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Crystal E, Brettle A, Maddox TW, Jones D, Walton MB. Effect of Medial Opening Wedge and External Rotational Humeral Osteotomies on Medial Elbow Compartment Pressure: An Ex Vivo Study. Vet Comp Orthop Traumatol 2024; 37:196-205. [PMID: 38395060 DOI: 10.1055/s-0044-1779711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2024]
Abstract
OBJECTIVE The aim of this study was to assess if the level of osteotomy (50 or 75% the length of the humerus), osteotomy angle (5, 10, or 20 degrees), direction of bone alteration (external rotational or medial opening wedge osteotomies), or orientation of osteotomy (perpendicular to the humeral long axis or perpendicular to the weight-bearing axis of the limb) affect pressure through the medial compartment of the elbow. STUDY DESIGN Humeral osteotomies were performed at 50 and 75% the length of the humerus on 12 canine cadaver thoracic limbs and patient-specific three-dimensional (3D) printed plates applied to induce the desired alteration. Sensors were placed into the medial and lateral aspects of the elbow joint and the limb compressed to 90 N in a universal testing system. RESULTS Increasing the angle of the induced change had a significant effect on the decreased load through the medial compartment. Performing the osteotomy at 75% of humeral length from proximal was significantly more effective at reducing the medial elbow load than performing it at 50%. Opening wedge osteotomies were more effective than external rotational osteotomies, but both were effective. Changing the direction of the osteotomy (comparing transverse to oblique) did not significantly affect the load reduction through the medial compartment. CONCLUSION Performing an osteotomy at a more distal location along the humerus and increasing the angle of the induced change increased the effectiveness of load-shifting humeral osteotomies.
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Affiliation(s)
- Ed Crystal
- Small Animal Teaching Hospital, Institute of Veterinary Science, University of Liverpool, Liverpool, United Kingdom
- Northwest Veterinary Specialists, Delamere House, Sutton Weaver, United Kingdom
| | - Alice Brettle
- Fusion Implants, Harrison Hughes Building of Engineering, University of Liverpool, Liverpool, United Kingdom
| | - Thomas W Maddox
- Small Animal Teaching Hospital, Institute of Veterinary Science, University of Liverpool, Liverpool, United Kingdom
- Department of Musculoskeletal and Ageing Sciences, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, United Kingdom
| | - Dan Jones
- Fusion Implants, Harrison Hughes Building of Engineering, University of Liverpool, Liverpool, United Kingdom
| | - Myles Benjamin Walton
- Fusion Implants, Harrison Hughes Building of Engineering, University of Liverpool, Liverpool, United Kingdom
- Movement Referrals, 3 Abbots Park, Preston Brook, Runcorn, United Kingdom
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Danielski A, Quinonero Reinaldos I, Solano MA, Fatone G. Influence of oblique proximal ulnar osteotomy on humeral intracondylar fissures in 35 spaniel breed dogs. Vet Surg 2024; 53:287-301. [PMID: 38071467 DOI: 10.1111/vsu.14061] [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: 09/06/2023] [Revised: 10/31/2023] [Accepted: 11/24/2023] [Indexed: 02/16/2024]
Abstract
OBJECTIVE To investigate the effects of oblique proximal ulnar osteotomy (PUO) on the healing of humeral intracondylar fissure (HIF) in spaniel breed dogs. STUDY DESIGN Clinical retrospective study. SAMPLE POPULATION A total of 51 elbows from 35 spaniel dogs. METHODS An oblique PUO was performed in dogs diagnosed with HIF. The degree of healing of HIF was subjectively and objectively assessed on preoperative and long-term follow-up CT imaging. Objective assessment was performed by measuring the bone density in Hounsfield units (HU) of a rectangular region of interest (ROI) encompassing the entire hypoattenuated humeral fissure. Major and minor complications were recorded. RESULTS A total of 24 partial and 27 complete HIFs were diagnosed. The follow-up CT scan was performed at a median 18.5 months (range 10-49 months). Subjective assessment confirmed partial or complete healing of the HIF in 41 elbows (80.3%). Objective assessment confirmed a difference in mean HU of the HIF's ROI between preoperative (HU 640) and last follow-up CT images (HU 835) (p = .001). Young dogs (<14 months) had the highest increase in HU of the HIF's ROI. Major complications occurred in five dogs (6 limbs) of which four were related to the lack of healing of the fissure (7.8%). CONCLUSION Oblique PUO resulted in partial or complete healing of HIF and pain resolution in the majority of dogs. CLINICAL SIGNIFICANCE This study introduces an innovative approach to achieve healing of the HIF in the dog, which may help reduce the high complication rate traditionally associated with the use of transcondylar screws.
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Affiliation(s)
- Alan Danielski
- The Ralph Veterinary Referral Center, Marlow, UK
- Department of Veterinary Medicine and Animal Production, University of Naples "Federico II", Naples, Italy
| | | | | | - Gerardo Fatone
- Department of Veterinary Medicine and Animal Production, University of Naples "Federico II", Naples, Italy
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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.
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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
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Lateral Approach and Plate Rod Sliding Humeral Osteotomy in Dogs-A Short Case Series. Vet Sci 2023; 10:vetsci10020070. [PMID: 36851374 PMCID: PMC9966408 DOI: 10.3390/vetsci10020070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/21/2023] Open
Abstract
Five dogs of different breeds and ages were diagnosed with medial compartment disease of the elbow (MCDE). To resolve the condition, a modified technique using a lateral approach and plate/rod sliding humeral osteotomy (SHO) was considered. All dogs recovered uneventfully after surgery. There were no major complications, and all dogs were significantly improved compared to pre-operative condition. This novel technique of adding a pin, based on the alteration of the original technique, optimized resistance to fixation failure. An additional benefit was that the lateral approach was surgically familiar and easily allowed bone grafting. All five dogs treated with the novel approach had improved scores for pain and lameness. This study showed that SHO was more stable and less technically demanding with the addition of an intramedullary pin. This is the first report of a lateral approach and plate rod sliding humeral osteotomy to treat MCDE in dogs.
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Vali Y, Villamonte-Chevalier A, Dorny M, Ludewig E, van Bree H, Gielen I. Radiographic and computed tomographic evaluation of supinator sesamoid bones in dogs. BMC Vet Res 2022; 18:377. [PMID: 36280865 PMCID: PMC9590118 DOI: 10.1186/s12917-022-03450-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/03/2022] [Indexed: 11/10/2022] Open
Abstract
Background The present study evaluated the frequency of supinator sesamoid bones (SSB) on radiography and computed tomography (CT). Interobserver agreement was evaluated in the detection of the SSBs in both methods. A correlation between the existence of SSBs and elbow diseases (ED) was assessed. For these purposes, radiographs, and CT scans of 100 dogs were scored by 3 observers. Results The SSB was identified as a round to oval-shaped opacity and measured 0.5–6.56 mm × 0.5–6.2 mm. SSBs were reported in an average of 8,33% of dogs on radiographs and 26% of dogs on CT; a bilateral sesamoid bone was present in 43,52% and 76,92% of these dogs, respectively. Seventy-two percent of the SSBs was identified on CT were not detected on radiographs. The Kappa test showed a substantial agreement (κ = 0.691) and a perfect agreement (κ = 1) between the observers in the detection of SSBs on radiography and on CT scans respectively. Additionally, a weak positive correlation was detected between ED and the existence of SSBs. Conclusion A supinator sesamoid bone can be detected occasionally in the evaluation of the canine elbow joints by routine radiography. CT is superior to radiography for assessing SSBs with a higher interobserver agreement. The correlation of the existence of the SSBs and ED, needs further evaluations to prove a probable pathophysiological connection.
