in scientific clinical research for the simulation of force, further model improvements are necessary.
Collapse
Affiliation(s)
- Michaela Rhode
- Clinic for Small Animal Medicine, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Oliver Harms
- Clinic for Small Animal Medicine, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | | | - Philipp Dautzenberg
- Clinic for Small Animal Medicine, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Julia Schweizer
- Veterinary Practice for Small Animal Surgery, Neuenrade, Germany
| | - Matthias Lüpke
- Institute for General Radiology and Medical Physics, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Fritjof Freise
- Institute for Biometry, Epidemiology and Information Processing, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Michael Fehr
- Clinic for Small Mammals, Reptiles and Birds, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| |
Collapse
|
11
|
Ballester CO, Canet CS, García JIR, Salesa NF, Canet VS, Aguado CIS. Proximal Abduction Ulnar Osteotomy (PAUL): Short- and Long-Term Evaluation in Dogs Presenting Medial Compartment Disease. Animals (Basel) 2022; 12:ani12040466. [PMID: 35203173 PMCID: PMC8868161 DOI: 10.3390/ani12040466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Revised: 02/03/2022] [Accepted: 02/05/2022] [Indexed: 02/01/2023] Open
Abstract
Simple Summary Developmental elbow disease is one of the main causes of lameness in the canine species and occurs often in large and giant breed dogs. The most frequent manifestation of this pathology is known as medial compartment disease due to a physiological overload in the medial region of the elbow. It is considered as a complex disease and the treatment is focused on relieving the pain and slowing the progression of osteoarthritis. The Proximal Abduction Ulnar Osteotomy (PAUL) technique is one of the newest techniques whose purpose is the transmission of loads from the medial to the lateral compartment. In this prospective case series, the authors use the combination of elbow arthroscopy and the PAUL technique and report a significant improvement in clinical signs, showing a low major complications rate with a high degree of owner satisfaction. Abstract The aim of the study is to report the results obtained from performing a Proximal Abduction Ulnar Osteotomy (PAUL) technique in a cohort of dogs with medial compartment disease with short- and long-term follow-up, assessing the perception of the owners and describing the long-term complications associated with the technique. This is a clinical prospective study, including dogs diagnosed with medial compartment disease treated with elbow arthroscopy and PAUL between 2013 and 2020. Long-term follow-up data and postoperative complications were registered, and a questionnaire adapted from Fitzpatrick et al. 2009 was collected from owners. Thirty-three elbows in 26 dogs were included. The duration of follow-up ranged from 4 to 61 months (median: 24.76 months). At the end of the study, 73.1% of the owners reported excellent satisfaction and 74.1% of the owners would repeat the surgery in the same circumstances. The owner questionnaire showed a greater capacity to walk and run, without lameness and pain, and climb up and down stairs a year after surgery, being constant at the end of the study. Major postoperative complications were documented in 4/33 elbows (12.12%), including delayed union, implant failure, and osteophytosis of the medial aspect of the coronoid process. In conclusion, elbow arthroscopy and the PAUL technique achieved an evident improvement in the quality of life of patients with great satisfaction for most of the owners.
Collapse
Affiliation(s)
- Carolina Oliver Ballester
- Hospital Veterinario de Referencia UCV, Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria y Ciencias Experimentales, Universidad Católica de Valencia San Vicente Mártir, 46018 Valencia, Spain; (C.S.C.); (N.F.S.); (V.S.C.)
- Correspondence: (C.O.B.); (C.I.S.A.)
| | - Carme Soler Canet
- Hospital Veterinario de Referencia UCV, Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria y Ciencias Experimentales, Universidad Católica de Valencia San Vicente Mártir, 46018 Valencia, Spain; (C.S.C.); (N.F.S.); (V.S.C.)
- Centro de Investigación Traslacional San Alberto Magno, Universidad Católica de Valencia San Vicente Mártir, 46002 Valencia, Spain
| | - José Ignacio Redondo García
- Departamento Medicina y Cirugía Animal, Universidad Cardenal Herrera-CEU, CEU Universities, 46115 Valencia, Spain;
| | - Nuria Fernández Salesa
- Hospital Veterinario de Referencia UCV, Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria y Ciencias Experimentales, Universidad Católica de Valencia San Vicente Mártir, 46018 Valencia, Spain; (C.S.C.); (N.F.S.); (V.S.C.)
| | - Vicente Sifre Canet
- Hospital Veterinario de Referencia UCV, Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria y Ciencias Experimentales, Universidad Católica de Valencia San Vicente Mártir, 46018 Valencia, Spain; (C.S.C.); (N.F.S.); (V.S.C.)
| | - Claudio Iván Serra Aguado
- Hospital Veterinario de Referencia UCV, Departamento de Medicina y Cirugía Animal, Facultad de Veterinaria y Ciencias Experimentales, Universidad Católica de Valencia San Vicente Mártir, 46018 Valencia, Spain; (C.S.C.); (N.F.S.); (V.S.C.)
- Centro de Investigación Traslacional San Alberto Magno, Universidad Católica de Valencia San Vicente Mártir, 46002 Valencia, Spain
- Correspondence: (C.O.B.); (C.I.S.A.)
| |
Collapse
|
12
|
Serrani D, Sassaroli S, Gallorini F, Salvaggio A, Tambella AM, Biagioli I, Palumbo Piccionello A. Clinical and Radiographic Evaluation of Short- and Long-Term Outcomes of Different Treatments Adopted for Elbow Medial Compartment Disease in Dogs. Vet Sci 2022; 9:vetsci9020070. [PMID: 35202323 PMCID: PMC8880173 DOI: 10.3390/vetsci9020070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 12/04/2022] Open
Abstract
Medial compartment disease is a common occurrence in dogs affected by elbow dysplasia. Despite many treatments suggested in the literature, only few studies reported comparative outcomes in the short and long term. The aim of this study is to report and compare short- and long-term clinical and radiographic outcomes of dogs treated for medial compartment disease (MCD) by distal dynamic ulnar ostectomy (DUO), bi-oblique dynamic proximal ulnar osteotomy (BODPUO) and conservative management (CM). From 2016 to 2018, all medium to large dogs, aged between 5 and 12 months, affected by uni/bilateral MCD and treated by DUO, BODPUO or CM, were enrolled in this study and followed up for 24 months. Orthopedic and radiographic examinations were performed at T0, T2, T12 and T24 months after treatment. Lameness score, elbow arthralgia, elbow range of motion (ROM), osteoarthritis (OA) score and percentage of ulnar subtrochlear sclerosis (%STS) were evaluated at each time point. According to the treatment performed, dogs were divided into three groups: DUO, BODPUO and CM. Forty-five elbows from twenty-six dogs, treated with DUO (n = 17), BODPUO (n = 17) or CM (n = 11), were prospectively enrolled in the study. The patients enrolled in the CM group were older and showed more severe radiographic signs of OA, compared to those enrolled in the other two groups. Lameness and arthralgia scores (p < 10−4) were significantly decreased in patients that underwent surgical treatment and increased in patients managed conservatively (lameness p < 10−4, arthralgia p = 0.3068), at T12 and T24. OA score (p < 0.0040) and ROM (DUO, CM p < 10−4; BODPUO p = 0.0740) worsened in every study group, but %STS decreased in DUO (p = 0.0108), increased in the CM group (p = 0.0025) and remained unchanged in the BODPUO group (p = 0.2740). This study supports the clinical efficacy of DUO and BODPUO in reducing lameness, arthralgia and progression of %STS. Early diagnosis and surgical attention in patients affected by MCD can improve the short- and long-term outcome and reduce the progression of secondary changes.