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Affiliation(s)
- Yasamin Vali
- grid.6583.80000 0000 9686 6466Diagnostic Imaging, Department of Companion Animals and Horses, University of Veterinary Medicine Vienna (Vetmeduni), Vienna, Austria, Veterinaerplatz 1, 1210 Vienna, Austria
| | - Aquilino Villamonte-Chevalier
- grid.5342.00000 0001 2069 7798Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Merelbeke, Ghent, Belgium, Salisburylaan 133, 9800 Merelbeke, Belgium
| | - Manon Dorny
- grid.5342.00000 0001 2069 7798Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Merelbeke, Ghent, Belgium, Salisburylaan 133, 9800 Merelbeke, Belgium
| | - Eberhard Ludewig
- grid.6583.80000 0000 9686 6466Diagnostic Imaging, Department of Companion Animals and Horses, University of Veterinary Medicine Vienna (Vetmeduni), Vienna, Austria, Veterinaerplatz 1, 1210 Vienna, Austria
| | | | - Ingrid Gielen
- grid.5342.00000 0001 2069 7798Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Ghent University, Merelbeke, Ghent, Belgium, Salisburylaan 133, 9800 Merelbeke, Belgium
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Gander Soares D, Allen MJ, Burton NJ. Bone density of the humeral condyle in Labrador retrievers with medial coronoid process disease. J Small Anim Pract 2022; 63:821-828. [PMID: 35859535 DOI: 10.1111/jsap.13538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 05/23/2022] [Accepted: 06/14/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To estimate, using CT imaging, differences in the regional bone density of the humeral condyle in Labrador retriever elbows with and without medial coronoid process disease. MATERIALS AND METHODS The elbows of Labrador Retrievers that had undergone CT were reviewed. Scans were divided into three categories: elbows without medial coronoid process disease; elbows with medial coronoid process disease involving fragmentation of the radial incisure; elbows with medial coronoid process disease involving fragmentation of the medial coronoid apex. A templating technique was employed to define the weight-bearing regions of the medial and lateral portion of the humeral condyle and estimates of volumetric bone density (defined by Hounsfield unit measurement) were compared across the three groups. RESULTS CT evaluation was performed on 122 elbows in 81 dogs. There was a higher mean Hounsfield unit measurement in the medial and lateral portions of the humeral condyles in elbows with medial coronoid process disease involving fragmentation of the medial coronoid apex compared with elbows with medial coronoid process disease involving fragmentation of the radial incisure. CLINICAL SIGNIFICANCE Dogs with apical fragmentation of the medial coronoid process exhibited significantly higher estimated bone mineral density within the medial portion of the humeral condyle when compared to dogs with radial incisure fragmentation. The medial portion of the humeral condyle may be associated with the pathogenesis of apical but not radial incisure medial coronoid process fragmentation in Labrador Retrievers.
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Affiliation(s)
- D Gander Soares
- Wear Referrals Veterinary Hospital Bradbury, Stockton-on-Tees, TS21 2ES, UK
| | - M J Allen
- Department of Veterinary Medicine, Surgical Discovery Centre, Cambridge, CB3 0ES, UK
| | - N J Burton
- Wear Referrals Veterinary Hospital Bradbury, Stockton-on-Tees, TS21 2ES, UK
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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.
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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.)
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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.
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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.)
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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.
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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
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Rohwedder T. Biomechanics of the Canine Elbow Joint. Vet Med Sci 2021. [DOI: 10.5772/intechopen.99569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
The canine elbow joint is a complex joint, whose musculoskeletal anatomy is well investigated. During the last 30 years kinematic analysis has gained importance in veterinary research and kinematics of the healthy and medial coronoid disease affected canine elbow joint are progressively investigated. Video-kinematographic analysis represents the most commonly used technique and multiple studies have investigated the range of motion, angular velocity, duration of swing and stance phase, stride length and other kinematic parameters, mostly in the sagittal plane only. However, this technique is more error-prone and data gained by video-kinematography represent the kinematics of the whole limb including the soft tissue envelope. A more precise evaluation of the in vivo bone and joint movement can only been achieved using fluoroscopic kinematography. Based on recent studies significant differences in the motion pattern between healthy joints and elbows with medial coronoid disease could be detected. Thereby not only adaptive changes, caused by pain and lameness, could be described, but primary changes in the micromotion of the joint forming bones could be found, which potentially represent new factors in the pathogenesis of medial coronoid disease. This chapter gives a review of current literature on elbow joint kinematics, with particular focus onto pathologic biomechanics in dysplastic canine elbows.
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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.
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Affiliation(s)
- Alan Danielski
- The Ralph Veterinary Referral Centre, Marlow, UK.,Department of Veterinary Medicine and Animal Sciences, University of Naples "Federico II", Naples, Italy
| | | | | | | | - Tim Parkin
- Bristol Veterinary School, University of Bristol, Langford, UK
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Rohwedder T, Böttcher P. Relation of Computed Tomography-Based Static Axial Radioulnar Incongruence Measurements under General Anaesthesia and Dynamic, In Vivo RUI during the Walk in Canine Elbow Joints with and without Medial Coronoid Process Disease. Vet Comp Orthop Traumatol 2021; 34:386-393. [PMID: 34344054 DOI: 10.1055/s-0041-1731811] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE This study aimed to evaluate the correlation of static axial radioulnar incongruence (sRUI) measured under general anaesthesia with the real in vivo dynamic RUI (dRUI) during walking. STUDY DESIGN This was a prospective clinical study that included 6 sound elbows (5 dogs) and 7 medial coronoid process disease (MCPD) affected elbows (6 dogs). MATERIALS AND METHODS Static axial radioulnar incongruence was measured using the sphere fitting technique on computed tomography-based three-dimensional (3D) models of radius and ulna. The in vivo pose of radius and ulna was derived from radiostereometric analysis during the walk and transferred onto previously calculated 3D models. Dynamic RUI was measured on those adjusted models using the sphere fitting technique, providing a measurement of RUI over time during walk. RESULTS Mean sRUI was 0.2 mm (standard deviation [SD]: 0.30) in control and 1.4 mm (SD: 0.73) in elbow joints with MCPD; being significantly different (p = 0.0035; confidence interval [CI]: 0.4772-1.8824). Mean dRUI in controls (-0.4 mm; SD: 0.47) was significantly different (p = 0.0004; CI: 0.9918-2.5225) from dRUI in the affected elbows (1.4 mm; SD: 0.73). Comparison of sRUI and dRUI within each group showed difference in the control group (0.2 vs. -0.4 mm; p = 0.0138; CI: 0.1820-1.0014). In affected elbows, no difference between sRUI and dRUI was found (1.4 vs. 1.4 mm; p = 0.8963). CONCLUSION In normal elbow joints, sRUI does not represent the in vivo condition during weight bearing. Dynamic and slightly negative RUI occurs during loading (0.2 mm positive to -0.4 mm negative RUI). In MCPD affected elbows with sRUI, no dynamic change of RUI occurs during the walk.
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Bruecker KA, Benjamino K, Vezzoni A, Walls C, Wendelburg KL, Follette CM, Déjardin LM, Guillou R. Canine Elbow Dysplasia: Medial Compartment Disease and Osteoarthritis. Vet Clin North Am Small Anim Pract 2021; 51:475-515. [PMID: 33558016 DOI: 10.1016/j.cvsm.2020.12.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Erosion of the articular cartilage of the medial compartment of the elbow (the humeroulnar articulation) secondary to incongruency associated with elbow dysplasia or traumatic injury has been termed, medial compartment disease. When nonsurgical strategies to manage osteoarthritis (OA) fail, surgical solutions may be warranted. Surgical strategies reduce pain through off-loading of the medial compartment by load-shifting osteotomies of the humerus or ulna. Other strategies involve replacement of portions or all of the articular surface of the medial compartment. With global elbow joint OA (medial and lateral compartment), a total elbow replacement may be required.
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Affiliation(s)
| | - Kevin Benjamino
- MedVet Medical and Cancer Centers for Pets, Columbus, 8155 Markhaven Drive, Columbus, OH 43235, USA
| | - Aldo Vezzoni
- Clinica Veterinaria Vezzoni srl, via Massarotti 60/A, Cremona, Cremona 26100, Italy
| | - Charles Walls
- Veterinary Clinical Sciences, School Of Veterinary Medicine, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Kirk L Wendelburg
- VCA Animal Specialty Group, 4641 Colorado Boulevard, Los Angeles, CA 90039, USA
| | | | - Loïc M Déjardin
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, 736 Wilson Road, East Lansing, MI 48824-1314, USA
| | - Reunan Guillou
- ACCESS Bone & Joint Center, 9599 Jefferson Boulevard, Culver City, CA 90232, USA
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Vezzoni A, Benjamino K. Canine Elbow Dysplasia: Ununited Anconeal Process, Osteochondritis Dissecans, and Medial Coronoid Process Disease. Vet Clin North Am Small Anim Pract 2021; 51:439-474. [PMID: 33558015 DOI: 10.1016/j.cvsm.2020.12.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Elbow dysplasia is a major cause of front limb lameness in medium to large dog breeds. Underlying causes include ununited anconeal process, medial coronoid process disease, and osteochondritis dissecans. When a definitive diagnosis of elbow dysplasia is made, the surgeon can improve elbow function but cannot entirely prevent progression of osteoarthrosis. Conventional surgical treatment with joint debridement and removal of loose osteocartilaginous bodies is not rewarding if joint incongruity persists; the result is overloading and subchondral bone exposure with erosion of the cartilage of the medial humeral condyle and medial coronoid area of the ulna leading to medial compartment disease.
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Affiliation(s)
- Aldo Vezzoni
- Clinica Veterinaria Vezzoni srl, via delle Vigne 190, Cremona 26100, Italy.
| | - Kevin Benjamino
- MedVet Medical and Cancer Centers for Pets, Columbus, 8155 Markhaven Drive, Columbus, OH 43235, USA
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15
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Abstract
Abstract
The mediolateral flexed, extended, or neutral elbow radiographic views are commonly used in clinical practice. However, there is currently no standardized methodology to accurately measure the elbow joint angle in mediolateral images that include only the elbow joint and surrounding tissues. The main aim of this work is to compare elbow joint angles obtained from mediolateral radiographs that include the complete arm and forearm of the dog, with angles measured in radiographs including only the elbow. Ninety mediolateral views of elbow joints were obtained from 50 canine thoracic limbs, with 39 joints <90º, 30 ≥90 - ≤120º and 21 >120º. Radiographs were centered on the elbow joint and include the shoulder and carpal joints. For each complete forelimb radiographic image, the elbow angle was measured using the methodology described in previous studies. Then, the digital images were cut to obtain only the joint and surrounding tissues, establishing a new set of anatomical landmarks to measure the joint angles: the lateral humeral epicondyle was used as an angular point, with the linking points being the nutritional orifice of the radius at the antebrachial interosseous space and the intersection point of the lateral supracondylar crest with the cranial humeral endosteum. There was a good agreement observed between the two elbow angle measurement methodologies. The intraclass correlation coefficient was statistically significant, with the lower limits of the 95% confidence interval (CI) at >0.75, and with zero being included in the standard error of the mean 95% confidence interval in the Bland-Altman test. This elbow angle measurement methodology based on anatomic landmarks next to the elbow joint is accurate and may be used for clinical and research purposes.
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Hersh-Boyle RA, Chou PY, Kapatkin AS, Spriet M, Filliquist B, Garcia TC, Marcellin-Little DJ. Comparison of needle arthroscopy, traditional arthroscopy, and computed tomography for the evaluation of medial coronoid disease in the canine elbow. Vet Surg 2021; 50 Suppl 1:O116-O127. [PMID: 33576043 DOI: 10.1111/vsu.13581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 12/07/2020] [Accepted: 12/16/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To evaluate the diagnostic value of still images of needle arthroscopy (SNAR), still images of traditional arthroscopy (STAR), and computed tomography (CT) to diagnose medial coronoid process (MCP) pathology. STUDY DESIGN Prospective clinical trial. ANIMALS Dogs (n = 17) presented for evaluation of elbow dysplasia. METHODS For each case, two SNAR and STAR images of the MCP were reviewed independently and in random order by three board-certified surgeons. Computed tomographic images were reviewed by one board-certified radiologist. Reviewers were blinded to surgical and clinical findings. Surgical findings from real-time TAR with palpation were used as the gold standard. Receiver operating characteristic (ROC) curves and concordance statistics tests for the diagnostic accuracy of MCP fissure, MCP fragment, medial compartment condition, and cartilage score were calculated. RESULTS Images of 27 elbows joints were reviewed. For MCP fissure detection, areas under the ROC curves for CT (0.84), STAR (0.73), and SNAR (0.57) did not differ. For the detection of MCP fragment, STAR had a larger area under the ROC curve (0.93) compared with SNAR (0.74, P = .015) and CT (0.54, P < .001). Still images of TAR and SNAR had comparable concordance for cartilage score (0.80 and 0.77, respectively) and medial compartment pathology (0.80 and 0.73, respectively). CONCLUSION Still images of NAR, STAR, and CT had similar diagnostic value to identify MCP fissures. Still images of TAR was superior to SNAR and CT to identify MCP fragments. CLINICAL SIGNIFICANCE The diagnostic accuracy of SNAR varied on the basis of the coronoid lesion being evaluated.
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Affiliation(s)
- Rebecca A Hersh-Boyle
- William R Prichard Veterinary Medical Teaching Hospital, School of Veterinary Medicine, University of California Davis, Davis, California
| | - Po-Yen Chou
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California
| | - Amy S Kapatkin
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California
| | - Mathieu Spriet
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California
| | - Barbro Filliquist
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California
| | - Tanya C Garcia
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California
| | - Denis J Marcellin-Little
- Department of Surgical and Radiological Sciences, School of Veterinary Medicine, University of California Davis, Davis, California
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Millis D, Janas K. Forelimb Examination, Lameness Assessment, and Kinetic and Kinematic Gait Analysis. Vet Clin North Am Small Anim Pract 2021; 51:235-251. [PMID: 33446365 DOI: 10.1016/j.cvsm.2020.10.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This article contains a guide for small animal practitioners to use when confronted with the challenge of diagnosing a forelimb lameness. The examination begins by monitoring the dog at a stance and a visual gait assessment. A hands-on evaluation includes the initial examination, checking for asymmetry and muscle atrophy while the dog is standing, and step-by-step instructions for a thorough forelimb examination.
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Affiliation(s)
- Darryl Millis
- University of Tennessee College of Veterinary Medicine, 2407 River Drive, Knoxville, TN 37996, USA.
| | - Krysta Janas
- University of Tennessee College of Veterinary Medicine, 2407 River Drive, Knoxville, TN 37996, USA
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18
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Bergström A, Johard S, Lee MH, Comin A. Long-Term Prognosis of Quality of Life in Dogs Diagnosed With Mild to Moderate Elbow Dysplasia in Sweden. Front Vet Sci 2020; 7:572691. [PMID: 33240952 PMCID: PMC7669830 DOI: 10.3389/fvets.2020.572691] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 10/01/2020] [Indexed: 12/03/2022] Open
Abstract
Objective: The objective of this study was to increase knowledge regarding long-term prognosis of mild to moderate elbow dysplasia (ED) using a canine orthopedic index. Study Design: Cross-sectional observational study. Sample Population: Sixty dogs randomly selected from each of five different breeds and three ED groups: ED0 (control), ED1, and ED2, based on the Kennel Club's screening results. The total number of selected dogs was 900 (60*5*3). Methods: Questionnaires were administered to owners by telephone interview. Bayesian network modeling was used to assess the relation between ED grade, treatment options, dog demographics, and quality-of-life indicators. Results: Seven hundred sixty-five questionnaires were collected (85% response rate), of which 61 concerned dogs euthanized due to osteoarthritis. There was no direct association between ED grade and owner's perceived quality of life, but ED1 and ED2 dogs were more likely to receive veterinary care and subsequent NSAID treatment compared to ED0 dogs. A significant association was found between the occurrence of euthanasia due to orthopedic disease and ED scores 1 and 2 in the sample (p < 0.001). Conclusion: The degree of osteoarthritis was not directly associated with the canine orthopedic index, except for ED2 and lameness score. It can be speculated that owners who paid closer attention to orthopedic symptoms and perceived them as impairing their dogs' lives were also more likely to seek veterinary care and get treatment, irrespective of the ED grading. Impact: ED1-graded dogs had a lower risk than might be expected to develop visible clinical symptoms and showed a similar quality of life as dogs with ED0. ED2-graded dogs were more likely than ED0-graded dogs to have their lives impaired by lameness, according to the owners' perception.