Collapse
Affiliation(s)
- Daniele Serrani
- Southern Counties Veterinary Specialists, Forest Corner Farm, Hangersley, Ringwood, Hampshire BH24 3JW, UK
- Correspondence:
| | - Sara Sassaroli
- Scuola di Bioscienze e Medicina Veterinaria, Università Degli Studi di Camerino, 62024 Matelica, Italy; (S.S.); (A.M.T.); (A.P.P.)
| | - Francesco Gallorini
- Clinica Veterinaria San Silvestro, 52043 Castiglion Fiorentino, Italy; (F.G.); (A.S.); (I.B.)
| | - Alberto Salvaggio
- Clinica Veterinaria San Silvestro, 52043 Castiglion Fiorentino, Italy; (F.G.); (A.S.); (I.B.)
| | - Adolfo Maria Tambella
- Scuola di Bioscienze e Medicina Veterinaria, Università Degli Studi di Camerino, 62024 Matelica, Italy; (S.S.); (A.M.T.); (A.P.P.)
| | - Ilaria Biagioli
- Clinica Veterinaria San Silvestro, 52043 Castiglion Fiorentino, Italy; (F.G.); (A.S.); (I.B.)
| | - Angela Palumbo Piccionello
- Scuola di Bioscienze e Medicina Veterinaria, Università Degli Studi di Camerino, 62024 Matelica, Italy; (S.S.); (A.M.T.); (A.P.P.)
| |
Collapse
|
13
|
Renner C, Medl N. Computed tomographic assessment of the completeness of arthroscopic subtotal coronoidectomy in dogs with medial coronoid disease. Vet Rec 2021; 190:e1069. [PMID: 34743341 DOI: 10.1002/vetr.1069] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 07/16/2021] [Accepted: 10/03/2021] [Indexed: 11/11/2022]
Abstract
BACKGROUND Until recent years, arthroscopic subtotal coronoidectomy has been the universally accepted treatment for medial coronoid disease but has variable clinical outcomes. The aim of this study was to evaluate the completeness of arthroscopic medial coronoid debridement and to detect the most vulnerable location of failure. METHODS Eighty-three dogs with a diagnosis of medial coronoid disease were included in the study. Arthroscopic debridement was performed in 92 elbow joints, and the completeness of removal was assessed by postoperative computed tomography scans. RESULTS Pathological changes were confined to the coronoid apex in 92/92 (100%) of cases and combined with radial incisure lesions in 39/92 (42%). Apical lesions were completely removed in 66/92 (72%) of cases and radial incisure lesions in 2/39 (5%). Bony remnants were detected at the apex (46%) and base (24%) of the medial coronoid process, free within the elbow joint (9%), and/or within the instrument port (84%). Fissures were positively associated with the occurrence of bony remnants (p = 0.038) and a 37% higher probability of incomplete removal of radial incisure lesions (p = 0.001). CONCLUSION In this study, incomplete removal was more likely to occur in the presence of radial incisure lesions. Thorough assessment of this region during arthroscopy is strongly recommended.
Collapse
Affiliation(s)
- Carina Renner
- AniCura Kleintierklinik Babenhausen GmbH, Alpenstraße 27, Babenhausen, Bavaria, 87727, Germany
| | - Nikola Medl
- AniCura Kleintierklinik Babenhausen GmbH, Alpenstraße 27, Babenhausen, Bavaria, 87727, Germany
| |
Collapse
|
14
|
Danielski A, Krekis A, Yeadon R, Solano MA, Parkin T, Vezzoni A, Pfeil I. Complications after proximal abducting ulnar osteotomy and prognostic factors in 66 dogs. Vet Surg 2021; 51:136-147. [PMID: 34370337 PMCID: PMC9292888 DOI: 10.1111/vsu.13697] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 05/22/2021] [Accepted: 07/20/2021] [Indexed: 02/07/2023]
Abstract
Objective To report complications and prognostic factors in dogs undergoing proximal abducting ulnar osteotomy (PAUL). To evaluate the ability to predict complications on the basis of post‐operative radiographic examination. Study Design Retrospective cohort study. Animals Sixty‐six dogs. Methods Medical records of dogs treated with PAUL between 2014 and 2019 were reviewed for demographics, intraoperative findings, and post‐operative complications. Post‐operative radiographs were reviewed by two masked expert orthopedic surgeons, who were asked to predict the likelihood of major mechanical complications. The prognostic value of variables was tested with univariate and multivariable logistic regression. Inter‐investigator agreement to predict complications was evaluated with two‐by‐two tables and kappa coefficient. Results Seventy‐four PAULs in 66 dogs were included. Duration of follow‐up ranged from 12 to 75 months (median: 53 months). Post‐operative complications were documented in 19/74 limbs (16 dogs), including major complications in 13 limbs. These complications consisted mainly of non‐union (six limbs), implant failure (two limbs), and infection (two limbs) requiring revision surgery in nine limbs. Body weight was the only variable associated with an increased risk of post‐operative complications (p = .04). Agreement between expert predictions was low (respectively k = −0.08 and k = 0.11). Conclusion Major complications were reported in one fourth of limbs treated with PAUL and were more likely as body weight increased. Suboptimal plate and screw placement or osteotomy reduction on post‐operative radiographs were poorly predictive of complications. Clinical Significance Complications are fairly common after PAUL, particularly in heavier dogs, and post‐operative radiographic examination seems unreliable to predict those.
Collapse
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
| | | | | | | | - Tim Parkin
- Bristol Veterinary School, University of Bristol, Langford, UK
| | | | | |
Collapse
|
15
|
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.
Collapse
|
16
|
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.
Collapse
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
| |
Collapse
|
17
|
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.
Collapse
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
| |
Collapse
|
18
|
Coghill FJ, Ho-Eckart LK, Baltzer WI. Mid- to Long-Term Outcome after Arthroscopy and Proximal Abducting Ulnar Osteotomy Versus Arthroscopy Alone in Dogs with Medial Compartment Disease: Thirty Cases. Vet Comp Orthop Traumatol 2020; 34:85-90. [PMID: 33003225 DOI: 10.1055/s-0040-1716843] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to determine owner-assessed mid- to long-term outcome for dogs with medial compartment disease treated arthroscopically with fragment removal with or without proximal abducting ulnar osteotomy (PAUL). STUDY DESIGN This was a retrospective clinical study. MATERIALS AND METHODS Records from 30 dogs with medial compartment disease treated with arthroscopy with or without PAUL were retrospectively reviewed over a 5-year period. Proximal abducting ulnar osteotomy cases were matched to arthroscopy-alone controls based on bodyweight and modified Outerbridge score. Outcome was assessed via owner questionnaire using the Canine Brief Pain Inventory (CBPI), frequency of non-steroidal anti-inflammatory drug (NSAID) administration and owner-assessed overall improvement. RESULTS Canine Brief Pain Inventory score for dogs in the PAUL group was not significantly different from the control group (p = 0.54). Non-steroidal anti-inflammatory drug administration was similar between groups (p = 0.61) and there was no significant difference between modified Outerbridge score and outcome (p = 0.57) over a median of 43 months post-surgically (range: 7-66 months). Canine Brief Pain Inventory and NSAID use were affected by the age of the dog with dogs greater than 3 years of age at the time of surgery having a higher CBPI score and increased NSAID use regardless of the surgery that was performed. Overall, owner-assessed improvement was not different between groups (p = 0.72). CLINICAL SIGNIFICANCE Proximal abducting ulnar osteotomy showed no owner-assessed benefit over arthroscopic medial coronoid fragment removal for dogs with medial compartment disease and modified Outerbridge score of 3 or greater. A prospective, blinded, controlled clinical trial is warranted to determine the appropriate clinical application of the PAUL procedure.