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Affiliation(s)
- Annika Bergström
- Department of Clinical Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden
| | - Sofia Johard
- Anicura Stockholm Animal Hospital, Stockholm, Sweden
| | | | - Arianna Comin
- Department of Disease Control and Epidemiology, National Veterinary Institute, Uppsala, Sweden
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19
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Erlen A, Potschka H, Volk HA, Sauter-Louis C, O'Neill DG. Seizures in dogs under primary veterinary care in the United Kingdom: Etiology, diagnostic testing, and clinical management. J Vet Intern Med 2020; 34:2525-2535. [PMID: 33128852 PMCID: PMC7694840 DOI: 10.1111/jvim.15911] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 09/11/2020] [Accepted: 09/15/2020] [Indexed: 12/16/2022] Open
Abstract
Background Although seizures are common in dogs, limited published information is available on the classifications of seizures, diagnostic approaches, or clinical management of seizure‐affected patients in the veterinary primary care setting. Objectives Explore seizure etiology, diagnostic testing, and clinical management of seizure‐affected dogs in the primary care veterinary setting. Animals A total of 455 553 dogs in VetCompass. Methods Cross‐sectional analysis by cohort clinical data. Results From 2834 incident seizure cases, we identified 579 (20.5%) dogs with epilepsy based on the International Veterinary Epilepsy Task Force (IVETF) classification system, including 484 (17.1%) with idiopathic epilepsy, 95 (3.4%) with structural epilepsy, and 179 dogs (6.3%) with reactive seizures. In their clinical first opinion records, 245 (8.6%) cases were recorded with epilepsy. Overall, 1415 (49.9%) cases received diagnostic evaluation equivalent to or higher than IVETF Tier 1 diagnostic testing. Being <12 years of age and being insured were risk factors for receiving IVETF Tier 1 or higher diagnostic evaluation among seizure cases. Anti‐seizure drug (ASD) treatment was not prescribed for 1960/2834 (69.2%) dogs in association with the incident seizure event. Of the remainder, 719 (25.3%) dogs received 1 ASD, whereas 155 (5.5%) an ASD combination. Conclusion and clinical importance The differences between seizure classifications in the clinical records and those retrospectively assigned by the researchers support the need for clearer diagnostic guidelines in clinical practice. Insured dogs and dogs <12 years of age were more likely to receive advanced diagnostic evaluation, suggesting that financial and perceived prognostic factors influence case management.
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Affiliation(s)
- Alexander Erlen
- Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University, Munich, Germany
| | - Heidrun Potschka
- Institute of Pharmacology, Toxicology, and Pharmacy, Ludwig-Maximilians-University, Munich, Germany
| | - Holger A Volk
- Department of Small Animal Medicine and Surgery, University of Veterinary Medicine Hannover, Hannover, Germany
| | | | - Dan G O'Neill
- Pathobiology and Population Health, The Royal Veterinary College, Hatfield, United Kingdom
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20
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Amadio A, Corriveau KM, Norby B, Stephenson TR, Saunders WB. Effect of proximal abducting ulnar osteotomy (PAUL) on frontal plane thoracic limb alignment: An ex vivo canine study. Vet Surg 2020; 49:1437-1448. [PMID: 32463515 DOI: 10.1111/vsu.13425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Revised: 02/10/2020] [Accepted: 03/18/2020] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To determine the effect of proximal abducting ulnar osteotomy (PAUL) on frontal plane thoracic limb alignment in standing and recumbent positions. STUDY DESIGN Ex vivo cadaveric study. SAMPLE POPULATION Canine thoracic limbs (n = 15 limb pairs). METHODS Limbs were acquired from healthy Labrador retrievers that had been euthanized for reasons unrelated to this study. A limb press was used to obtain standing and recumbent caudocranial radiographs before and after PAUL. Foot lateralization and rotation were directly measured in standing position. Mechanical joint angles were determined using full limb radiographic montages and the center of rotation of angulation (CORA) method for pre-PAUL (Pre), 2-mm PAUL (PAUL2), and 3-mm PAUL (PAUL3). Data are reported as mean ± SD and 95% CI. Mixed linear modeling was used to identify differences in limb alignment values and foot position, with significance established at P ≤ .004. RESULTS There were differences in five of 12 limb alignment values pre-PAUL and post-PAUL in standing and recumbent positions. In the standing position, there was an increase in mechanical medial proximal radioulnar angle (Pre, 80.6° ± 2.5°; PAUL2, 82.6° ± 2.4°; PAUL3, 84° ± 2.4°) and a decrease in elbow compression angle (Pre, 1.4° ± 1.3°; PAUL2, 1° ± 0.9°; PAUL3, 0.8° ± 1°). There was a movement of mechanical humeral radioulnar angle (Pre, -8.9° ± 2.8°; PAUL2, -6.1° ± 2.7°; PAUL3, -5.2 ± 2.7°), mechanical thoracic humeral angle (Pre, 3.9° ± 1.7°; PAUL2, 2.4° ± 1.4°; PAUL3, 2.6° ± 1.5°), and elbow mechanical axis deviation (Pre, 1.9% ± 1.1%; PAUL2, 0.9% ± 1.1%; PAUL3, 0.4% ± 1.4%) toward a value of "0" representing coaxial alignment of the limb. The foot underwent lateralization (Pre, 1.4 ± 0.6 cm; PAUL2, 1.8 ± 0.7 cm; PAUL3, 2.3 ± 0.7 cm) and external rotation (Pre, 10.5° ± 4.7°; PAUL2, 13.7° ± 5.1°; PAUL3, 16° ± 6.6°). CONCLUSION In the ex vivo setting, PAUL resulted in translation of the mechanical axis of the thoracic limb from a medial to lateral direction through alterations in limb alignment values associated with the elbow, humerus, and proximal radius/ulna. CLINICAL SIGNIFICANCE Additional studies are required to determine whether PAUL alters thoracic limb alignment in client-owned dogs.
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Affiliation(s)
- Alexandra Amadio
- Department of Animal Medicine, Production and Health, University of Padua, Padua, Italy.,Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Kayla M Corriveau
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
| | - Bo Norby
- Department of Large Animal Clinical Sciences, Michigan State University, East Lansing, Michigan, USA
| | - Timothy R Stephenson
- College of Veterinary Medicine & Biomedical Sciences, Texas A&M University, College Station, Texas, USA
| | - W Brian Saunders
- Department of Small Animal Clinical Sciences, Texas A&M University, College Station, Texas, USA
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Baud K, Griffin S, Martinez-Taboada F, Burton NJ. CT evaluation of elbow congruity in dogs: radial incisure versus apical medial coronoid process fragmentation. J Small Anim Pract 2020; 61:224-229. [PMID: 32017094 DOI: 10.1111/jsap.13110] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 12/06/2019] [Accepted: 12/18/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To compare elbow congruity in two cohorts of Labrador retrievers affected with either radial incisure or apex fragmentation of the medial coronoid process. MATERIALS AND METHODS Dogs were included if they had elbow lameness and a CT diagnosis of a fissure or fragmentation of the medial coronoid process occurring either along the radial incisure or at the coronoid apex. Radioulnar joint space was measured incrementally from the lateral to the medial coronoid process on transverse slice images. Axial radioulnar congruency was also measured at the apex and mid-coronoid in the dorsal plane and at the base of the coronoid in the sagittal plane. RESULTS We studied 99 elbows (in 66 dogs) of which 56 had a fissure or fragmentation along the radial incisure and 43 had an apical fragment. No difference was found between the two groups at the different measuring points - with the exception of a transverse plane radioulnar joint space measurement in the radial incisure group that was smaller adjacent to the lateral coronoid process. CLINICAL SIGNIFICANCE Abnormal ulnar morphology in the radial incisure group could result in a fulcrum effect within the radioulnar joint, overloading the radial incisure and predisposing to osteochondral damage at this site.
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Affiliation(s)
- K Baud
- Wear Referrals, Bradbury, Stockton-on-Tees, TS21 2ES, UK
| | - S Griffin
- Willows Referral Service, Solihull, West Midlands, B90 4NH, UK
| | - F Martinez-Taboada
- University Veterinary Teaching Hospital, School of Veterinary Science, University of Sydney, Sydney, NSW, 2050, Australia
| | - N J Burton
- Wear Referrals, Bradbury, Stockton-on-Tees, TS21 2ES, UK
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22
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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.
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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
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23
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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.
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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
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24
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Petkov EP, Lesser AS, Lozier SM, Maguire PJ, Fischetti AJ, Ahn J. Radial torsion in dogs with medial compartment disease. Vet Surg 2019; 48:869-877. [PMID: 30820996 DOI: 10.1111/vsu.13180] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 01/06/2019] [Accepted: 01/23/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate the magnitude and direction of radial torsion (RT) in dogs with medial compartment disease (MCD). STUDY DESIGN Case-control study. SAMPLE POPULATION Twenty-eight healthy dogs and 28 dogs with confirmed MCD. METHODS Computed tomography images of each dog's antebrachium were evaluated. Radial torsion was measured by using previously described landmarks on the proximal and distal radius. Differences between groups were tested with Student's t tests and Wilcoxon rank-sum tests. RESULTS Healthy dogs had a mean RT angle of 3.44° (range, 1.28°-5.44°). Dogs with MCD had a mean RT angle of 11.84° (range, 2.31°-26.55°). Both groups included similar proportions of dogs with external (76% vs 77%) and internal (24% vs 23%) torsion. The direction of torsion (P = .21 and P = .69) did not appear to affect the magnitude of the RT angle. CONCLUSION Dogs with MCD had an increased RT angle compared with healthy controls. The direction of torsion varied similarly between groups regardless of the disease status of dogs in this study. CLINICAL SIGNIFICANCE The fourfold increase in the RT seen in dogs with MCD may contribute to the rotational overload proposed recently, potentially modifying the orientation of the elliptical radial head and the ligaments crossing the elbow joint.
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Affiliation(s)
- Emanouil P Petkov
- Small Animal Surgery, New York Veterinary Specialty Center, Farmingdale, New York
| | - Arnold S Lesser
- Small Animal Surgery, New York Veterinary Specialty Center, Farmingdale, New York
| | - Scott M Lozier
- Small Animal Surgery, VCA Northwest Veterinary Specialists, Clackamas, Oregon
| | - Patrick J Maguire
- Small Animal Surgery, New York Veterinary Specialty Center, Farmingdale, New York
| | | | - Jaeil Ahn
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University Medical Center, Washington, DC
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25
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Mielke B, Kulendra N, Halfacree Z, Kulendra E. Bicipital Tendinopathy and Carpal Valgus Following a Distant Direct Thoracoabdominal Skin Flap in a German Shepherd with Necrotizing Fasciitis. J Am Anim Hosp Assoc 2018; 54:226-230. [PMID: 29757663 DOI: 10.5326/jaaha-ms-6616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
A 4 mo old German shepherd dog was presented following an acute onset lameness and swelling of the thoracic limb. Clinical signs, surgical findings, and culture results were consistent with a diagnosis of necrotizing fasciitis. Initial management consisted of extensive surgical debridement, wound lavage, and bandaging. Surgical closure was achieved with an axillary fold flap and distant direct single-pedicle thoracoabdominal flap. Three mo later, following deterioration of the lameness that was associated with carpal valgus, carpal subluxation, and tendinopathy of the distal radial insertion of the biceps brachii tendon, a closing wedge pancarpal arthrodesis and tenotomy of the biceps brachii tendon was performed. We hypothesize that extensive soft tissue trauma and subsequent fibrosis and tendon contracture following soft tissue reconstruction contributed to the complications seen. To the authors' knowledge, this is the first report of carpal valgus deformity and biceps brachii tendinopathy following a distant direct skin flap and axillary skin fold flap.
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Affiliation(s)
| | | | - Zoe Halfacree
- From the Royal Veterinary College, London, United Kingdom
| | - Elvin Kulendra
- From the Royal Veterinary College, London, United Kingdom
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Preston T, Wills A. A single hydrotherapy session increases range of motion and stride length in Labrador retrievers diagnosed with elbow dysplasia. Vet J 2018; 234:105-110. [DOI: 10.1016/j.tvjl.2018.02.013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 02/15/2018] [Accepted: 02/21/2018] [Indexed: 11/15/2022]
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Radiographic and computed tomographic assessment of the development of the antebrachia and elbow joints in Labrador Retrievers with and without medial coronoid disease. Vet Comp Orthop Traumatol 2017; 28:186-92. [DOI: 10.3415/vcot-14-09-0144] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2014] [Accepted: 03/02/2015] [Indexed: 11/17/2022]
Abstract
SummaryObjectives: To compare the development, monitored by radiography and computed tomography, of the antebrachia and elbow joints in seven Labrador Retrievers with healthy elbow joints and in seven Labrador Retrievers that developed medial coronoid disease (MCD), in order to determine whether disturbances in the development of the antebrachia and elbow joints, between the age of six and 17 weeks may lead to medial coronoid disease.Methods: A prospective study of 14 Labrador Retrievers in their active growth stage was performed. The development of the antebrachia and elbow joints was assessed between six and 17 weeks of age using radio graphy and computed tomography determining the development of secondary ossification centres, radioulnar length ratio, radial angulation, and inter-relationship between the humerus, ulna and radius.Results: For the parameters of ossification of secondary ossification centres, radioulnar length ratio, radial angulation, and joint congruence evaluation, there was no significant difference in the development of the ante-brachia and elbow joints of seven Labrador Retrievers positive and seven Labrador Retrievers negative for MCD at the age of six to 17 weeks.Clinical significance: These findings demonstrate that the development of MCD in the Labrador Retrievers in our study was not related to any disturbance in the development of the antebrachia and elbow joints during the rapid growth phase.
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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.
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Kinematic gait analysis of the canine thoracic limb using a six degrees of freedom marker set. Vet Comp Orthop Traumatol 2017; 27:461-9. [DOI: 10.3415/vcot-14-03-0051] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2014] [Accepted: 07/29/2014] [Indexed: 11/17/2022]
Abstract
SummaryObjectives: To determine if the use of a six degrees of freedom marker set would allow new kinematic data of the canine thoracic limbs to be calculated. To identify any significant differences in thoracic limb gait patterns in all planes of motion, between the normal canine population and patients with confirmed medial coronoid disease (MCD).Method: Two groups of dogs were selected representing the normal Labrador Retriever population (n = 13) and Labrador Retrievers with confirmed MCD (n = 13). Normal dogs had “normal” hip and elbow radiographic scores in line with the International Elbow Working Group and British Veterinary Association guidelines. Medial coronoid disease was confirmed using arthroscopy after kinematic analysis was performed with a six degrees of freedom marker set.Results: The diseased elbow was nine degrees more extended between 43%-55% of the gait cycle and 16° more supinated prior, early during and after foot strike. The antebrachium was nine degrees more supinated during foot strike and three degrees more abducted during early stance. None of the other parameters were significantly different.Clinical significance: The use of a six degrees of freedom marker set made it possible for the elbow and antebrachium to be reliably tracked in more than one plane of motion. Significant differences were identified between the normal canine population and those affected by MCD. These data may help elucidate biomechanical factors contributing to aetiopathogenesis of MCD.
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The double-arch modified type-1b external skeletal fixator. Vet Comp Orthop Traumatol 2017; 24:374-82. [DOI: 10.3415/vcot-10-06-0086] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2010] [Accepted: 06/06/2011] [Indexed: 11/17/2022]
Abstract
SummaryObjectives: To describe acute correction of antebrachial angular and rotational limb deformities (ARLD) using a new external skeletal fixator (ESF).Methods: Dogs that were presented with lameness caused by ARLD were treated by radial and ulnar osteotomies and acute realignment. A modified type-1b ESF incorporating double arches (DA-ESF) and a novel connecting configuration facilitated alignment with six degrees of freedom. Bilateral deformities were corrected surgically in the same session. Aseptic preparation of both antebrachii allowed comparison of limb alignment. Radiographic evaluation was performed using centre of rotation of angulation (CORA) methodology.Results: Thirty-five antebrachii (22 dogs) underwent surgery. Postoperative limb function was graded as good (n = 31), fair (n = 2), or poor (n = 2). Persistent medial carpal instability was associated with a suboptimal outcome. Postoperative radiographic images of the frontal and sagittal plane joint angles and elbow-to-carpus translation were compared with values that were reported in previous studies, and were within published reference ranges in most cases. Complications included delayed radial osteotomy union (n = 5), delayed ulnar osteotomy union (n = 2) and implant-associated morbidity (n = 3).Clinical relevance: A practical technique for acute correction of complex antebrachial ARLD is suggested, incorporating a new configuration of ESF. Putative limitations of radio-graphic planning using CORA may be compensated by careful attention to intra-operative visual and palpatory assessment.