Collapse
Affiliation(s)
| | | | - Wendy I Baltzer
- School of Veterinary Science, Massey University, Palmerston North, New Zealand
| |
Collapse
|
19
|
Martin SA, Kirby BM, Kelly G, Gilchrist MD, Milgram J. Force Distribution in the Canine Proximal Radio-Ulnar Joint on Extension of the Carpal Joint: A Cadaveric Study. Vet Comp Orthop Traumatol 2020; 33:402-408. [PMID: 32862413 DOI: 10.1055/s-0040-1715495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The aim of this study was to measure the load on the lateral and medial aspects of the proximal radio-ulnar joint during extension of the carpus. STUDY DESIGN This was an ex vivo biomechanical study. SAMPLE POPULATION Twenty-two cadaveric Greyhound thoracic limbs were used. METHODS Twenty-two paired thoracic limbs were used. The olecranon was attached to a custom jig with the foot resting on a stationary anvil. Load sensors were inserted into the proximal radio-ulnar joint, between the radial head and the lateral coronoid process, and between the radial head and the medial coronoid process. Specimens were tested under compression with measurements taken at 0, 4, 9 and 13.5 mm of axial displacement. Data collected at each point included forces on the specimen and medial and lateral coronoid processes as well as the angle of carpal joint extension. RESULTS A linear mixed effects model relating load on the specimen and carpal joint extension angle had an R-squared value of 0.66, and load at the level of the medial coronoid process and angle of carpal extension had an R-squared value of 0.61. There was a significant difference in the loads measured on the lateral and medial coronoid processes at all angles (p < 0.0001). CONCLUSION Extension of the carpus results in asymmetric loading of the proximal radio-ulnar joint. CLINICAL SIGNIFICANCE The findings of this study show that loading of the medial coronoid process may be more complex than originally thought and supports the future investigation of novel management and therapeutic options for affected patients.
Collapse
Affiliation(s)
- Stephen A Martin
- Department of Small Animal Surgery, Small Animal Clinical Studies Section, School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Barbara M Kirby
- Department of Small Animal Surgery, Small Animal Clinical Studies Section, School of Veterinary Medicine, University College Dublin, Belfield, Dublin, Ireland
| | - Gabrielle Kelly
- School of Mathematics and Statistics, University College Dublin, Belfield, Dublin, Ireland
| | - Michael D Gilchrist
- School of Mechanical and Materials Engineering, University College Dublin, Belfield, Dublin, Ireland
| | - Joshua Milgram
- Laboratory of Biomechanics, Koret School of Veterinary Medicine, Hebrew University of Jerusalem, Israel
| |
Collapse
|
20
|
Reicher B, Tichy A, Bockstahler B. Center of Pressure in the Paws of Clinically Sound Dogs in Comparison with Orthopedically Diseased Dogs. Animals (Basel) 2020; 10:ani10081366. [PMID: 32781721 PMCID: PMC7459534 DOI: 10.3390/ani10081366] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Revised: 08/01/2020] [Accepted: 08/03/2020] [Indexed: 11/16/2022] Open
Abstract
Simple Summary The analysis of the center of pressure is an important tool that allows conclusions to be drawn about the body balance of a patient. This balance can be altered by orthopedic or neurological diseases. To date, there are few data on the center of pressure in the paws of walking dogs. This study aimed to show the compensatory changes in the center of pressure parameters within the paw during stance-phase in the walking dog, with data being collected non-invasively by walking dogs with osteoarthritis and healthy dogs (control group) over a pressure platform. Differences in the center of pressure parameters were found between the affected and non-affected limbs of the diseased dogs, but also in comparison to the corresponding limbs of sound dogs. It was shown that dogs with osteoarthritis show different compensatory changes in the center of pressure parameters depending on whether a front or a hind limb are affected. This can reflect a compensatory redistribution of the body mass as well as compensatory changes of body balance. Based on these observations, a deeper investigation of the center of pressure within the paws of dogs would be of interest and a diagnostic application could become possible in the future. Abstract The center of pressure (COP) is recognized as a valuable tool for the assessment of orthopedic and neurologic disorders in humans. Relatively few studies are available in veterinary medicine, particularly concerning the COP in the individual paw. This study assessed the dynamic paw COP parameters during the stance phase of dogs with cox- or cubarthrosis (20 dogs each), as well as of 20 sound dogs. Data were obtained by walking over a pressure platform and analyzed within the diseased groups in comparison to the control group. Both diseased groups showed significant differences between the affected and non-affected limbs, but also in comparison to the reference limbs of sound animals. For coxathrosis, the primary increase was in the medio-lateral COP displacement and the COP area in both hind limbs. For cubarthrosis, the most prominent changes were an increase in the medio-lateral COP displacement in the ipsilateral hind limb and in the cranio-caudal COP displacement in the lame limb. Additionally, the COP area increased in both hind limbs. This can reflect a compensatory redistribution of the body mass as well as compensatory changes of body balance.
Collapse
Affiliation(s)
- Bianca Reicher
- Department of Companion Animals and Horses, University Clinic for Small Animals, Small Animal Surgery, Section of Physical Therapy, University of Veterinary Medicine, 1210 Vienna, Austria;
- Correspondence:
| | - Alexander Tichy
- Department of Biomedical Sciences, Platform of Bioinformatics and Biostatistics, University of Veterinary Medicine, 1210 Vienna, Austria;
| | - Barbara Bockstahler
- Department of Companion Animals and Horses, University Clinic for Small Animals, Small Animal Surgery, Section of Physical Therapy, University of Veterinary Medicine, 1210 Vienna, Austria;
| |
Collapse
|
21
|
Wennemuth J, Tellhelm B, Eley N, von Pückler K. Computed Tomography Enhances Diagnostic Accuracy in Challenging Medial Coronoid Disease Cases: An Imaging Study in Dog Breeding Appeal Cases. Vet Comp Orthop Traumatol 2020; 33:356-362. [PMID: 32712948 DOI: 10.1055/s-0040-1714299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES The aim of this study was to determine the radiographic sensitivity in detecting medial coronoid disease (MCD), using computed tomography (CT) as reference in dogs presented for an official second opinion, and to compare the medial coronoid process (MCP) in fragmented and fissured MCP as well as those unaffected by MCD. MATERIALS AND METHODS The data of dogs, presented for official second opinion radiographs and CT, were reviewed by three board-certified observers and in accordance with the International Elbow Working Group guidelines regarding MCD. Radiographic delineation, radiopacity and Hounsfield Units (HU) of the MCP were recorded additionally and the correlation between radiography and CT was investigated. RESULTS Sensitivity and specificity of radiography compared with CT yielded values of 83.6% for the former and 83.5% for the latter. False-negative grading in radiography correlated significantly (p = 0.0001) with a present fissure line in CT. The mean delineation (p = 0.03) and mean HU of fragmented MCP (p = 0.0045) were significantly reduced compared with fissured MCP and no significant differences in measured HU for fissured MCP were detected in comparison to elbows unaffected by MCD. CONCLUSION The results of the present study show substantial agreement between radiography and CT in second opinion cases. However, sensitivity is reduced compared with not preselected cases. A present fissure line in CT was significantly associated with a false-negative grading in radiography. Therefore, CT imaging of the elbows is strongly recommended in cases of appeal.
Collapse
Affiliation(s)
- Jan Wennemuth
- Department of Radiology, Justus-Liebig-Universität Gießen, Giessen, Germany
| | - Bernd Tellhelm
- Department of Radiology, Justus-Liebig-Universität Gießen, Giessen, Germany
| | - Nele Eley
- Department of Radiology, Justus-Liebig-Universität Gießen, Giessen, Germany
| | | |
Collapse
|
22
|
O'Neill DG, Brodbelt DC, Hodge R, Church DB, Meeson RL. Epidemiology and clinical management of elbow joint disease in dogs under primary veterinary care in the UK. Canine Med Genet 2020; 7:1. [PMID: 32835227 PMCID: PMC7371807 DOI: 10.1186/s40575-020-0080-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 02/05/2020] [Indexed: 11/10/2022] Open
Abstract
Background Conditions affecting the elbow joint are a common cause of lameness in dogs. Primary-care veterinary clinical data are now recognised as a valuable research resource. Using data from the VetCompass Programme, this study aimed to report the frequency and risk factors for elbow joint disease in dogs under primary veterinary care in the UK and describe clinical management. Results From 455,069 dogs under veterinary care, the one-year period prevalence for elbow joint disease diagnosis was 0.56% (95% CI: 0.53-0.60). Of 616 incident cases, the most common specific variants of elbow joint disease were osteoarthritis (n = 468, 75.97%), elbow dysplasia (190, 30.84%) and traumatic (41, 6.66%). The most common signs described by the owners were lameness (n = 466, 75.65%), difficulty exercising (123, 19.97%) and pain (86, 13.96%). The most common findings recorded on veterinary examination were pain (n = 283, 45.94%), lameness (278, 45.13%) and reduced range of movement (243, 39.45%). Common medications used included non-steroidal anti-inflammatory drugs (n = 544, 88.31%), tramadol (121, 19.64%) and disease modifying agents (118, 19.16%). Of 109 deaths involving euthanasia with information available from the 616 incident cases, elbow joint disease contributed to the decision to euthanase in 45 (41.28%) dogs.Five breeds showed increased odds of elbow joint disease compared with crossbred dogs: Rottweiler (OR: 6.16, 95% CI 3.89-9.75), Labrador Retriever (OR: 5.94, 95% CI 4.65-7.60), German Shepherd Dog (OR: 4.13, 95% CI 2.88-5.93), Golden Retriever (OR: 3.11, 95% CI 1.93-5.00) and English Springer Spaniel (OR: 2.00, 95% CI 1.26-3.18). Additional risk factors included having an adult bodyweight that was equal or higher than their breed/sex mean, advancing age, being male, being neutered, being insured and larger bodyweight. Conclusions Elbow joint disease is a relatively common diagnosis in dogs and has a high welfare impact as evidenced by the high proportion of cases recorded with pain, lameness and analgesic therapy. There are strong breed predispositions, in particular for large breed dogs. These findings present a clear case for improved breeding programmes to reduce the burden of elbow joint disease.
Collapse
Affiliation(s)
- Dan G O'Neill
- Production and Population Health, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA UK
| | - Dave C Brodbelt
- Production and Population Health, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA UK
| | - Rebecca Hodge
- Production and Population Health, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA UK
| | - David B Church
- Clinical Sciences and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA UK
| | - Richard L Meeson
- Clinical Sciences and Services, The Royal Veterinary College, Hawkshead Lane, North Mymms, Hatfield, Herts AL9 7TA UK
| |
Collapse
|
23
|
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.
Collapse
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
| |
Collapse
|
24
|
Veksins A, Kozinda O, Sandersen C. Computed tomographic morphometry of the biceps brachii muscle tendon of dogs affected by the medial coronoid disease. Anat Histol Embryol 2019; 49:196-202. [PMID: 31709577 DOI: 10.1111/ahe.12513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 09/30/2019] [Accepted: 10/21/2019] [Indexed: 12/01/2022]
Abstract
The objective of this study was to measure the biceps brachii muscle (BBM) attachment to the medial coronoid process (MCP) using computed tomography images and to compare these data between clinically healthy and dogs affected by medial coronoid disease (MCD). Computed tomography was performed in MCD-affected and healthy dogs. Multiplanar reconstruction views were obtained to measure distance (cm) of the BBM attachment point to the MCP. Results showed that the mean BBM attachment point-to-MCP was 1.42 ± 0.23 cm in MCD-affected and 1.27 ± 0.20 cm in healthy dogs, respectively. In dogs with MCD, the BBM attachment point-to-MCP was significantly more abaxial than in clinically healthy dogs (p < .001). The results of this study support the hypothesis that the BBM attachment site is more abaxial to the MCP and therefore may contribute to supraphysiological overload leading to MCD. Albeit more research is necessary, this study proves a relationship between the BBM attachment point and the development of MCD.
Collapse
Affiliation(s)
- Armands Veksins
- Latvia University Life Sciences and Technologies, Jelgava, Latvia
| | - Oskars Kozinda
- Latvia University Life Sciences and Technologies, Jelgava, Latvia
| | - Charlotte Sandersen
- Latvia University Life Sciences and Technologies, Jelgava, Latvia.,The University of Liege, Liege, Belgium
| |
Collapse
|
25
|
Mostafa AA, Nolte I, Wefstaedt P. Radiographic determination of humeroradial, humeroulnar, and radioulnar subluxation indices to quantify elbow incongruence in dogs confirmed to have medial coronoid disease. Res Vet Sci 2019; 126:83-88. [PMID: 31442716 DOI: 10.1016/j.rvsc.2019.08.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Revised: 08/07/2019] [Accepted: 08/12/2019] [Indexed: 11/19/2022]
Abstract
Medial coronoid disease and elbow incongruence are common orthopedic problems causing forelimb lameness in large breed dogs. Therefore, the objective of this retrospective clinical study is to radiographically quantify the incongruity of humeroradial, humeroulnar, and radioulnar joints in dogs with confirmed medial coronoid disease compared to controls. Sixty-six (93 elbows) control and 73 (113 elbows) diseased Labrador and Golden Retrievers were enrolled. Our objective was achieved by measuring the central humeroradial, humeroulnar, and radioulnar distances and calculating the corresponding subluxation index of each joint on the extended mediolateral elbow radiograph. The traditional radioulnar step was also measured on the same mediolateral projection. Variables were compared between control and diseased groups, and the significance level was P < .05. The central humeroradial, humeroulnar, and radioulnar distances and corresponding subluxation indices increased significantly (P ≤ .007) in elbows with confirmed medial coronoid disease compared to controls. Radioulnar step increased significantly (P < .0001) in diseased elbows. Elbow incongruence, manifested by increased humeroradial, humeroulnar, and radioulnar subluxation indices, appeared to be consistent with medial coronoid disease in Labrador and Golden Retrievers. An elbow with a humeroradial, humeroulnar, or radioulnar subluxation index >0.15, 0.10, or 0.14, respectively, or radioulnar step >1.4 mm, is more likely to be incongruent and may have a concomitant coronoid disease. However, future validation of the reported measurements is still warranted.
Collapse
Affiliation(s)
- Ayman A Mostafa
- Small Animal Hospital, College of Veterinary Medicine, Cairo University, Egypt
| | - Ingo Nolte
- Small Animal Hospital, University of Veterinary Medicine, Hannover, Foundation, Germany.
| | - Patrick Wefstaedt
- Small Animal Hospital, University of Veterinary Medicine, Hannover, Foundation, Germany
| |
Collapse
|
26
|
Bayer K, Winkels P, Andreoni AA, Schmierer P, Rohwedder T, Pozzi A, Böttcher P. Complications and short-to-midterm results in a case series of 52 CUE procedures using a modified caudo-medial approach. Open Vet J 2019; 9:205-215. [PMID: 31998613 PMCID: PMC6794397 DOI: 10.4314/ovj.v9i3.4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 07/05/2019] [Indexed: 11/17/2022] Open
Abstract
Background: Medial coronoid process disease is the most common manifestation of canine developmental elbow disease which can progress to a more severe medial compartment disease (MCompD) characterized by full-thickness cartilage loss of the medial coronoid process and the medial humeral condyle. Among others, the “Canine Unicompartmental Elbow” (CUE) has been reported to be an effective treatment strategy for MCompD, with full in 47.6% and acceptable function in 43.7% at 6 months or later of follow-up. Aim: To report on our clinical experiences with the CUE system using the caudo-medial approach in terms of both complications and functional outcome. Methods: Medical records of dogs that underwent CUE procedure using a caudo-medial approach over a 3-year period were retrospectively reviewed. This covered epidemiological data, bi-planar radiographs, subjective gait analysis, owner questionnaire, surgical reports, as well as second-look arthroscopic findings when available. Results: In total, 52 CUE procedures were performed in 44 dogs with a median age of 8.0 years (IQ: 5.0–10.0) and a median bodyweight of 31.9 kg (ranging 20–48 kg) at the surgery. Four cases never return for follow-up, but were included in the analysis to increase the number of cases with pre- and intra-operative data. Mean follow-up time available for the remaining 48 cases was 7.1 (SD: 5.2) months. Radiographic derived implant positioning and alignment proved to be satisfactory in the sagittal plane but parallelism in the frontal plane was only present in three cases. Second-look arthroscopy in five cases with delayed or disappointing functional improvement showed evidence of implant-related contact lesions and progressive erosion of the medial coronoid area in three elbows. Overall, complications occurred in 11 cases (21%), being major in eight (15%) and minor in three (6%). Major complications included refractory pain and lameness 6 to 12 months postoperatively in five cases. At last follow-up, 12 cases (25%) were considered to have full function, 35 cases (73%) acceptable function, and in one case, the function was considered unacceptable. As the only variable related to functional outcome, age had a negative predictive value for full function. Conclusion: The CUE procedure appears to be an effective treatment option for patients with MCompD. Older dogs might be at risk of having an inferior clinical outcome when compared to young patients. The reason for this is unknown and will have to be evaluated in future studies. Compared to a CUE case series of 103 elbows operated through a medial approach, using a caudo-medial approach decreased the incidence of approach-related complication. Nevertheless, the functional outcome in the current case series was less favorable than previously reported. These conflicting findings as well as the occurrence of potentially implant mechanical conflict at the medial joint compartment despite CUE warrants further studies.