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Burton NJ, Meakin L, Hosworth A, Parsons KJ. Reliability of CT measurement of induced radioulnar step in dogs using a circle superimposition technique. J Small Anim Pract 2017; 59:92-97. [DOI: 10.1111/jsap.12782] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 09/01/2017] [Accepted: 09/19/2017] [Indexed: 11/27/2022]
Affiliation(s)
- N. J. Burton
- Wear Referrals Veterinary Hospital; Stockton-on-Tees Durham TS21 2ES UK
| | - L. Meakin
- Langford Veterinary Services; University of Bristol, Langford House; Bristol BS40 5DU UK
| | - A. Hosworth
- Langford Veterinary Services; University of Bristol, Langford House; Bristol BS40 5DU UK
| | - K. J. Parsons
- Langford Veterinary Services; University of Bristol, Langford House; Bristol BS40 5DU UK
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Rohwedder T, Fischer M, Böttcher P. In vivo fluoroscopic kinematography of dynamic radio-ulnar incongruence in dogs. Open Vet J 2017; 7:221-228. [PMID: 28795018 PMCID: PMC5538087 DOI: 10.4314/ovj.v7i3.4] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Accepted: 07/06/2017] [Indexed: 11/17/2022] Open
Abstract
Aim of the study was to investigate dynamic radio-ulnar incongruence (dRUI) in the
canine elbow joint comparing orthopedic healthy and dysplastic dogs in a prospective
in vivo study design. In 6 orthopedic sound elbow joints (5 dogs, median age 17
months & mean body weight 27.9 kg) and 7 elbow joints with medial coronoid
disease (6 dogs, median age 17.5 months & mean body weight 27.6 kg) 0.8 mm
Ø tantalum beads were surgically implanted into radius, ulna and humerus for
dynamic radiosteriometric analysis (RSA) using high-speed biplanar fluoroscopy with
the dogs walking on a treadmill. dRUI, in the form of proximo-distal translation of
the radius relative to the ulna, was measured for the first third of stance phase and
compared between groups using unpaired t-testing. Healthy elbow joints exhibited a
relative radio-ulnar translation of 0.7 mm (SD 0.31 mm), while dysplastic joints
showed a translation of 0.5 mm (SD 0.30 mm). No significant difference between groups
was detected (p = 0.2092, confidence interval -0.6 – 0.2). Based on these
findings dRUI is present in every canine elbow joint, as part of the physiological
kinematic pattern. However, dysplastic elbow joints do not show an increased
radio-ulnar translation, and therfore dRUI cannot be considered causative for medial
coronoid disease.
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Affiliation(s)
- Thomas Rohwedder
- Department of Small Animal Medicine, University of Leipzig, An den Tierkliniken 23, 04103 Leipzig, Germany
| | - Martin Fischer
- Institute of Systematic Zoology and Evolutionary Biology with Phyletic Museum, Friedrich-Schiller-University, Jena, Germany
| | - Peter Böttcher
- Department of Small Animal Medicine, University of Leipzig, An den Tierkliniken 23, 04103 Leipzig, Germany
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Alves-Pimenta S, Colaço B, Fernandes AM, Gonçalves L, Colaço J, Melo-Pinto P, Ginja MM. Radiographic assessment of humeroulnar congruity in a medium and a large breed of dog. Vet Radiol Ultrasound 2017; 58:627-633. [PMID: 28665533 DOI: 10.1111/vru.12521] [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: 11/29/2016] [Revised: 04/03/2017] [Accepted: 05/08/2017] [Indexed: 11/30/2022] Open
Abstract
Elbow joint incongruity is recognized as an important factor in the development, treatment, and prognosis of canine elbow dysplasia. Elbow incongruity has been measured based on radiographic joint space widths, however these values can be affected by the degree of elbow joint flexion. Recent studies have reported radiographic curvature radii as more precise measures of humeroulnar congruity in dogs. The aim of this prospective observational study was to describe radiographic curvature radii measured from flexed and extended elbow radiographs for a sample of dogs representing a medium breed (Portuguese Pointing Dog) and a large breed (Estrela Mountain Dog). The curvature radii from the ulnar trochlear notch and humeral trochlea were measured in 114 mediolateral elbow extended radiographic views (30 Portuguese Pointing Dog and 27 Estrela Mountain Dog), and 84 mediolateral flexed views (22 Portuguese Pointing Dog and 20 Estrela Mountain Dog). The sampled animals' ages ranged from 12 to 84 months (34.6 ± 17.8 months). Good agreement was observed between curvature radii measurements for flexed vs. extended views in both breed groups. Ulnar trochlear notch curvature radii measurements were greater than humeral trochlea curvature radii measurements in both breed groups. Both curvature radii were greater in the large-breed dog group vs. the medium-breed dog group. Both breed groups had ulnar and humeral curves with similar typology. However, the large breed group had greater intermediate differences between the humeroulnar surface curvature radii. Results from this study supported the use of curvature radii as measures of humeroulnar congruity in mediolateral flexed elbow radiographs of medium and large breed dogs.
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Affiliation(s)
- Sofia Alves-Pimenta
- Department of Animal Science, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,CITAB - Centre for the Research and Technology of Agro-Environmental and Biological Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - Bruno Colaço
- Department of Animal Science, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,CITAB - Centre for the Research and Technology of Agro-Environmental and Biological Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | | | - Lio Gonçalves
- Department of Engineering, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,The INESC-TEC - Institute for Systems and Computer Engineering, Technology and Science, Porto, Portugal
| | - Jorge Colaço
- Department of Animal Science, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - Pedro Melo-Pinto
- CITAB - Centre for the Research and Technology of Agro-Environmental and Biological Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Department of Engineering, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
| | - Mário M Ginja
- CITAB - Centre for the Research and Technology of Agro-Environmental and Biological Sciences, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal.,Department of Veterinary Science, University of Trás-os-Montes and Alto Douro, Vila Real, Portugal
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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.
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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
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Breiteneicher AH, Norby B, Schulz KS, Kerwin SC, Hulse DA, Fox DB, Saunders WB. The Effect of Sliding Humeral Osteotomy (SHO) on Frontal Plane Thoracic Limb Alignment: An Ex Vivo Canine Cadaveric Study. Vet Surg 2016; 45:1095-1107. [DOI: 10.1111/vsu.12574] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 07/24/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Adam H. Breiteneicher
- Department of Small Animal Clinical Sciences; Texas A&M University, College Station; Texas
| | - Bo Norby
- Department of Large Animal Clinical Sciences; Michigan State University; East Lansing Michigan
| | | | - Sharon C. Kerwin
- Department of Small Animal Clinical Sciences; Texas A&M University, College Station; Texas
| | - Don A. Hulse
- Department of Small Animal Clinical Sciences; Texas A&M University, College Station; Texas
| | - Derek B. Fox
- Department of Veterinary Medicine and Surgery; University of Missouri; Columbia Missouri
| | - W. Brian Saunders
- Department of Small Animal Clinical Sciences; Texas A&M University, College Station; Texas
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Coppieters E, Van Ryssen B, van Bree H, Verhoeven G, Broeckx B, de Bakker E, Deforce D, Gielen I. COMPUTED TOMOGRAPHIC FINDINGS IN CANINE ELBOWS ARTHROSCOPICALLY DIAGNOSED WITH EROSION OF THE MEDIAL COMPARTMENT: AN ANALYTICAL METHOD COMPARISON STUDY. Vet Radiol Ultrasound 2016; 57:572-581. [PMID: 27699921 DOI: 10.1111/vru.12425] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 08/09/2016] [Indexed: 01/11/2023] Open
Abstract
Medial compartment erosion is an advanced stage of medial coronoid disease, an important cause of elbow lameness in dogs, with treatment and the expected prognosis depending on the extent of the cartilage lesions. The identification of specific computed tomographic (CT) findings might facilitate the nonsurgical diagnosis and add to treatment decision making. Aims of this retrospective, analytical, method comparison study were to describe CT findings in elbows of dogs arthroscopically diagnosed with medial compartment erosion and to compare CT vs. arthroscopic findings. A total of 56 elbows met inclusion criteria. Elbows with focal (n = 13), diffuse (n = 11), and complete (n = 32) erosion were compared. Prevalence findings for CT lesions were as follows: periarticular osteophytosis (100%), abnormal shape of the medial coronoid process of the ulna (96.4%), and subchondral bone defect of the medial part of the humeral condyle (MHC; 96.4%). The three groups significantly differed for presence of medial coronoid process fragmentation, radial head subchondral bone sclerosis, and widening of the humeroulnar joint space. No significant agreement was found between CT and arthroscopy for presence of a subchondral bone defect of the MHC. A significant agreement was found between CT and arthroscopy for presence of fragmentation of the medial coronoid process. However, some of the calcified body/fragment(s) visualized on CT in the region of the medial coronoid process could not be identified via arthroscopy. Findings indicated that an accurate estimation of the extent of the elbow cartilage lesions still requires arthroscopic joint inspection.