Collapse
Affiliation(s)
- Karol Bayer
- Small Animal Clinic, Free University of Berlin, Berlin, Germany
| | | | | | - Philipp Schmierer
- Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | | | - Antonio Pozzi
- Clinic for Small Animal Surgery, Vetsuisse Faculty University of Zurich, Zurich, Switzerland
| | - Peter Böttcher
- Small Animal Clinic, Free University of Berlin, Berlin, Germany
| |
Collapse
|
27
|
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.
Collapse
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
| |
Collapse
|
28
|
Krier EM, Johnson TA, Breiteneicher AH, Peycke LE, Hulse DA. Articular cartilage lesions associated with complete lateral meniscal tears in the dog. Vet Surg 2018; 47:958-962. [PMID: 30242858 DOI: 10.1111/vsu.12961] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 06/21/2018] [Accepted: 08/09/2018] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To describe articular cartilage (AC) lesions associated with complete lateral meniscal tears in dogs. STUDY DESIGN Observational series. ANIMALS Seventeen dogs with arthroscopic evidence of a complete lateral meniscal tear and associated AC lesions. METHODS Medical records of dogs with arthroscopic evidence of complete lateral meniscal tear and associated AC lesions between March 2006 and December 2017 were examined for arthroscopic findings. RESULTS The cranial cruciate ligament (CrCL) was intact in 11 of 17 dogs, partially ruptured but competent in 4 of 17 dogs, and completely ruptured in 2 of 17 dogs. All dogs had grossly normal caudal cruciate ligament, medial meniscus, and AC of the medial compartment. In each dog, a complete radial tear of the caudal body of the lateral meniscus was associated with degenerative osteoarthritis (OA) of the lateral compartment of the stifle. The Outerbridge score of the lateral tibial condyle and lateral femoral condyle was 5 of 5 in 15 dogs, 3 of 5 in 1 dog, and 4 of 5 in 1 dog. CONCLUSION Dogs with complete tears of the lateral meniscus developed degenerative OA of the lateral compartment of the stifle leading to AC loss and clinical dysfunction. CLINICAL SIGNIFICANCE Complete lateral meniscal tears may occur as isolated injuries in dogs with a functional CrCL.
Collapse
Affiliation(s)
| | | | | | - Laura E Peycke
- Texas A&M University College of Veterinary Medicine, College Station, Texas
| | - Don A Hulse
- Austin Veterinary Emergency and Specialty Center, Austin, Texas.,Texas A&M University College of Veterinary Medicine, College Station, Texas
| |
Collapse
|
29
|
Mostafa A, Nolte I, Wefstaedt P. The prevalence of medial coronoid process disease is high in lame large breed dogs and quantitative radiographic assessments contribute to the diagnosis. Vet Radiol Ultrasound 2018; 59:516-528. [DOI: 10.1111/vru.12632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2017] [Revised: 02/22/2018] [Accepted: 03/08/2018] [Indexed: 11/29/2022] Open
Affiliation(s)
- Ayman Mostafa
- Small Animal Hospital; College of Veterinary Medicine, Cairo University; Giza Egypt
| | - Ingo Nolte
- Small Animal Hospital; University of Veterinary Medicine, Hannover, Foundation; Hannover Germany
| | - Patrick Wefstaedt
- Small Animal Hospital; University of Veterinary Medicine, Hannover, Foundation; Hannover Germany
| |
Collapse
|
30
|
Carrillo JM, Manera ME, Rubio M, Sopena J, Santana A, Vilar JM. Posturography and dynamic pedobarography in lame dogs with elbow dysplasia and cranial cruciate ligament rupture. BMC Vet Res 2018; 14:108. [PMID: 29573740 PMCID: PMC5866518 DOI: 10.1186/s12917-018-1435-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 03/16/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The usefulness of studying posture and its modifications due to locomotor deficiencies of multiple origins has been widely proven in humans. To assess its suitability in the canine species, static posturography and dynamic pedobarography were performed on lame dogs affected with unilateral elbow dysplasia and cranial cruciate ligament rupture by using a pressure platform. With this objective, statokinesiograms and stabilograms, the percentage of pressure distribution between limbs, paw area, mean pressure, and peak pressure, were obtained from lame and sound dogs. These data were compared with Peak Vertical Force values originated from a force platform in the same recording sessions. RESULTS Significant differences were found in the parameters mentioned above between sound and lame dogs and limbs. CONCLUSIONS Posturography and pedobarography are useful and reliable for the monitoring of fore and hindlimb lameness in dogs, providing a new set of parameters for lameness detection.
Collapse
Affiliation(s)
- José M Carrillo
- Departamento Medicina y Cirugía Animal, Cátedra García Cugat, Universidad CEU Cardenal Herrera, Valencia, Spain
| | - Maria E Manera
- Departamento de Patología Animal, Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de las Palmas de Gran Canaria, Arucas, Las Palmas, Spain
| | - Mónica Rubio
- Departamento Medicina y Cirugía Animal, Cátedra García Cugat, Universidad CEU Cardenal Herrera, Valencia, Spain
| | - Joaquin Sopena
- Departamento Medicina y Cirugía Animal, Cátedra García Cugat, Universidad CEU Cardenal Herrera, Valencia, Spain
| | - Angelo Santana
- Departamento de Matemáticas, Universidad de las Palmas de Gran Canaria, Las Palmas, Spain
| | - José M Vilar
- Departamento de Patología Animal, Instituto Universitario de Investigaciones Biomédicas y Sanitarias, Universidad de las Palmas de Gran Canaria, Arucas, Las Palmas, Spain.
| |
Collapse
|
31
|
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
| |
Collapse
|
32
|
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.
Collapse
|
33
|
Erosion of the medial compartment of the canine elbow: occurrence, diagnosis and currently available treatment options. Vet Comp Orthop Traumatol 2017; 28:9-18. [DOI: 10.3415/vcot-13-12-0147] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2013] [Accepted: 10/23/2014] [Indexed: 11/17/2022]
Abstract
SummaryErosion of the medial compartment of the elbow joint refers to full thickness cartilage loss with exposure of the subchondral bone (modified Outerbridge grades 4–5) of the medial part of the humeral condyle (MHC) and the corresponding ulnar contact area. This finding may appear in the absence of an osteochondral fragment or a cartilage flap, or in combination with fragmentation of the medial coronoid process (MCP) or osteochondritis dissecans (OCD) of the MHC. With regard to the prognosis, it is important to diagnose these severe erosions. Imaging of cartilage lesions by means of radiography, ultrasonography, computed tomography or magnetic resonance imaging is challenging in dogs. In contrast, direct arthroscopic inspection provides detailed information about the cartilage.The treatment of these severe erosions is difficult because of the limited regenerative capacity of cartilage and presumed mechanical or physical triggering factors. Several conservative and surgical treatment methods have been proposed to treat elbows with severe cartilage defects. However, due to irreversible loss of cartilage, the prognosis in these cases remains guarded.
Collapse
|
34
|
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.
Collapse
|
35
|
Diagnostic intra-articular anaesthesia of the elbow in dogs with medial coronoid disease. Vet Comp Orthop Traumatol 2017; 25:307-13. [DOI: 10.3415/vcot-11-11-0166] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2011] [Accepted: 03/27/2012] [Indexed: 11/17/2022]
Abstract
SummaryObjective: Assessment of the effect of intraarticular anaesthesia on lameness caused by medial coronoid disease.Methods: This study included 90 dogs that were evaluated for the complaint of unilateral forelimb lameness. All dogs were suspected of having an elbow problem for which orthopaedic examination and radiographs showed inconclusive findings. Following a short sedation, mepivacaine was injected intra-articularly to determine whether lameness was caused by a suspected elbow problem. This effect was compared with the final diagnosis based on computed tomography and arthroscopy.Results: Out of 90 dogs, 78 (87%) dogs had an improvement of lameness after injection of the local anaesthetic, which confirmed the elbow joint as the primary source of lameness. A positive response was seen in all types of medial coronoid lesions. A false negative result was observed in 12 dogs (13%).Clinical relevance: Medial coronoid disease is represented by different types of pathologic lesions including chondromalacia, fissures, fragments, and medial compartment disease. Diagnosis may be difficult because of limited clinical or radiographic signs or a combination of both. Intra-articular anaesthesia can be a helpful diagnostic tool to localize the problem by eliminating pain and reducing lameness to a great extent in all types of coronoid lesions.
Collapse
|
36
|
Rogatko CP, Warnock JJ, Bobe G, Verpaalen VD. Comparison of iatrogenic articular cartilage injury in canine stifle arthroscopy versus medial parapatellar mini-arthrotomy in a cadaveric model. Vet Surg 2017; 47:O6-O14. [DOI: 10.1111/vsu.12736] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 06/13/2017] [Accepted: 07/06/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Cleo P. Rogatko
- Department of Clinical Sciences, College of Veterinary Medicine; Oregon State University; Corvallis Oregon
| | - Jennifer J. Warnock
- Department of Clinical Sciences, College of Veterinary Medicine; Oregon State University; Corvallis Oregon
| | - Gerd Bobe
- Department of Rangeland Sciences and The Linus Pauling Institute; Oregon State University; Corvallis Oregon
| | - Valentine D. Verpaalen
- Department of Clinical Sciences, College of Veterinary Medicine; Oregon State University; Corvallis Oregon
| |
Collapse
|
37
|
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.
Collapse
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
| |
Collapse
|
38
|
Mineral status in canine medial coronoid process disease: a cohort study using analysis of hair by mass spectrometry. Vet Rec 2017; 180:448. [DOI: 10.1136/vr.103953] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2017] [Indexed: 11/03/2022]
|
39
|
Franklin SP, Burke EE, Holmes SP. Utility of MRI for Characterizing Articular Cartilage Pathology in Dogs with Medial Coronoid Process Disease. Front Vet Sci 2017; 4:25. [PMID: 28286752 PMCID: PMC5323379 DOI: 10.3389/fvets.2017.00025] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2016] [Accepted: 02/10/2017] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE To determine whether assessment of morphological MRI sequences or delayed gadolinium-enhanced MRI of cartilage (dGEMRIC) would have strong correlations with arthroscopic assessment of cartilage pathology in dogs with naturally occurring medial compartment pathology of the elbow. METHODS Dogs tentatively diagnosed with medial coronoid disease had evaluation of their affected elbows using radiography, morphological MRI sequences, and dGEMRIC MRI evaluation prior to arthroscopy. Elbow radiographs were graded 0-6 for severity of changes. Cartilage of the medial coronoid process (MCP) and humeral trochlea (HT) were scored on a 0-3 scale using anatomical MRI sequences. The T1 relaxation times for the MCP and trochlea were quantified using dGEMRIC. Cartilage pathology was graded arthroscopically using a modified Outerbridge score (MOS) by a surgeon blinded to MRI assessment. Correlations between radiography and MOS, and between MRI and MOS, were quantified. RESULTS Twenty-six elbows in 14 dogs were evaluated. There were statistically significant (p < 0.05) moderate correlations between radiographic scores and MOS for the MCP (r = 0.71) and HT (0.57). There was a statistically significant moderate correlation between morphological MRI scoring and MOS for the HT (r = 0.54; p < 0.05), but not for the MCP (p > 0.05). There was a weak, but significant correlation, between the dGEMRIC value and MOS of the MCP (r = 0.41; p < 0.05), but no correlation between the dGEMRIC values and MOS for the HT (p > 0.05). CLINICAL RELEVANCE Statistically significant correlations to MOS were identified for both radiography and MRI but neither diagnostic modality provided sufficiently strong correlations to serve as a substitute for arthroscopic evaluation of the articular cartilage.
Collapse
Affiliation(s)
- Samuel P Franklin
- Department of Small Animal Medicine and Surgery, Veterinary Teaching Hospital, University of Georgia, Athens, GA, USA; Regenerative Bioscience Center, University of Georgia, Athens, GA, USA
| | - Emily E Burke
- Veterinary Biosciences and Diagnostic Imaging, University of Georgia , Athens, GA , USA
| | - Shannon P Holmes
- Veterinary Biosciences and Diagnostic Imaging, University of Georgia , Athens, GA , USA
| |
Collapse
|
40
|
Oberbauer AM, Keller GG, Famula TR. Long-term genetic selection reduced prevalence of hip and elbow dysplasia in 60 dog breeds. PLoS One 2017; 12:e0172918. [PMID: 28234985 PMCID: PMC5325577 DOI: 10.1371/journal.pone.0172918] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Accepted: 02/10/2017] [Indexed: 11/24/2022] Open
Abstract
Canine hip dysplasia (CHD) and elbow dysplasia (ED) impact the health and welfare of all dogs. The first formally organized assessment scheme to improve canine health centered on reducing the prevalence of these orthopedic disorders. Phenotypic screening of joint conformation remains the currently available strategy for breeders to make selection decisions. The present study evaluated the efficacy of employing phenotypic selection on breed improvement of hips and elbows using the Orthopedic Foundation for Animals complete database spanning the 1970–2015 time period. Sixty breeds having more than 1000 unique hip evaluations and 500 elbow evaluations (1,056,852 and 275,129 hip and elbow records, respectively) were interrogated to derive phenotypic improvement, sex and age at time of assessment effects, correlation between the two joints, heritability estimates, estimated breeding values (EBV), and effectiveness of maternal/paternal selection. The data demonstrated that there has been overall improvement in hip and elbow conformation with a reduction in EBV for disease liability, although the breeds differed in the magnitude of the response to selection. Heritabilities also differed substantially across the breeds as did the correlation of the joints; in the absence of a universal association of these differences with breed size, popularity, or participation in screening, it appears that the breeds themselves vary in genetic control. There was subtle, though again breed specific, impact of sex and older ages on CHD and ED. There was greater paternal impact on a reduction of CHD. In the absence of direct genetic tests for either of these two diseases, phenotypic selection has proven to be effective. Furthermore, the data underscore that selection schemes must be breed specific and that it is likely the genetic profiles will be unique across the breeds for these two conditions. Despite the advances achieved with phenotypic selection, incorporation of EBVs into selection schemes should accelerate advances in hip and elbow improvement.