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Affiliation(s)
- Eva Coppieters
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820, Belgium.
| | - Bernadette Van Ryssen
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820, Belgium
| | - Henri van Bree
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820, Belgium
| | - Geert Verhoeven
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820, Belgium
| | - Bart Broeckx
- Laboratory for Pharmaceutical Biotechnology, Faculty of Pharmaceutical Sciences, Ghent University, Ghent 9000, Belgium
| | - Evelien de Bakker
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820, Belgium
| | - Dieter Deforce
- Laboratory for Pharmaceutical Biotechnology, Faculty of Pharmaceutical Sciences, Ghent University, Ghent 9000, Belgium
| | - Ingrid Gielen
- Department of Veterinary Medical Imaging and Small Animal Orthopaedics, Faculty of Veterinary Medicine, Ghent University, Merelbeke 9820, Belgium
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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. .
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Burton NJ, Parsons KJ, Cunliffe M, Warren-Smith CM, Ness MG, Fenton G. Canine Elbow Realignment Osteotomy (CERO): Validation of the Accuracy of Acute Radial Lengthening in a Cadaveric Incongruency Model. Vet Surg 2016; 45:642-50. [PMID: 27357274 DOI: 10.1111/vsu.12497] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2015] [Revised: 08/22/2015] [Accepted: 10/05/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Neil J. Burton
- Langford Veterinary Services, Small Animal Hospital; Langford House Langford Bristol United Kingdom
| | - Kevin J. Parsons
- Langford Veterinary Services, Small Animal Hospital; Langford House Langford Bristol United Kingdom
| | - Mark Cunliffe
- Orthomed (UK) Ltd; Edgerton, Huddersfield, West Yorkshire United Kingdom
| | - Chris M.R. Warren-Smith
- Langford Veterinary Services, Small Animal Hospital; Langford House Langford Bristol United Kingdom
| | - Malcolm G. Ness
- Harrogate Cottage; Longframlington, Morpeth, Northumberland United Kingdom
| | - Gary Fenton
- Formative Design; Huddersfield, West Yorkshire United Kingdom
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Bone density of elbow joints in Labrador retrievers and Golden retrievers: Comparison of healthy joints and joints with medial coronoid disease. Vet J 2016; 216:1-7. [PMID: 27687919 DOI: 10.1016/j.tvjl.2016.06.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 05/25/2016] [Accepted: 06/13/2016] [Indexed: 11/23/2022]
Abstract
The aims of this study were: (1) to determine the inter-observer repeatability of particular regions of the canine elbow joints; (2) to assess the effect of age, bodyweight and breed on bone density in healthy young dogs; (3) to compare Hounsfield units (HU) and bone density (BD) measurements between normal elbow joints and diseased elbow joints; and (4) to determine the sensitivity and specificity for HU and BD measurements in specific regions in the canine elbow joint. Regions with the highest repeatability were located at the medial coronoid process (MCP) base and apex, and at the level of the humerus, on the sagittal and sagittal oblique planes of the elbow joint. Age and breed were significantly associated with several regions of interest; conversely, none of the measurements were associated with bodyweight. Increased HU and BD values in the MCP base and apex regions are likely to be related to medial coronoid disease. Labrador retrievers had higher HU and BD values than Golden retrievers and an increase in BD was found in older animals. Cut-offs determined with receiver operating characteristic plots of the MCP base and apex suggested fairly good sensitivity and specificity (base: area under the curve 0.85, sensitivity 75.0%, specificity 88.8%; apex: area under the curve 0.89, sensitivity 80.0%, specificity 92.5%).
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40
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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.
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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.)
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41
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Caron A, Fitzpatrick N. Bi-Oblique Dynamic Proximal Ulnar Osteotomy: Surgical Technique and Clinical Outcome in 86 Dogs. Vet Surg 2016; 45:356-63. [PMID: 27008917 DOI: 10.1111/vsu.12464] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2014] [Accepted: 10/05/2015] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To describe the technique of bi-oblique dynamic proximal ulnar osteotomy (BODPUO) and report the clinical outcome in a series of dog with medial compartment disease and other developmental elbow diseases. STUDY DESIGN Retrospective case series. ANIMALS Dogs (n=86; 120 elbows) treated for elbow disease with BODPUO. METHODS Medical records and diagnostic images were reviewed. Type and frequency of complications and treatment required were recorded. Force plate data were reported in dogs for which data had been recorded preoperatively and at follow-up. RESULTS Mean (standard deviation) final follow-up was 23.4 (35.6) weeks. There were minor complications in 15 elbows (12%, 14 dogs). There were no major complications. The caudo-cranial and latero-medial mean osteotomy angles were 55° (7°) and 48° (10°), respectively. The most caudo-proximal point of the osteotomy was located at a mean of 39% (5%) of the total ulnar length from the olecranon. Sixty of 68 elbows (88%) were considered healed by 4 months postoperative based on radiographs. Subjective lameness scores were significantly decreased by final follow-up for all dogs. For dogs treated with BODPUO alone for medial compartment disease, peak vertical force was significantly higher at 6 months postoperative. CONCLUSION Dogs with medial compartment disease undergoing BODPUO showed clinical improvement in the 6 month follow-up. No complications required surgical intervention.
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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
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Alves-Pimenta S, Ginja MM, Colaço J, Fernandes AM, Melo-Pinto P, Colaço B. Curvature Radius Measurements From the Ulnar Trochlear Notch in Large Dogs. Anat Rec (Hoboken) 2015; 298:1748-53. [DOI: 10.1002/ar.23194] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 05/19/2015] [Accepted: 05/28/2015] [Indexed: 11/08/2022]
Affiliation(s)
- Sofia Alves-Pimenta
- Department of Animal Science; Universidade de Trás-os-Montes e Alto Douro; Vila Real Portugal
- CITAB-Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro; Vila Real Portugal
| | - Mário Manuel Ginja
- Department of Veterinary Science; Universidade de Trás-os-Montes e Alto Douro; Vila Real Portugal
- CITAB-Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro; Vila Real Portugal
| | - Jorge Colaço
- Department of Animal Science; Universidade de Trás-os-Montes e Alto Douro; Vila Real Portugal
| | - Armando Manuel Fernandes
- CITAB-Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro; Vila Real Portugal
- Center of Intelligent Systems, IDMEC/LAETA, Instituto Superior Técnico, Universidade de Lisboa; Lisbon 1049-001 Portugal
| | - Pedro Melo-Pinto
- Department of Engineering; Universidade de Trás-os-Montes e Alto Douro; Vila Real Portugal
- CITAB-Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro; Vila Real Portugal
| | - Bruno Colaço
- Department of Animal Science; Universidade de Trás-os-Montes e Alto Douro; Vila Real Portugal
- CITAB-Centre for the Research and Technology of Agro-Environmental and Biological Sciences, Universidade de Trás-os-Montes e Alto Douro; Vila Real Portugal
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Bräuer S, Böttcher P. Focal humero-ulnar impingement following subtotal coronoid ostectomy in six dogs with fragmented medial coronoid process. TIERAERZTLICHE PRAXIS AUSGABE KLEINTIERE HEIMTIERE 2015; 43:156-60. [PMID: 26013600 DOI: 10.15654/tpk-140606] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2014] [Accepted: 01/08/2015] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To report acute eburnation of joint cartilage at the humeral trochlea following subtotal coronoid ostectomy (SCO) in a clinical case series of six elbows. MATERIAL AND METHODS Six dogs (median BW 27.1 kg; median age 7.5 months) with fragmented medial coronoid process (FCP) and varying degree of radio-ulnar incongruence (RUI) (mean 2 mm) were treated with SCO using an arthroscopic burr. Second look arthroscopy 4-12 weeks later was performed either because of recurrent or persistent lameness in three dogs. In the others, second-look arthroscopy was scheduled prospectively because of RUI, which was thought to be a risk factor for the observed humero-ulnar impingement. RESULTS All six elbows had a 1-2 mm wide line of focal full-thickness cartilage loss along the edge of the SCO, while the opposing trochlea had diffuse cartilage damage of Outerbridge grade III-IV, indicating focal humero-ulnar impingement. None of the elbows showed repeated FCP. CONCLUSION In some cases SCO might lead to focal humero-ulnar impingement along the osteotomy line. CLINICAL SIGNIFICANCE Whether this relays to variations in respect the amount of resected bone (too much vs. too less) or concomitant joint pathologies like RUI or joint instability remains unknown and warrants further studies.