Collapse
Affiliation(s)
- A M Oberbauer
- Department of Animal Science, University of California, Davis, Davis, CA United States of America
| | - G G Keller
- Orthopedic Foundation for Animals, Columbia, MO United States of America
| | - T R Famula
- Department of Animal Science, University of California, Davis, Davis, CA United States of America
| |
Collapse
|
41
|
Bonilla AG, Bertone AL, Brokken MT, Santschi EM. Concurrent or sequential tibial subchondral cystic lesions in 4 horses with medial femoral condyle subchondral cystic lesions. J Am Vet Med Assoc 2016; 249:1313-1318. [DOI: 10.2460/javma.249.11.1313] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
|
42
|
Traumatic fracture of the medial coronoid process in 24 dogs. Vet Comp Orthop Traumatol 2016; 29:325-9. [PMID: 27102430 DOI: 10.3415/vcot-15-09-0154] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2015] [Accepted: 03/21/2016] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To describe traumatic fracture of the medial coronoid process in dogs as a clinically distinct disease unrelated to congenital elbow dysplasia. METHODS Clinical records of dogs with acute, traumatic, unilateral lameness attributable to medial coronoid process disease were reviewed retrospectively. Clinical interpretation included findings on physical examination, orthopaedic examination, and subjective gait analysis. Radiographs of the affected and contralateral elbows were obtained and reviewed for pathology. Arthroscopy of the elbow joints was performed by one of three surgeons and findings were compared to preoperative diagnostics. Postoperative follow-up was continued for 16 weeks. RESULTS Twenty-four dogs were included in this study. All dogs in this study were free of radiographic evidence of medial coronoid pathology. All dogs were diagnosed with a single, large, displaced or non-displaced fracture of the medial coronoid process, with no other joint pathology. Dogs generally had an excellent short-term outcome following arthroscopic treatment of the fractured medial coronoid process. CLINICAL SIGNIFICANCE Traumatic fracture of the medial coronoid process should be considered a clinical disease distinct from dysplasia-related fragmentation and should be considered as a differential diagnosis in dogs that are presented with the complaint of acute unilateral elbow discomfort or lameness, especially after concussive activities involving the forelimb. .
Collapse
|
43
|
Hans EC, Saunders WB, Beale BS, Hulse DA. Fragmentation of the Medial Coronoid Process in Toy and Small Breed Dogs: 13 Elbows (2000-2012). J Am Anim Hosp Assoc 2016; 52:234-41. [PMID: 27259019 DOI: 10.5326/jaaha-ms-6295] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Fragmentation of the medial coronoid process (FCP) is an uncommon cause of thoracic limb lameness in toy and small breed dogs. Arthroscopic findings and treatment remains poorly described. The objective of this study was to describe the arthroscopic findings and short-term outcome following arthroscopic treatment in toy and small breed dogs with FCP. Medical records were retrospectively reviewed. Arthroscopic findings were available from 13 elbows (12 dogs). Outcome data ≥4 wk postoperatively were available for nine elbows. Owner satisfaction scores were available for 10 elbows. Common preoperative findings included lameness, elbow pain, and imaging abnormalities consistent with FCP. Displaced FCP was the most common FCP lesion identified. Cartilage lesions at the medial coronoid process were identified in 92.3% of elbows (n = 12), with a median Outerbridge score of 4 (range 1-5). Concurrent cartilage lesions of the medial humeral condyle were identified in 76.9% of elbows (n = 10). Seven of nine elbows had full or acceptable function postoperatively. Median owner outcome satisfaction was 91% (range 10-100). FCP should be considered a cause of thoracic limb lameness in toy and small breed dogs. Arthroscopy can be safely and effectively used to diagnose and treat FCP in these breeds.
Collapse
Affiliation(s)
- Eric C Hans
- From the Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX (W.B.S., D.A.H., E.C.H.); Capital Area Veterinary Specialists, Austin, TX (D.A.H.); and Gulf Coast Veterinary Specialists, Houston, TX (B.S.B.)
| | - W Brian Saunders
- From the Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX (W.B.S., D.A.H., E.C.H.); Capital Area Veterinary Specialists, Austin, TX (D.A.H.); and Gulf Coast Veterinary Specialists, Houston, TX (B.S.B.)
| | - Brian S Beale
- From the Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX (W.B.S., D.A.H., E.C.H.); Capital Area Veterinary Specialists, Austin, TX (D.A.H.); and Gulf Coast Veterinary Specialists, Houston, TX (B.S.B.)
| | - Don A Hulse
- From the Department of Veterinary Small Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, TX (W.B.S., D.A.H., E.C.H.); Capital Area Veterinary Specialists, Austin, TX (D.A.H.); and Gulf Coast Veterinary Specialists, Houston, TX (B.S.B.)
| |
Collapse
|
44
|
Knapp JL, Tomlinson JL, Fox DB. Classification of Angular Limb Deformities Affecting the Canine Radius and Ulna Using the Center of Rotation of Angulation Method. Vet Surg 2016; 45:295-302. [PMID: 27011252 DOI: 10.1111/vsu.12460] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2014] [Accepted: 07/09/2015] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To classify the type of angular deformity affecting the radius and ulna in canine limbs using the center of rotation of angulation methodology. STUDY DESIGN Retrospective case series. ANIMALS Dogs (n=71) diagnosed with thoracic limb lameness attributable to antebrachial angular limb deformities. METHODS Medical records from 2006-2013 were searched and cases with orthogonal radiographs or computed tomographic scans of the affected antebrachium were included. Classification of the deformity in the frontal plane and the presence of sagittal plane angulation, torsion, and adjacent joint radiographic disease were determined and compared. RESULTS Chondrodystrophic (n=26; 44 limbs) and non-chondrodystrophic (n=45; 62 limbs) dogs were included. Thirty-five uniapical and 71 biapical or multiapical deformities in the frontal plane were identified. The incidence of biapical deformities was statistically higher in chondrodystrophic compared to non-chondrodystrophic dogs (P=.02). When breeds were combined, biapical deformities were associated with a significantly higher incidence of adjacent radiographic joint disease (P=.049), more frequently affecting the elbow (P=.022). Overall, 82% of the 106 limbs had radiographic evidence of either elbow or carpal joint disease at the time of presentation. CONCLUSION Biapical deformities are common in dogs with limb deformities, particularly chondrodystrophic dogs. Radiographic evidence of disease in adjacent joints should be evaluated in patients presenting for antebrachial deformities.
Collapse
Affiliation(s)
- Jessica L Knapp
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri
| | - James L Tomlinson
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri
| | - Derek B Fox
- Department of Veterinary Medicine and Surgery, College of Veterinary Medicine, University of Missouri, Columbia, Missouri
| |
Collapse
|
45
|
McConkey MJ, Valenzano DM, Wei A, Li T, Thompson MS, Mohammed HO, van der Meulen MCH, Krotscheck U. Effect of the Proximal Abducting Ulnar Osteotomy on Intra-Articular Pressure Distribution and Contact Mechanics of Congruent and Incongruent Canine Elbows Ex Vivo. Vet Surg 2016; 45:347-55. [DOI: 10.1111/vsu.12456] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Accepted: 06/12/2015] [Indexed: 11/28/2022]
Affiliation(s)
| | | | - Alexander Wei
- Sibley School of Mechanical and Aerospace Engineering; Cornell University; Ithaca New York
| | - Ting Li
- Sibley School of Mechanical and Aerospace Engineering; Cornell University; Ithaca New York
| | | | | | | | - Ursula Krotscheck
- Department of Clinical Sciences; Cornell University; Ithaca New York
| |
Collapse
|
46
|
Fitzpatrick N, Garcia TC, Daryani A, Bertran J, Watari S, Hayashi K. Micro-CT Structural Analysis of the Canine Medial Coronoid Disease. Vet Surg 2016; 45:336-46. [DOI: 10.1111/vsu.12449] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
| | - Tanya C. Garcia
- JD Wheat Veterinary Orthopedic Research Laboratory; University of California, Davis; Davis California
| | - Anjolie Daryani
- JD Wheat Veterinary Orthopedic Research Laboratory; University of California, Davis; Davis California
| | - Judith Bertran
- Department of Veterinary Clinical Sciences; The Ohio State University Veterinary Medical Center; Columbus Ohio
| | - Shinya Watari
- JD Wheat Veterinary Orthopedic Research Laboratory; University of California, Davis; Davis California
| | - Kei Hayashi
- Department of Clinical Sciences; Cornell University College of Veterinary Medicine; Ithaca New York
| |
Collapse
|
47
|
Intra-articular implantation of gentamicin impregnated collagen sponge causes joint inflammation and impaired renal function in dogs. Vet Comp Orthop Traumatol 2016; 29:159-63. [PMID: 26898340 DOI: 10.3415/vcot-15-05-0088] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 11/20/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Gentamicin impregnated collagen sponge (GICS) can be used to treat intra-articular surgical site infections. High local concentrations of gentamicin can be reached for short periods; however the collagen vehicle may persist for much longer periods. We wished to determine the effect of sponge implantation on joint inflammation and renal function. METHODS Eighteen medium sized mixed breed research dogs of hound type were randomized to two groups; arthroscopic implantation of GICS at gentamicin dose = 6 mg/kg (n = 9) or sham operation (n = 9). Endpoints consisted of joint inflammation measured by synovial fluid cell counts and cytokine concentrations; lameness measured by force plate asymmetry indices; and renal function measured by glomerular filtration rate (GFR) study. The prevalence of lesions associated with aminoglycoside nephrotoxicity was assessed by renal biopsy and transmission electron microscopy. RESULTS Gentamicin impregnated collagen sponge implantation caused joint inflammation (p <0.01), lameness (p = 0.04), and decreased GFR (p = 0.04). No difference was observed in the prevalence of renal lesions on biopsy between the treatment and control groups (p = 0.49). CLINICAL SIGNIFICANCE Gentamicin impregnated collagen sponge implantation causes joint inflammation and lameness as well as GFR reductions at the dose assessed. Gentamicin impregnated collagen sponge are not recommended for intra-articular implantation in dogs.
Collapse
|
48
|
Coppieters E, Seghers H, Verhoeven G, Gielen I, Samoy Y, de Bakker E, Van Ryssen B. Arthroscopic, Computed Tomography, and Radiographic Findings in 25 Dogs With Lameness After Arthroscopic Treatment of Medial Coronoid Disease. Vet Surg 2016; 45:246-53. [PMID: 26767932 DOI: 10.1111/vsu.12443] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To describe the radiographic, computed tomography (CT), and arthroscopic findings in the elbow of dogs admitted for elbow lameness after previous arthroscopic treatment of medial coronoid disease (MCD). STUDY DESIGN Retrospective case series. ANIMALS Client-owned dogs (n = 25) admitted for elbow lameness after arthroscopic treatment. METHODS Clinical records (2005-2009), including radiographs, CT images, and arthroscopic findings, from the first and second presentation of dogs diagnosed with medial coronoid disease were searched and reviewed. RESULTS Twenty-nine joints were included in this study. The mean age at first treatment was 2.2 years. Second presentation was at a mean of 2.7 years later and progressive osteoarthritis and cartilage damage was noticed in all joints. Arthroscopic findings included a calcified body in 11/29 joints (38%), multiple small calcified bodies in 1/29 joint (3%), loose scar tissue in 12/29 joints (42%), and immobile scar tissue in 2/29 joints (7%). Three of 29 joints (10%) did not have any calcified body or loose scar tissue found but had erosion of the medial compartment as the only pathology diagnosed in the coronoid region. Characteristics of flexor enthesopathy were identified in 9/29 joints (31%). CONCLUSION Arthroscopic treatment of MCD, even with limited cartilage lesions, may not resolve lameness in some dogs. Calcified bodies or loose scar tissue near the medial coronoid process are a frequent followup finding in these joints.
Collapse
Affiliation(s)
- Eva Coppieters
- Faculty of Veterinary Medicine, Department of Veterinary Medical Imaging and Small Animals Orthopaedics, Ghent University, Merelbeke, Belgium
| | - Hanna Seghers
- Faculty of Veterinary Medicine, Department of Veterinary Medical Imaging and Small Animals Orthopaedics, Ghent University, Merelbeke, Belgium
| | - Geert Verhoeven
- Faculty of Veterinary Medicine, Department of Veterinary Medical Imaging and Small Animals Orthopaedics, Ghent University, Merelbeke, Belgium
| | - Ingrid Gielen
- Faculty of Veterinary Medicine, Department of Veterinary Medical Imaging and Small Animals Orthopaedics, Ghent University, Merelbeke, Belgium
| | - Yves Samoy
- Faculty of Veterinary Medicine, Department of Veterinary Medical Imaging and Small Animals Orthopaedics, Ghent University, Merelbeke, Belgium
| | - Evelien de Bakker
- Faculty of Veterinary Medicine, Department of Veterinary Medical Imaging and Small Animals Orthopaedics, Ghent University, Merelbeke, Belgium
| | - Bernadette Van Ryssen
- Faculty of Veterinary Medicine, Department of Veterinary Medical Imaging and Small Animals Orthopaedics, Ghent University, Merelbeke, Belgium
| |
Collapse
|
49
|
Shimizu N, Warren-Smith CM, Langley-Hobbs SJ, Burton NJ, Kulendra E, Bradley K, Bowen E, Holdsworth A, Parsons KJ. Inter- and intraobserver agreement in interpretation of CT features of medial coronoid process disease. J Small Anim Pract 2015; 56:707-13. [DOI: 10.1111/jsap.12411] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Revised: 08/08/2015] [Accepted: 09/15/2015] [Indexed: 11/26/2022]
Affiliation(s)
- N. Shimizu
- Department of Clinical Veterinary Science; University of Bristol; Langford
| | - C. M. Warren-Smith
- Department of Clinical Veterinary Science; University of Bristol; Langford
| | | | - N. J. Burton
- Department of Clinical Veterinary Science; University of Bristol; Langford
| | - E. Kulendra
- Department of Veterinary Clinical Sciences; The Royal Veterinary College; North Mymms Hatfield
| | - K. Bradley
- Department of Clinical Veterinary Science; University of Bristol; Langford
| | - E. Bowen
- Department of Clinical Veterinary Science; University of Bristol; Langford
| | - A. Holdsworth
- Department of Clinical Veterinary Science; University of Bristol; Langford
| | - K. J. Parsons
- Department of Clinical Veterinary Science; University of Bristol; Langford
| |
Collapse
|
50
|
Villamonte-Chevalier A, van Bree H, Broeckx B, Dingemanse W, Soler M, Van Ryssen B, Gielen I. Assessment of medial coronoid disease in 180 canine lame elbow joints: a sensitivity and specificity comparison of radiographic, computed tomographic and arthroscopic findings. BMC Vet Res 2015; 11:243. [PMID: 26407863 PMCID: PMC4582713 DOI: 10.1186/s12917-015-0556-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 09/21/2015] [Indexed: 11/18/2022] Open
Abstract
Background Diagnostic imaging is essential to assess the lame patient; lesions of the elbow joint have traditionally been evaluated radiographically, however computed tomography (CT) has been suggested as a useful technique to diagnose various elbow pathologies. The primary objective of this study was to determine the sensitivity and specificity of CT to assess medial coronoid disease (MCD), using arthroscopy as gold standard. The secondary objective was to ascertain the radiographic sensitivity and specificity for MCD compared with CT. Methods For this study 180 elbow joints were assessed, of which 141 had been examined with radiography, CT and arthroscopy; and 39 joints, had radiographic and CT assessment. Sensitivity and specificity were calculated for CT and radiographic findings using available statistical software. Results Sensitivity and specificity of CT using arthroscopy as gold standard resulted in high values for sensitivity (100 %) and specificity (93 %) for the assessment of MCD. For the radiographic evaluation, a sensitivity of 98 % and specificity of 64 - 69 % using CT as the technique of reference, were found. Discussion These results suggest that in case of doubt during radiographic assessment, CT could be used as a non-invasive technique to assess the presence of MCD. Conclusion Based on the high sensitivity and specificity obtained in this study it has been considered that CT, rather than arthroscopy, is the preferred noninvasive technique to assess MCD lesions of the canine elbow joint.
Collapse
Affiliation(s)
| | - H van Bree
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Ghent, Belgium.
| | - Bjg Broeckx
- Laboratory for Pharmaceutical Biotechnology, Ghent University, Ghent, Belgium.
| | - W Dingemanse
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Ghent, Belgium.
| | - M Soler
- Department of Animal Medicine and Surgery, University of Murcia, Murcia, Spain.
| | - B Van Ryssen
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Ghent, Belgium.
| | - I Gielen
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Ghent, Belgium.
| |
Collapse
|