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Affiliation(s)
| | - P Böttcher
- Prof. Dr. Peter Böttcher, Klinik für Kleintiere, der Universität Leipzig, An den Tierkliniken 23, 04103 Leipzig, Germany,
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45
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Fitzpatrick N, Bertran J, Solano MA. Sliding Humeral Osteotomy: Medium-Term Objective Outcome Measures and Reduction of Complications With a Modified Technique. Vet Surg 2014; 44:137-49. [DOI: 10.1111/j.1532-950x.2014.12213.x] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Accepted: 04/08/2013] [Indexed: 12/01/2022]
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Wavreille V, Fitzpatrick N, Drost WT, Russell D, Allen MJ. Correlation between histopathologic, arthroscopic, and magnetic resonance imaging findings in dogs with medial coronoid disease. Vet Surg 2014; 44:501-10. [PMID: 25227614 DOI: 10.1111/j.1532-950x.2014.12233.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 05/01/2014] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To describe the magnetic resonance imaging (MRI), arthroscopic, and histopathologic changes in dogs with medial coronoid disease and to identify potential relationships between these findings. STUDY DESIGN Retrospective case series. SAMPLE POPULATION Twenty-five diseased medial coronoid processes (MCP) were collected from 19 dogs with a confirmed diagnosis of medial coronoid disease that were surgically treated by subtotal coronoid ostectomy. A reference group of normal MCP was collected from 9 dogs euthanatized for reasons unrelated to elbow disease. METHODS MCP specimens were evaluated by MRI using a novel grading scheme (all dogs), arthroscopy using a modified Outerbridge scheme (affected dogs only) and histopathology (all dogs). RESULTS The common histopathologic findings were subchondral microfractures, subchondral microfractures continuous with cartilaginous fissures, moderate to severe hypercellularity of the marrow space, trabecular bone necrosis, and articular cartilage degeneration. The severity of cartilage disease in the MCP was moderate to severe in most specimens, even in cases with minimal arthroscopic pathology. Three distinct patterns of bone marrow lesion (BML) were identified adjacent to the MCP, but there was no correlation between BML pattern and either histopathologic or arthroscopic findings. There was moderate correlation between modified Outerbridge scores and MRI scores. No correlation was identified between the histopathologic changes and either MRI or arthroscopic scores. CONCLUSION There was no significant correlation between the clinical scores and histopathologic changes. Ongoing improvements in the resolution of noninvasive imaging techniques will likely improve description and understanding of the MCP disease in dogs.
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Affiliation(s)
- Vincent Wavreille
- Department of Veterinary Clinical Sciences, Ohio State University, Columbus, Ohio
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Wendelburg KM, Beale BS. Medium and Long Term Evaluation of Sliding Humeral Osteotomy in Dogs. Vet Surg 2014; 43:804-13. [DOI: 10.1111/j.1532-950x.2014.12252.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2011] [Accepted: 08/01/2012] [Indexed: 11/26/2022]
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Villamonte-Chevalier AA, Soler M, Sarria R, Agut A, Gielen I, Latorre R. Ultrasonographic and Anatomic Study of the Canine Elbow Joint. Vet Surg 2014; 44:485-93. [DOI: 10.1111/j.1532-950x.2014.12249.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2013] [Accepted: 05/01/2014] [Indexed: 12/01/2022]
Affiliation(s)
| | - Marta Soler
- Department of Animal Medicine and Surgery; University of Murcia; Murcia Spain
| | - Ricardo Sarria
- Department of Anatomy and Comparative Pathological Anatomy; University of Murcia; Murcia Spain
| | - Amalia Agut
- Department of Animal Medicine and Surgery; University of Murcia; Murcia Spain
| | - Ingrid Gielen
- Department of Veterinary Medical; Imaging and Small Animal Orthopaedics; University of Ghent; Merelbeke Belgium
| | - Rafael Latorre
- Department of Anatomy and Comparative Pathological Anatomy; University of Murcia; Murcia Spain
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Eljack H, Böttcher P. Relationship Between Axial Radioulnar Incongruence With Cartilage Damage in Dogs With Medial Coronoid Disease. Vet Surg 2014; 44:174-9. [DOI: 10.1111/j.1532-950x.2014.12234.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 04/01/2014] [Indexed: 11/28/2022]
Affiliation(s)
- Hamdi Eljack
- Department of Small Animal Medicine; University of Leipzig; Leipzig Germany
| | - Peter Böttcher
- Department of Small Animal Medicine; University of Leipzig; Leipzig Germany
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50
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Wilson DM, Goh CSS, Palmer RH. Arthroscopic biceps ulnar release procedure (BURP): technique description and in vitro assessment of the association of visual control and surgeon experience to regional damage and tenotomy completeness. Vet Surg 2014; 43:734-40. [PMID: 24617615 DOI: 10.1111/j.1532-950x.2014.12127.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Accepted: 06/16/2013] [Indexed: 11/28/2022]
Abstract
OBJECTIVES (1) Describe arthroscopic BURP surgical technique, (2) assess association of visual control and surgeon experience to tenotomy completeness and regional iatrogenic tissue damage. STUDY DESIGN Cadaveric study. SAMPLE POPULATION Canine cadavers weighing >20 kg (n = 16; 32 elbows). METHODS Phase 1 = dissection/anatomic description/procedural refinement (n = 6). Phase 2 = technique description (n = 6). Phase 3 = association of surgeon experience and procedural visual control to tenotomy completion and regional iatrogenic damage (n = 20). Elbows were randomly assigned via coin toss to an experienced- or inexperienced-arthroscopist. Using conventional medial portals, surgeons sought to identify the medial collateral ligament (MCL) and ulnar insertion of the biceps tendon (uBT) before attempting complete tenotomy. Upon procedural completion, surgeons assigned a standardized "visual control score" (VCS) describing viewing that governed procedure and predicted % uBT release, MCL, and median nerve damage. Post-procedural dissection determined actual tenotomy completion and iatrogenic tissue damage. RESULTS Complete BURP was achieved in 16 of 19 elbows. VCS was associated with tenotomy completeness (P < .01). "Blind" BURP was incomplete in both elbows in which it was attempted. Perception of complete BURP was associated with complete release (P < .01). MCL damage occurred in 10% of elbows. Surgeon experience did not influence VCS, regional damage, or BURP completeness. CONCLUSION In canine cadavers, arthroscopic BURP can be consistently performed using conventional arthroscopic instruments and portals by both experienced and inexperienced arthroscopists when visual control guides the tenotomy into the distal aspect of the tendon.
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Affiliation(s)
- David M Wilson
- Department of Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Colorado State University, Fort Collins, Colorado
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